Medicare has not released an official statement yet if prescription glasses and sunglasses will be covered in 2022. However, there are a few things that we can infer from the current Medicare guidelines. We will take a look at whats covered under Medicare Part B. We will try to predict whether or not coverage for prescription eyewear will change in the next few years. Stay tuned for updates!
What Are the Circumstances When Medicare Will Cover Glasses?
There are a few specific circumstances in which Medicare will cover the cost of glasses or contact lenses. First, if you have an eye exam because of diabetes, Medicare Part B will cover one exam per year. This benefit also covers any diagnostic tests and screenings that your doctor recommends. Additionally, If diagnosed with glaucoma, Medicare will cover one comprehensive dilated eye exam every twelve months. Part B will also pay for up to three sets of contact lenses or glasses per year. They must be medically necessary and prescribed by your doctor. These benefits are available regardless of whether you have Original Medicare or a Medicare Advantage Plan.
Will Medicare Help With Prescription Sunglasses?
Medicare does not currently cover the cost of prescription sunglasses. However, if you have cataract surgery, Medicare will cover one pair of standard frames following the surgery. If you want to upgrade for different frames, use your Medicare Supplement insurance to help cover the cost.
What About Over-the-Counter Glasses?
Unfortunately, Medicare does not cover the cost of over-the-counter reading glasses or magnifying lenses. However, if you have a vision problem that can’t be corrected. Check and see is you may be eligible for low-vision rehabilitation services. These services are covered by Medicare Part B and can help you make the most of your remaining vision.
Medicare Part B Will Cover Corrective Lenses Under One Condition
If you get cataract surgery to implant an intraocular lens, Medicare Part B will help pay for corrective lenses. Part B will cover 1 pair of eyeglasses with standard frames or a single set of contact lenses. You will pay 20% for the lenses after each surgery. The Part B deductible will also apply.
Coverage for lenses and glasses is limited outside of a Medicare Advantage plan. You should consider your eye health needs carefully when choosing Medicare coverage.
Will Medicare Advantage Plans Cover Glasses and Prescription Sunglasses?
Medicare Advantage plans are required to cover all of the benefits that are available under Original Medicare. This means that, in addition to Part A and Part B benefits, you will also have access to extra perks. This will include routine vision care and prescription drug coverage. Some Medicare Advantage plans even offer dental coverage. MAPD’s cover at least one eye exam per year. However, coverage for other vision services, like prescription glasses and contact lenses, will vary from plan to plan.
It’s important to note that all Medicare Advantage plans must offer the same basic benefits as Original Medicare. Although, they are still allowed to charge different out-of-pocket costs for services. This means that you could end up paying more for your vision care. This is if you choose a Medicare Advantage plan over Original Medicare.
As you can see, there are a few circumstances in which Medicare will help cover the cost of glasses. However, coverage is generally limited to medically necessary items. There are some out-of-pocket costs that you will be responsible for. If you have questions about your specific coverage, contact your Medicare Advantage plan or the Social Security Administration. You can also visit our website for more information about Medicare coverage.
Besides Medicare and Medicare Advantage we also work with stand-alone vision plans. These will help with eye examinations, frames, contact lenses, and prescription sunglasses. Give us a call so we can see what works best for you and your budget.