As you get older, you might notice some changes in your vision, such as having trouble seeing things up close. This is a normal part of aging, but older adults are also at a higher risk for more serious eye conditions.1 To help cover exams and vision correction as you age, it may be a good idea to consider vision insurance.

Except for special circumstances, Original Medicare does not cover eye exams or other vision-related costs. However, older adults on Medicare have several options, such as vision coverage through individual insurance or certain Medicare Advantage plans (Medicare Part C) with vision coverage.2

Does Medicare cover vision?

If you’re eligible for Medicare, you can get a “Welcome to Medicare” preventive visit that includes a simple vision test within the first year of enrolling in Medicare Part B.3 You can enroll in Original Medicare if you:4

  • Are 65 or older
  • Qualify by disability

Original Medicare generally does not include coverage for vision services such as routine eye exams for eyeglasses or contact lenses.

But Original Medicare does provide some vision coverage under certain conditions. Medicare Part B can help cover yearly diabetic eye exams for individuals with diabetes.5 If you have cataract surgery to implant an intraocular lens, Medicare Part B may also help pay for eyeglasses or contacts.6

Do Medicare Advantage plans provide vision coverage?

Some Medicare Advantage plans could help cover routine vision care and prescription eyewear. The coverage options and cost may vary from plan to plan and may not be available in all locations. Find out what options are available in your area.

You can also choose a vision plan through optional supplemental benefits (OSBs) for an additional monthly premium. OSBs provide additional vision coverage and are paired with specific Medicare Advantage plans. Learn more about our Medicare optional dental and vision coverage.

Find a Medicare Advantage plan with vision coverage

Many of Humana’s Medicare Advantage plans provide coverage for routine vision care. Your vision benefits under Medicare Advantage may vary based on your choice of plan.

What do vision insurance plans cover?

Most vision insurance plans at least partially cover expenses like routine eye exams, prescription glasses and contact lenses.

Eye exams

There are generally two standard eye exams—routine and medical. Routine eye exams may include diagnosis and treatment of non-medical complaints like astigmatism or farsightedness. Medical eye exams may include diagnosis and treatment of an eye disease or malady like glaucoma or cataracts.

Coverage can depend on your insurance carrier, your policy and your plan. Some carriers may offer coverage for medical exams, but not routine exams. Other carriers may require a co-pay on routine exams, but may help pay for the remaining balance.

Eye surgery

As with eye exams, the coverage for eye surgery can rely on your insurance carrier, your policy and your plan.

If the eye surgery is considered medically necessary, such as to correct significant vision impairment due to cataracts, some of the cost may be covered by Medicare.7 But if the procedure is considered elective or cosmetic, like Laser-assisted in situ keratomileusis (LASIK), most vision insurance plans usually won’t cover it.

Humana answers your Medicare questions

Sources

  1. “Aging and Your Eyes,” National Institute on Aging, last accessed June 6, 2022, https://www.nia.nih.gov/health/aging-and-your-eyes.
  2. “Eye exams (routine),” Medicare.gov, last accessed June 6, 2022, https://www.medicare.gov/coverage/eye-exams-routine.
  3. “’Welcome to Medicare’ preventive visit,” Medicare.gov, last accessed June 6, 2022, https://www.medicare.gov/coverage/welcome-to-medicare-preventive-visit.
  4. “Original Medicare (Part A and B) Eligibility and Enrollment,” Centers for Medicare & Medicaid Services, last accessed June 6, 2022, https://www.cms.gov/Medicare/Eligibility-and-Enrollment/OrigMedicarePartABEligEnrol.
  5. “Eye exams (for diabetes),” Medicare.gov, last accessed June 6, 2022, https://www.medicare.gov/coverage/eye-exams-for-diabetes.
  6. “Eyeglasses & contact lenses,” Medicare.gov, last accessed June 6, 2022, https://www.medicare.gov/coverage/eyeglasses-contact-lenses.
  7. “Cataract Surgery,” Centers for Medicare and Medicaid Services, last accessed June 6, 2022, https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=34413.

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