Original Medicare does not cover routine vision care, including standard eye exams, eyeglasses and contact lenses.
Original Medicare (Part A and Part B) may cover certain vision exams if the exam is considered medically necessary by your primary care physician.
If you want Medicare coverage for your eye exams and for other routine vision care, you may consider enrolling in a Medicare Advantage plan (also known as Medicare Part C).
Below are some examples of the types of vision exams that may be covered by Original Medicare.
For medically necessary vision services that are covered under Medicare Part B, you must first meet your Part B deductible ($185 per year in 2019) before Medicare will begin paying its share of the costs for your eye exams.
After you meet your Medicare Part B deductible, you typically pay 20 percent of the Medicare approved amount of the costs, and Medicare pays the remaining 80 percent.
Medicare Advantage plans are sold by private insurance companies and combine the benefits covered by Medicare Part A and Part B into one plan.
Some Medicare Advantage plans include benefits that aren’t offered by Original Medicare, such as vision care coverage.
If your Medicare Advantage plan covers vision care, it may provide benefits that include corrective lenses, frames, routine eye exams and other benefits.
Some of the other additional benefits that may be offered by some Medicare Advantage plans can include:
A licensed insurance agent can help you find Medicare Advantage plans in your area that may offer vision coverage. You can compare plans, and you may be able to sign up for a Medicare plan that covers eye exams.
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Or call 1-800-557-6059 (TTY: 711) 24/7 to speak with a licensed insurance agent.
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