What is the allowable amount for prescription eyeglasses under Medicare?

Vince s asked...

What's the Medicare coverage for prescription eyeglasses following cataract surgery?

Expert Answer

Medicare coverage for eyeglasses is handled through Medicare Part B. Medicare can pay for one pair of eyeglasses following your cataract surgery, if you had a new lens implanted in your eye. If you have two separate cataract operations, one on each eye, Medicare will cover new glasses after each surgery. Medicare Part B will pay for the lenses and the frames, but only for plain lenses and a low-cost frame.

The exact amount Medicare pays varies from region to region (because prices vary geographically). When you are considering the frames -- as well as any lens extras such as tinting or scratch protection -- you have to discuss with the optometrist or optician which specific glasses are fully covered by Medicare Part B. If you buy more expensive frames than the basic ones approved by Medicare, or have any extra treatment to your lenses, you'll have to pay out of pocket for the difference between the amount Medicare approves and the amount your frames actually cost. The optometrist or optician can tell you how much extra any particular pair of frames or lens treatment would cost.

To get Medicare Part B eyeglasses coverage, you must get your glasses from an optician or optometrist that participates in Medicare. Whatever glasses and lenses you choose, you have to pay a Medicare Part B coinsurance amount, which is 20 percent of the amount Medicare approves for the lenses and frames. To read more about these rules, you can go online to the Medicare pamphlet Medicare Coverage of Durable Medical Equipment and Other Devices.