Do WellCare Medicare Plans Cover Routine Vision Services?

Last Updated : 10/21/20183 min read

If you’re new to WellCare Medicare Advantage plans, or are comparing plans before deciding which one is right for you, you may have questions about Medicare vision coverage and managing your costs for routine vision care. Here’s some information to help you figure out your options.

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What’s included in Medicare vision coverage?

Under Original Medicare (Part A and Part B), there are no benefits for routine vision care. Original Medicare only covers eye care in very specific circumstances. For example, if you have an injury or disease of the eye that requires medical treatment, Medicare covers medically necessary care to treat your condition. Medicare may also cover cataract surgery and postoperative eye care.

Medicare also covers certain eye screening exams if you have a qualifying health condition or risk factors. If you have diabetes, for example, Medicare may cover screening exams for diabetic retinopathy if certain eligibility requirements are met.

Medicare Part B may cover one pair of eyeglasses or contact lenses after cataract surgery involving placement of an intraocular lens. As a general rule, however, there is no Medicare vision coverage for routine eye care and prescription eyewear.

Do WellCare Medicare Advantage plans cover routine vision services?

Let’s start with a brief overview of Medicare Advantage (Medicare Part C). Medicare Advantage plans are available from private, Medicare-approved insurance companies. Under federal guidelines, all Medicare Advantage plans must provide the same coverage as Original Medicare at a minimum (except for hospice care, which is still covered under Part A). Some WellCare Medicare Advantage plans offer additional benefits such as coverage for prescription drugs, routine vision and dental care, and even wellness programs.

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Depending on the WellCare Medicare Advantage plan you select, you may be eligible for additional Medicare vision coverage for routine services, which may include:

  • Annual eye exams (with or without a copayment requirement)
  • Glaucoma preventive care
  • Fixed-cost benefits to help cover your out-of-pocket expenses for prescription eyewear, contact lenses, and other eye care services

Some things to remember about WellCare Medicare Advantage plans:

  • Not all WellCare MedicareAdvantage plans may be available in all areas, and extra benefits options (vision, dental, prescription drugs) may vary depending on the plan you select.
  • You must continue to pay your Part B premium while enrolled in a WellCare MedicareAdvantage plan; you may also owe an additional monthly premium to WellCare for your coverage. Plan premiums may vary.
  • You may have to use WellCare Medicarenetwork providers to access your plan benefits, or to keep your out-of-pocket costs
  • You may have a copayment, coinsurance, or deductible amount depending on the plan you choose, and there may be an annual cap on plan benefits for certain products and services.

Since plan options and benefits may vary from state to state, it’s important to read your plan documents carefully to make sure you understand coverage and cost details. Learn more about WellCare. To start comparing Medicare plans right now, just enter your zip code and click Find Plans in the form on this page.

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