Does Medicare Cover Glasses? What's Covered, What Isn't and Where Seniors Can Get Medicare Help

Many people are surprised to learn that Original Medicare usually doesn't pay for routine eye exams or a new pair of glasses. But that's not the whole story. Medicare Part B covers glasses in one important situation, pays for several medically necessary eye exams, and many Medicare Advantage plans add routine vision benefits. This guide explains what Medicare covers for vision, how to get help with glasses if your plan doesn't cover them, and where to talk with someone about your Medicare options, including during this fall's Open Enrollment.

What Original Medicare Covers for Glasses and Eye Care

Original Medicare is made up of Part A (hospital insurance) and Part B (medical insurance). In general, it doesn't cover routine eye exams for glasses or contact lenses, and it doesn't pay for eyeglasses or contacts. There are important exceptions.

Glasses after cataract surgery

Medicare Part B helps pay for corrective lenses after cataract surgery that implants an intraocular lens. That generally means one pair of eyeglasses with standard frames, or one set of contact lenses, after each cataract surgery. You typically pay 20% of the Medicare-approved amount, and the Part B deductible applies. You'll need to buy them from a supplier enrolled in Medicare, and upgraded frames cost extra.

Medically necessary eye exams and tests

Part B also helps cover certain eye care tied to medical conditions, including:

A yearly eye exam for diabetic retinopathy for people with diabetes
Glaucoma tests once every 12 months for people at high risk
Certain tests and treatments for age-related macular degeneration
Cataract surgery itself

How Medicare Advantage Plans Can Help With Glasses

Medicare Advantage plans (Part C) are offered by private insurers approved by Medicare. They must cover everything Original Medicare covers, and many include extra benefits that Original Medicare doesn't, such as routine eye exams and an allowance toward glasses or contacts. Dental and hearing benefits are often bundled in as well.

Vision benefits vary a lot from plan to plan. Some cover a yearly eye exam and a set dollar amount for frames and lenses. Others limit you to certain providers or retail chains. When you compare plans, check the exam coverage, the eyewear allowance, how often it renews and which eye doctors are in network.

Medicare Supplement (Medigap) policies help with costs like deductibles and coinsurance for services Original Medicare covers, but they generally don't add routine vision coverage.

Medicare Open Enrollment: When You Can Change Plans

If you want a plan with better vision benefits, timing matters. During the annual Medicare Open Enrollment Period, from October 15 through December 7, you can switch between Original Medicare and Medicare Advantage, change Medicare Advantage plans, or change drug plans. Changes take effect January 1.

If you're already in a Medicare Advantage plan, there's also a Medicare Advantage Open Enrollment Period from January 1 through March 31, when you can switch to a different Medicare Advantage plan or return to Original Medicare.

Medicare Eligibility Basics

Most people become eligible for Medicare at age 65. People under 65 may qualify if they've received Social Security disability benefits for 24 months, or if they have end-stage renal disease or ALS. Your Initial Enrollment Period is a seven-month window that begins three months before the month you turn 65. Signing up for Part B late can lead to a lasting late-enrollment penalty unless you qualify for a Special Enrollment Period, such as having coverage through a current employer.

Other Ways to Get Help Paying for Glasses

Medicaid. If you qualify for both Medicare and Medicaid, your state's Medicaid program may cover eye exams and glasses. Coverage for adults varies by state.
Medicare Savings Programs. Programs such as the Qualified Medicare Beneficiary (QMB) program help people with limited income pay Medicare premiums and cost-sharing, which can free up money for other expenses.
Standalone vision insurance or discount plans can lower the cost of exams and glasses if your Medicare plan doesn't include vision.
Nonprofit and community programs, including some service clubs, may help seniors with limited income get eye exams or glasses.

Medicare also covers some items and services people don't expect. Recommended vaccines, for example, are covered under the drug benefit, as our article on the shingles vaccine under Medicare explains. Some medical equipment is covered under Part B too, as covered in our guide to Medicare coverage for walkers.

Where to Get Medicare Help

If you have questions about what your plan covers or which plan fits your needs, you don't have to figure it out alone:

Speak to a Medicare representative by calling 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, every day except some federal holidays.
Contact your State Health Insurance Assistance Program (SHIP) for free, unbiased one-on-one counseling about Medicare coverage and plan choices.
Call your current plan using the number on your member card to ask exactly what vision benefits you have.

Frequently Asked Questions

Does Medicare pay for eye exams?

Original Medicare doesn't cover routine eye exams for glasses, but it does cover certain exams and tests for conditions such as diabetic retinopathy, glaucoma risk and macular degeneration. Many Medicare Advantage plans cover routine exams.

Will Medicare pay for glasses after cataract surgery?

Yes. Part B helps pay for one pair of glasses with standard frames, or one set of contacts, after each cataract surgery with an implanted lens.

Which Medicare plans cover glasses?

Many Medicare Advantage plans include an eyewear allowance. Compare plans' vision benefits during Open Enrollment, from October 15 to December 7.

This article is general information, not insurance or medical advice. Coverage, costs and plan benefits vary, so confirm details with Medicare or your plan.