By: The My Medicare Matters Team
About 1.3 billion people in the world live with some form of vision impairment. The reasons vary but the fact is, your risk of developing vision problems drastically increases as you age. Over 91% of people age 55+ use some form of vision correction, so having access to quality vision care is critical as you get older. Issues with vision can increase the risk of falls, driving incidents, and impacting quality of life.
Medicare plans cover a wide variety of services including doctor visits, home health care, and a range of preventive screenings and treatments, but when it comes to vision coverage, beneficiaries’ options are extremely limited. So, what are the available options when you retire?
Original Medicare (Part A and Part B)
Vision coverage through Original Medicare is limited to mostly preventive and emergency services. Original Medicare generally doesn’t cover routine eye exams for eyeglasses or contact lenses. Medicare Part A covers medical emergency related to your vision if you are admitted to the hospital and Medicare Part B covers preventive treatments and screening related to diseases affecting your vision.
Medicare Part B covers annual glaucoma test for at-risk individuals which includes those with diabetes, African-Americans aged 50+, Hispanics aged 65+, and/or those with a family history of glaucoma. Annual exams to test for diabetic retinopathy among diabetics, diagnostic tests and screenings for macular degeneration, cataract surgery and one pair of post-surgery eyeglasses or contact lenses are also covered. Medicare will only pay for contact lenses or eyeglasses from a supplier enrolled in Medicare. For each of these services, the out-of-pocket costs is the 20% Medicare-approved amount, and Part B deductible.
Medicare Advantage (Part C)
One of the easiest options for vision coverage when you retire is Medicare Part C. Part C includes the same emergency and preventive benefits included with Original Medicare, but some Part C plans may also offer additional benefits that include a yearly eye exam, eyeglass frames and lenses, or contact lenses. The cost and coverage for these services vary from plan to plan. The best way to find a Medicare Advantage plan that covers all the services you need is to compare plans online or speak with a licensed benefits advisor.
Enrolling in a Medicare Advantage plan to receive vision coverage is not necessarily the best option for everyone, but that doesn’t mean you should not be able to get adequate vision coverage. There are national and local programs available that can provide vision care for little to no cost, but there may be additional requirements to participate and resources may be limited.
- EyeCare America®, a service from the Foundation of the American Academy of Ophthalmology, provides free eye exams and up to one year of care for low-income individuals who qualify.
- Local Lions’ Club chapters often have programs to assist those with severe vision impairment. Local chapters will be able to provide more information on how to get assistance.
- Vision USA, a program of the American Optometric Association and Mission Cataract USA both offer vision services for those without insurance including Medicare or Medicaid. Vision USA provides free eye exams for low-income Americans and Mission Cataract USA offers free cataract surgery to those who qualify.
As you begin to research your Medicare options keep in mind the enhanced services you may need to maintain, or maybe even improve your quality of life. Having yearly eye exams and updated prescriptions or dental cleanings and fillings may not be the things you consider when choosing a Medicare plan, but they should be.
To get help discovering a plan that covers your needs try taking our Medicare Questionnaire, which allows you to compare plans online or connects you to free professional advice from licensed benefits advisors. You can also contact your local State Health Assistance Insurance Program (SHIP) for access to federally-funded Medicare counseling from trained staff members.