Medicare Vision Benefits

Generally, Original Medicare (Medicare Part A and Medicare Part B) does not cover routine vision care except in certain cases. Medicare Part A does not cover vision care unless something happens to the eyes that requires hospitalization. Medicare Part B does offer some vision benefits, but not everything related to vision care is covered. Other vision care benefits are covered by Medicare Advantage (Medicare Part C) plans, but you may have to pay higher premiums to get these vision benefits.

For vision care that is covered by Original Medicare, you will pay 20% of the amount approved by Medicare.

Routine Vision Care

Medicare Part A and Medicare Part B do not cover routine vision care as part of vision benefits. However, Medicare Part B vision benefits include one preventive vision screening per year for those at high risk for glaucoma. People at high risk for this degenerative vision disease are African-Americans over 50, people with diabetes and people with a family history of glaucoma.

Some Medicare Part C plans cover routine vision care as part of their vision benefits.

Eyeglasses, Intraocular Lenses and Contact Lenses

Some Medicare Part C vision benefits cover eyeglasses, intraocular lenses and contact lenses, but Original Medicare generally does not include these vision benefits except following cataract surgery.

Cataract Surgery

Medicare Part B vision benefits cover the cost for cataract surgery. This includes the cost to restore your vision by replacing the damaged lens with an artificial lens. Medicare will also cover the cost for one pair of eyeglasses, contact lenses or intraocular lenses that may be needed to correct your vision following cataract surgery. Medicare will only cover the cost for standard lenses. Medicare Part B vision benefits cover the cost to correct your vision with eyeglasses, contact lenses or intraocular lenses following cataract surgery even if the surgery happened before your Medicare coverage began.

Eye Prostheses

Medicare Part B covers the cost for eye prostheses for patients who have lost their vision in one or both eyes due to absence or shrinkage of the eye. Polishing and resurfacing of prostheses is covered by Medicare Part B vision benefits twice per year.

Medicare Part B vision benefits cover one enlargement or reduction in size. Medicare Part B vision benefits cover additional enlargements and reductions, but only with documented medical necessity.

Replacement of lost or stolen eye prostheses is covered by Medicare Part B vision benefits after five years of use. Medicare will cover the cost for replacement eye prostheses only if lost, stolen or irreparably damaged during the first five years of use.

Eye Refraction Tests

An eye refraction test is a simple procedure to check a person's vision. Medicare Advantage plans do offer coverage for these vision tests, but Original Medicare does not offer this vision benefit.

Treatment of Macular Degeneration

Macular degeneration is a disabling vision disease associated with aging that gradually causes a loss of vision in the center of the visual field. The condition can make it hard to read or recognize faces even though your vision allows you to see around the edges. Medicare Part B vision benefits cover the cost of photodynamic therapy with verteporfin, which is a treatment for macular degeneration.

Vision Medications

Medicare Part D (prescription drug coverage) covers the cost of some vision medications like eye drops, but the medications must be prescribed by a licensed physician.

Medicare has neither reviewed nor endorsed this information.