Routine exams and medical eye care
Original Medicare generally does not cover routine eye exams for glasses or contact lenses. Part B may cover medically necessary eye care, cataract surgery and certain diabetes or high-risk glaucoma screenings when Medicare’s rules are met.
After each cataract surgery that implants an intraocular lens, Part B covers one pair of standard-frame glasses or one set of contact lenses through a Medicare-enrolled supplier. Deductibles, coinsurance and upgrade costs may apply.
How different coverage works
Some Medicare Advantage plans offer routine vision benefits in addition to Medicare-covered medical care. Medigap can help with covered Original Medicare cost sharing, but generally does not add routine vision benefits.
A Part D plan may cover prescribed eye medicines on its formulary; it is not a routine exam or eyewear plan.
Check the details before buying
| Benefit | What to verify |
|---|---|
| Eye exam | Frequency, copayment and whether refraction is included. |
| Eyeglasses | Frame allowance, covered lenses and upgrade charges. |
| Contact lenses | Whether fitting is included and whether the benefit replaces the glasses allowance. |
| Network | Participation of your optometrist, ophthalmologist and optical supplier. |
| Medical care | Which health-plan benefit pays for disease treatment or surgery. |
| Cost | Premiums plus expected copayments and costs above any allowance. |
Choose coverage that fits your routine
Review your current benefits before adding another plan. A separate vision policy may help with routine costs, while a discount program offers negotiated prices and is not insurance. Neither guarantees savings for everyone.
Ask your eye-care professional about a suitable exam schedule. For a fuller comparison, see vision insurance options.