Generally, Medicare does not cover the cost of eyeglasses or contact lenses. However, coverage for some items may be available after certain types of cataract surgery.
Some Medicare Advantage plans also offer vision care.
Coverage for vision care may have associated costs, such as premiums, deductibles, copays, and coinsurance. Various programs are available to help with these costs, depending on a person’s circumstances.
Keep reading to learn more about Medicare and coverage for eyeglasses.
Glossary of Medicare terms
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Coverage may be available for eyeglasses or corrective eyeglass lenses, depending on the Medicare plan.
Original Medicare
Original Medicare (Part A and Part B) does not cover routine vision care, including eyeglasses, except in certain situations. Therefore, a person must pay 100% of the costs.
However, Medicare coverage is available after a person has cataract surgery if it includes an intraocular lens implant. In this case, Medicare Part B will pay for one pair of eyeglasses with standard frames or one set of contact lenses.
The eyeglasses must have standard frames and come from a Medicare-enrolled supplier, as Medicare will not pay for designer frames. A person can upgrade their frames if they are willing to pay the additional costs over the medically approved amount.
Learn about Medicare coverage for cataract surgery.
Medicare Advantage
While Medicare Advantage plans must offer the same coverage as original Medicare, they might include additional benefits, such as hearing, dental, and vision care. The latter coverage may include eye exams and eyeglasses, though there may be out-of-pocket costs.
Depending on the Advantage plan, a person may need to use in-network providers to get the best cost savings.
Learn about the advantages and drawbacks of Medicare Advantage.
The coverage of eyeglasses may have several associated costs and conditions.
Original Medicare
If a person gets coverage for eyeglasses through Medicare Part B, they will need to meet the Medicare Part B annual deductible of $240 in 2024 plus 20% of the Medicare-approved amount. They will also pay the Part B monthly premium, which is $174.70.
Medicare Advantage
The costs for Medicare Advantage plans vary depending on several factors, including the type and provider of the plan and the geographical area it covers.
However, they may include a monthly premium, deductibles, copays, and coinsurance. In addition, plans generally have out-of-pocket costs — both in-network and out-of-network.
According to the National Council on Aging, the average monthly Advantage plan premium in 2024 is $18.50. However, a person would also need to factor in the monthly premium for Medicare Part B.
In addition, a plan’s out-of-pocket costs generally have yearly limits, after which a person will not pay for covered services.
A person can use this online tool to search for plans and compare benefits and costs.
People may be able to get
- EyeCare America: EyeCare America is a program that is available through the American Academy of Ophthalmology. In most cases, it pays for a person’s eye exams with no out-of-pocket costs.
- OneSight EssilorLuxottica Foundation: The OneSight EssilorLuxottica Foundation provides free eyeglasses to some individuals. A nonprofit organization must refer the individual to OneSight’s free eyewear voucher program.
- Lions Club: Local clubs may help people purchase eyeglasses or get eye exams. A person’s local chamber of commerce may provide more information, or a person can use this online tool.
- New Eyes: New Eyes offers prescription glasses to children and adults. However, a person’s doctor or social service agency must apply to the group on their behalf.
- Prevent Blindness: Prevent Blindness provides vision screenings with a doctor’s referral.
- Respectacle: People can search the online Respectacle database of used eyeglasses to find a pair that matches their prescription. The nonprofit organization will then mail the eyeglasses to the person’s home address.
- Sight for Students: Sight for Students is a VSP Global program that helps children from families with low incomes to get glasses. A person will need to access the program through a school or another community partner.
Learn about how much eyeglasses cost.
Original Medicare (Part A and Part B) does not generally pay for eye exams or eyeglasses. However, Medicare Part B provides coverage for eyeglasses or contact lenses after cataract surgery when surgeons place an artificial lens in the eye.
Some Medicare Advantage plans offer coverage for vision healthcare. This may include exams and eyeglasses.