Many American elderly citizens rely on Medicare for their healthcare coverage. Vision care becomes more and more important as we age; therefore, it is important to have a thorough knowledge of what vision care services are and are not covered by Medicare. Unfortunately, the details of Medicare vision coverage can be difficult for many to understand. What vision benefits does Medicare allow? Here is a simple breakdown:
Routine eye examinations. A routine eye exam is basically a yearly screening. Some eye care professionals recommend routine eye exams once every year, especially for elderly patients. Other reasons for a routine eye screening may be if the patient needs new contacts or glasses. Unfortunately, Medicare does not cover routine eye examinations. Therefore, if you present to an eye doctor for a vision check or “just to see” if anything is wrong, you can be sure that Medicare won’t cover the expense.
Medically necessary eye examinations. Medicare does cover eye exams that are deemed as medically necessary. There are many medical reasons that may necessitate a visit to the eye doctor, including glaucoma (or diabetes, which can lead to glaucoma), advancing cataracts, previous eye surgery, or trauma. However, medical reasons don’t include things like needing new glasses or contacts. It may be that your primary care physician must refer you to an eye doctor for a medical reason in order for Medicare to pay for the exam; it is a good idea to check with a Medicare representative first before going in to the doctor. However, Medicare will cover eye examinations for preexisting medical conditions that are already proven (such as chronic dry eye syndrome and blepharitis, for example).
Vision correction. You may wonder if, under any circumstances, your Medicare coverage might include vision correction (eye glasses and/or contact lenses, for example). The answer is that, yes, Medicare will cover new eye glasses – but only once in a lifetime, directly following (and as necessitated by) cataract surgery.
Where to find more information. If you have any specific questions about your vision coverage, then you can explore the Medicare website (Medicare.gov) to find answers to many commonly asked questions. If you cannot find what you are looking for on the website, or simple prefer to speak to a person, you can also call the 1-800 number found on the Medicare website to speak with a live Medicare representative.
As you can see, Medicare vision benefits are very limited. If you require extended vision care (for regular eyeglass and contact exams, for example), then you should explore your supplemental insurance options to find coverage that will meet all of your needs.
About the Author: Annita Lahue is currently covered under Medicare and pays for her eye care out of pocket. She tries to see discount vision specialists and purchases her eyeglasses online at discounted rates.
