Do Coventry Medicare Plans Cover Routine Vision?
This article was updated on: 11/30/2016
Medicare vision coverage under Original Medicare (Part A and Part B) is generally limited to only medically necessary treatment for injuries, diseases, and conditions that affect the health and integrity of the eye, such as cataract surgery. For most routine vision care (such as annual eye exams, glasses, and contacts), you have to pay out of pocket unless you have other coverage.
As an alternative to Original Medicare, some Coventry Medicare Advantage plans may include coverage for routine vision services.
Do Coventry Medicare Advantage plans cover routine vision care?
It’s important to understand how the Medicare Advantage program works in the overall context of Medicare. The Medicare program has four parts: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage). If you enroll in a Coventry Medicare Advantage plan, which is an alternative way to get your benefits under Original Medicare, you are automatically entitled to all the same coverage, at a minimum, included under Part A and Part B (except for hospice care, which is still covered under Part A). This means that you have the same Medicare vision coverage as someone with Original Medicare; for example, Original Medicare covers cataract surgery and one pair of eyeglasses or contact lenses after a cataract surgery to implant an intraocular lens. You’d be covered for this benefit under Medicare Advantage, regardless of whether your plan covers additional coverage.
Under a Coventry Medicare Advantage plan, however, you may also be eligible for additional benefits, such as coverage for prescription drugs, routine vision care or dental care, and even coverage for wellness programs. Coventry Medicare Advantage plans with vision coverage might include help with costs like:
- Annual, routine eye exams
- Prescription eyeglasses, lenses, and frames
- Contact lenses
- Appointments for adjusting and/or fitting eyewear and contact lenses
Keep in mind that, depending on the specific plan, you may still be responsible for cost-sharing expenses like deductibles, copayments, or coinsurance.
How does vision coverage work under a Coventry Medicare Advantage plan?
Depending on the plan you select, such as a Health Maintenance Organization (HMO) you may have to use providers in the Coventry Medicare provider network in order for your vision care to be covered. In other cases, if you enroll in a Preferred Provider Organization (PPO) plan* your out-of-pocket costs may be lower if you use preferred providers. Check the details of the specific plan that you’re considering for more information.
You may have to pay a copayment or coinsurance amount when you access your vision care, and there may be a maximum benefit limit you may use each year.
Not all Coventry Medicare Advantage plans are available in all locations, and your plan benefits may vary depending on where you live. In addition, your Coventry Medicare Advantage plan premiums may vary based on the options you choose and location you live in. You must continue to pay your Part B premium as long as you are enrolled in a Medicare Advantage plan; you may also pay an additional monthly premium to Coventry for your Medicare Advantage coverage.
Coventry is a private insurance company approved by Medicare to offer benefits under the Medicare Advantage program. While Coventry Medicare Advantage plans must provide the same coverage as Original Medicare, at a minimum, optional plan benefits (such as routine vision care) and costs may change from time to time. Not all Coventry Medicare Advantage plans may offer routine vision care benefits, so always check with the plan before enrolling if you’re interested in this coverage.
Are you interested in learning more about Coventry Medicare Advantage plans that may include vision benefits?
- To learn more about Coventry Medicare coverage, visit the Coventry page.
- If you’re ready to start browsing right away, use the Find Plans button on this page to view Medicare plan options in your zip code.
- For assistance with your Medicare questions, you can always call me or another licensed insurance agent.
Call licensed insurance agents to learn about Coventry Medicare plans at 1-844-847-2659, TTY users 711; Monday through Friday, 8AM to 8PM ET.
*Out-of-network/non-contracted providers are under no obligation to treat Coventry plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
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