look for a Medicare Advantage plan with vision coverage

How to Get Vision Coverage With Medicare

It’s common knowledge that there are some gaps in Medicare coverage. As our eyes age over time, many of us will need corrective lenses. If you have Medicare, you’ll need supplemental coverage or a comprehensive Medicare Advantage plan to fill your vision care needs.

Medicare doesn’t cover routine vision care, such as eye exams, glasses, or contacts. If you have Original Medicare, you will pay 100% of the cost for your eye exams and corrective lenses. 

In the case of medically necessary care, you may have coverage. Medicare Part B covers eye exams for those with diabetes and covers tests for glaucoma and macular degeneration, as well as macular degeneration treatment. If you have cataract surgery, Medicare covers one pair of glasses or contact lenses. Medicare will also cover eye prostheses and replacements every five years. For all Medicare-covered services, Medicare will pay for 80% of the Medicare-approved amount, leaving you with 20% of the remaining costs.

To receive vision coverage, you will need to look for a Medicare Advantage plan with those benefits.

1) Medicare Advantage Plans

Medicare Advantage Plans, known as Medicare Part C, are plans offered by private insurance companies approved by Medicare to provide your Part A and Part B coverage. Most Part C plans offer prescription drug coverage, many offer additional packages for dental, vision, or hearing benefits, and some may build this care right into the plan.

Vision coverage under Medicare Advantage plans may vary. You can expect to find coverage for yearly eye exams with an optometrist or ophthalmologist. Medicare Advantage plans usually operate with networks of healthcare providers, meaning you may not be able to stay with your current eye doctor. 

Your coverage will include annual visits as well as reduced prices for frames and lens enhancements. 

To be eligible for a Medicare Advantage plan, you need to be enrolled in Medicare Part A and Part B and live within the plan’s service area. You will continue to pay your Part B premiums while on your Medicare Advantage plan.

Enroll in a Medicare Advantage plan during your initial enrollment, special enrollment period, or open enrollment. Open enrollment occurs every fall from October 15 through December 7.

2) Supplemental Vision Packages

You can add a supplemental vision package to bring you coverage not offered under Original Medicare or your Medicare Advantage plan. Many of the top carriers offer this coverage, so you can be confident that your coverage will be reliable.

Supplemental plans can usually be purchased as individual or family coverage. Most come with networks of certified optometrists and ophthalmologists. Your coverage includes yearly comprehensive vision exams, which can help to detect degeneration, changes in your prescription, or health conditions. 

Plans often bring you special discounts to help you save on designer frames and lens enhancements such as anti-reflection or scratch protection.

There are also discount vision plans available, which are not truly insurance but help with cost savings. Under these plans, your provider does not bill insurance but rather you pay directly after the discount is applied.

Reach Out to an Agent

Keep in mind that these supplemental plans should not be confused with Medicare Supplements, which do not offer this kind of coverage.
For more information regarding vision coverage and how to obtain this coverage through a Medicare Advantage plan, give us a call today!