Does Medicare Cover Contact Lenses?
This article was updated on: 10/21/2018
In very specific circumstances, Original Medicare’s Part B will cover some costs associated with contact lenses. Routine vision care, including prescription eyewear and contact lenses, is not covered.
Original Medicare (Part A and B) typically limits vision care coverage to costs related to an illness or injury that affects the eye. For example, if you have cataracts (a clouding of the lens of the eye), your health-care provider may recommend cataract removal surgery and implantation of an intraocular lens. In this case, Medicare Part B will cover 80 percent of one pair of contact lenses or prescription eyeglasses, after you’ve met your Part B deductible. To qualify for coverage, both your doctor and the supplier who provides your contact lenses must accept Medicare assignment.
How does Medicare coverage apply to vision care and contact lenses?
Original Medicare is divided into Part A and Part B; each pays for different health-care expenses. Typically, Part A (hospital insurance) pays for care you receive as an inpatient in a hospital or skilled nursing facility, while Part B (medical insurance) pays for for care and supplies you receive as an outpatient. For example, if you’re hospitalized for cataract surgery, Part A will cover your Medicare-covered hospital costs, less any copayments, once you’ve paid the Part A annual deductible. Part B also comes with an annual deductible, but once you’ve paid that, Part B generally pays 80% of your Medicare-covered doctor visits and postoperative supplies, including one pair of contact lenses.
Is there any other Medicare coverage for contact lenses?
If you are concerned about health-care costs related to vision care and contact lenses, a Medicare Advantage plan may provide the additional coverage you need. Medicare Advantage (Medicare Part C) offers an alternative way to receive your Original Medicare benefits; Medicare Advantage plans cover all the same care and services as Original Medicare, except for hospice care, which is still covered under Part A.
However, many Medicare Advantage plans also have additional coverage and benefits; they may cover routine dental, hearing, and vision care, including contact lenses and prescription eyewear. Medicare Advantage plans usually offer coverage for prescription drugs, as well. There are several different types of Medicare Advantage plans; availability, costs, and additional benefits (beyond Original Medicare) may vary. With any type of Medicare Advantage plan, you might have to pay a monthly plan premium – and you need to continue paying your Medicare Part B premium as well.
Where can I get more information about Medicare coverage and contact lenses?
If you have questions about vision care, contact lenses, and your Medicare coverage, I would be happy to assist you. You can find out more about me by clicking the “View profile” link below. You can also arrange a phone call with me, or request a personalized email from me, by clicking one of the buttons below. If you’d like to compare some of the Medicare plans in your area that you may be eligible for, click the “Compare Plans” button at the bottom of the page.
Would you like information about non-Medicare insurance plans that may cover your contact lenses? You can use eHealth’s plan finder tool to find plans that serve the area where you live.