Understanding Your Vision Benefits

Original Medicare Vision Coverage

Original Medicare provides limited vision coverage. Under these rules, you are responsible for paying out of pocket for most routine vision needs.

Original Medicare does not cover:

• Routine eye exams
• Glasses
• Contact lenses
• Most vision correction services

For these services, beneficiaries must pay the full cost themselves unless another form of coverage is in place.

Medicare Advantage Plans and Understanding Your Vision Benefits

Fortunately, Medicare Advantage plans (Part C) may offer expanded vision coverage. Understanding your vision benefits under Medicare Advantage helps you know what services may be included in your plan.

Common Medicare Advantage vision benefits may include:

• Routine vision exams
• Glaucoma screenings
• Cataract surgery coverage
• Eyeglasses
• Contact lenses
• Diabetic retinopathy screenings

Note: Vision benefits vary by plan. Always consult a licensed professional for personalized guidance.

Understanding Your Vision Benefits: Part A Coverage

Medicare Part A provides vision coverage only for emergency or medically necessary care, such as injuries or trauma to the eye.

It does not cover:

• Routine eye exams
• Eyeglasses
• Contact lenses
• Refraction tests

If you rely solely on Medicare Part A, you will be responsible for the cost of most vision-related needs.

Understanding Your Vision Benefits: Part B Coverage

Medicare Part B offers limited vision benefits under specific medical conditions.

Medicare Part B covers:

• Vision correction after cataract surgery: Provides one pair of glasses or contact lenses.
• Annual glaucoma screenings for individuals at high risk.
• Medically necessary cataract surgery (subject to standard cost-sharing).

Medicare Part B does not cover:

• Routine corrective lenses beyond post-cataract coverage
• Refraction exams
• Elective vision correction procedures

Understanding Your Vision Benefits Through Medicare Advantage (Part C)

Medicare Part C combines all Original Medicare benefits, while many plans include additional vision benefits.

Medicare Advantage Vision Benefits may include:

• Routine eye exams
• Glasses
• Contact lenses
• Vision correction devices
• Allowances for frames or lenses
• Expanded diabetic or glaucoma screenings

Plans must provide at least what Original Medicare covers, but many offer added benefits such as dental, vision, and prescription drug coverage.

Important: Premiums may vary based on the services included in your Medicare Advantage plan.

Why Understanding Your Vision Benefits Matters

Understanding your vision benefits ensures that you can:

• Use your benefits effectively
• Estimate potential out-of-pocket costs
• Compare Medicare Advantage plans accurately
• Receive the vision care that meets your health needs

Because coverage differs between plans, reviewing your benefits regularly helps avoid unexpected costs and ensures you receive all qualifying vision services.