Vision Insurance

Original Medicare typically doesn’t include vision benefits in its coverage. Under Part A, which is hospital insurance, beneficiaries will be covered for traumatic eye injury which requires hospitalization. Under Part B, which is medical insurance, beneficiaries may be covered for outpatient services like cataract surgery or detached retina. In general Part B will cover all medically necessary outpatient services and preventive care. Other examples that Part B may cover are screenings for glaucoma or diabetic retinopathy,  eye cancer surgery, retinal detachment, etc.

So, if you are a senior on Original Medicare and need glasses, lenses, or services that aren’t considered a medical necessity, you will need to purchase a stand-alone plan.

Medicare Advantage Vision Coverage 

Medicare Advantage plans are sold by private insurance companies and are approved by Medicare as another option to get your Part A and Part B coverage benefits. These plans must cover a minimum amount of basic benefits typically covered under Original Medicare. However, most MA plans come with additional benefits that may include vision. Therefore Medicare Advantage plans may cover:

• eyeglasses
• lenses
• fitting for frames and contact lenses

These benefits come as an addition to all services that are considered prevention or diagnostic treatment which is covered under Part A and B. Since Medicare Advantage plans often offer different ranges of coverage, always check with your insurance agent what your benefits actually are, and what your costs may be, before you choose a specific plan as your coverage option. 

For example, if your vision insurance is through an HMO plan, your network of providers will be limited which means that you will only use vision service providers which accept your network to get covered. However, if your insurance plan is a trough PPO plan, you may seek out-of-network services but be prepared for paying higher out-of-pocket costs. So, always check if your current eye doctor is part of your network to avoid higher costs.

Stand-alone Vision Insurance Plan

If you are on Original Medicare and have a Medicare Supplement plan as additional coverage, be aware that supplement plans only help cover the costs that are left by Original Medicare. Additional benefits, like vision insurance, are not included. If you want vision insurance benefits, you will have to purchase a stand-alone vision insurance plan from a private insurance company like Turning 65 Solutions.

Some companies, like us, offer dental, vision, and hearing all in one. But if you think that only vision insurance is enough you can buy a vision insurance policy only.

Vision insurance policies typically cover:

• annual routine eye exams
• eyeglasses or contact lenses prescriptions 
• eyeglass lens coatings (anti-reflective coating, photochromic lenses, progressive lenses) and vision correction surgeries like LASIK may be included in more comprehensive policies 

Typically, monthly costs for vision insurance are between 5$ to15$. Also, policyholders will be responsible for copays and deductibles which may vary from plan to plan and your living area. Some plans also may include a deductible.