Medicare Coverage of Eyeglasses and Contact Lenses
What It Is
Prescription eyeglasses and frames or contact lenses
Corrective lenses: Medicare doesn't cover any part of the cost of eyeglasses, frames, or contact lenses (except in special circumstances related to cataract surgery, described below).
After cataract surgery: Medicare Part B covers either one pair of eyeglasses (lenses and frames) or a pair of contact lenses for someone who's had cataract surgery in which an intraocular lens was implanted. If there's more than one surgery, Medicare covers one pair of glasses or contacts after each operation.
If you have a Medicare Part C Medicare Advantage plan: Medicare Part C Medicare Advantage plans, also called Medicare Advantage plans, must cover everything that's included in original Medicare Part A and Part B coverage. But sometimes a Part C plan covers more, with extra services or an expanded amount of coverage. (Co-payments for Part C plans may also be different than those for Part A or Part B.) To find out whether your plan provides extra coverage or requires different co-payments for eyeglasses, frames, or contact lenses, contact the plan directly.
What Medicare Pays
If Medicare Part B covers lenses and frames or contact lenses, it pays 80 percent of the amount it approves for those glasses or lenses. If you choose frames or special features on the lenses that cost more than the Medicare-approved amount, you pay the difference.
Important: Regardless of the rules regarding any particular type of care, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:
The care must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?
The care must be performed or delivered by a healthcare provider who participates in Medicare.
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