Original Medicare generally doesn’t pay for eyeglasses or contact lenses. You can obtain some vision care insurance through Medicare Advantage or a private or group plan, but you should assess the value of such coverage before enrolling.
What you pay for eyeglasses and contacts
In most cases, as a Medicare Part B beneficiary you’ll pay 100% of the cost of contacts and eyeglasses, including frames and lenses.
There’s one exception: If you have cataract surgery, Medicare Part B will cover one set of corrective lenses if you need them after your intraocular lens is implanted. The Part B deductible, $203 in 2021, will apply, and you’ll owe a copayment of 20% of the Medicare-approved amount for vision correction. You must buy from a supplier enrolled in Medicare.
Alternative No. 1: Medicare Advantage vision coverage
If you do want vision coverage, you may want to look at what locally available Medicare Advantage plans offer.
The good news is that 99% of Medicare Advantage enrollees find a plan with some vision coverage, according to the Kaiser Family Foundation. The bad news is that the average annual dollar limit for this coverage is $160, way less than the $366 average price tag for a pair of glasses with single-vision lenses.
The bottom line is that in 2018, the average Medicare Advantage beneficiary paid $194 out of pocket for vision services, which is only $48 less than the typical Original Medicare beneficiary spent, according to the KFF. Given this relatively small difference in out-of-pocket costs, it may not make sense to sign up for Medicare Advantage if vision care is the only benefit you need beyond what Original Medicare offers.
Alternative No. 2: An individual or group vision plan
Individual or group vision insurance comes with similar questions about the value to the consumer. Typically requiring a monthly premium of around $15 or $20, vision plans that you buy on your own or through your or your spouse’s employer often have a host of limitations.
Here are some possible limitations of private vision insurance:
- There’s likely a dollar limit on frames.
- The plan may not pay for extras like lightweight or antiglare lenses.
- You may not get coverage for both glasses and contacts in the same year.
- When you enroll, there may be a waiting period of up to 30 days, or longer.
Are the limited benefits of private vision coverage worth the bother? Take a hard look before you enroll.
If you still can’t afford glasses
People who can’t pay out of pocket for corrective lenses can apply to the nonprofit New Eyes for a free pair of basic eyeglasses. Your application will need the support of a social service agency or other advocate.
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John Rossheim writes for NerdWallet. Email: USexpansion@nerdwallet.com.
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