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?
A prescription order signed by your doctor (ophthalmologist or optometrist) must be on file with the supplier. Suppliers must be enrolled in Medicare and must meet strict standards to qualify for a Medicare supplier number. Medicare won’t pay your claim if your supplier doesn’t have a number, even if your supplier is a large chain or department store that sells more than just durable medical equipment (DME).
Does Medicare Pay for Eyeglasses
The only other possibility for Medicare to contribute to the cost of your mother’s glasses is if she belongs to a Medicare Part C “Medicare Advantage” HMO or other managed care plan. These plans provide slightly broader coverage than traditional Medicare Part B does, and a few of them pay some of the cost of eye exams and glasses. If she belongs to a Medicare Advantage plan, check with the plan administrator to see if there is any coverage for glasses.
Does Medicare Cover Rx Eyeglasses?
Medicare Part B is medical insurance that does provide limited coverage for eyeglasses. It will pay for one pair of glasses, but only if you have had cataract surgery that required lenses be implanted in your eye and an ophthalmologist or an optometrist prescribes eyeglasses for you. You pay 20 percent of the Medicare-approved amount and the Part B deductible ($135 as of 2009) applies. It also covers only standard frames.