Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.
What is the Medicare coverage for eye care and eyeglasses?
Keep in mind that the specific benefits may vary, depending on the Medicare Advantage plans available in your service area. For more information, check with the individual health plan you’re considering. If you’d like help finding a Medicare Advantage plan that includes vision benefits, you can visit Medicare.gov or call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week (TTY users, call 1-877-486-2048. You can also contact eHealth to speak with a licensed insurance agent about your Medicare plan options.
Medicare/Medicaid Vision Benefits
Cataract surgery. Medicare covers many of the costs associated with cataract surgery, including the cost of a standard intraocular lens (IOL) implant. If you choose a premium intraocular lens, such as an accommodating IOL or a multifocal IOL to reduce your need for reading glasses after surgery, you must pay the additional cost of the premium IOL (above the cost of a standard IOL) out-of-pocket.
Medicare and Cataracts Surgery
Surgery to remove cataracts is covered by Medicare, but Medicare only pays expenses directly related to the cataracts. If you had a non Medicare-covered condition before developing cataracts, you may be able to treat that condition during the same surgery, but Medicare only covers the costs associated with cataracts. Medicare will ask the surgeon to bill you separately for the parts not related to the cataracts.