Medicare Vision Benefits
As vision expenses continue to increase, many of our clients ask us if Medicare covers vision. This is a complex question because while Medicare might cover vision in certain capacities, it fails to cover it under the most basic and routine circumstances.
Original Medicare vision benefits
Part B of Medicare covers some vision, but typically it does not cover very basic things like exams, refractions, frames, lenses or contacts. Most of the things relating to the eye that are covered aren’t specifically vision oriented. For instance, Glaucoma, Macular Degeneration, or other diseases of the eye might warrant coverage due to their overall health effects.
For diabetics and other select special groups at high risk, Medicare will cover annual Glaucoma tests.
Medicare will cover Cataract surgery. After you have Cataract surgery Medicare Part B will cover a pair of glasses since the cataracts would change your necessary prescription. You of course would have to pay the 20% coinsurance on these, unless you had a Medicare Supplement or Medigap plan that covered it.
If you have a Medicare Advantage plan, also referred to as Medicare Replacement, Part C, PPO/HMO Medicare Plan, you would have to reference the Summary of Benefits for that plan to see what added Vision benefits it might have.
Medigap or Medicare Supplements do not cover additional routine vision services, but just like mentioned before, the Medigap plan may pay the 20% coinsurance as it relates to certain Medicare approved vision procedures.
Separate Vision Plans
There are many plans that cover vision, and when selecting one it is important to ensure they have a good benefit structure.
We have found that the best benefit combination comes in the dental, vision and hearing plans. One such plan we really like to use is Central United Life’s Dental, Vision and Hearing plan. They recently changed their name to Manhattan Assurance, but their Dental, Vision and Hearing plan is still the same. Its flexibility or ability to use any dentist, optometrist or audiologist has been key in our deciding to recommend it to our clients.
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