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Medicare Vision Coverage: How to Save Money on Eyeglasses and Exams
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You’re enrolled in Medicare, and you need to go to your routine optometrist check-up. But then you discover that, actually, routine vision care isn’t guaranteed.
Yes, the vast majority — about 90%, according to Fierce Healthcare — of Medicare Advantage enrollees have access to vision, dental or hearing care. Many have coverage for both eye exams and eyewear. But these are private plans that often put an annual dollar limit on vision coverage.
Original Medicare, which insures about 33.9 million people in the United States, doesn’t include dental, vision or hearing services. That means you won’t have your new eyeglasses frames or annual vision exam covered.
But the real challenge is determining what is covered and what isn’t, depending on what plan you have. Whether you’re new to Medicare and wondering what to expect at your next eye exam, or you’re a long-time beneficiary trying to save money on glasses, our guide to Medicare vision coverage and affordable eye care is here to help.
Unfortunately, insurance doesn’t cover everything. These resources can help you manage those unexpected expenses.
If you have a serious eye disease like glaucoma or macular degeneration, you may qualify for certain coverage under original Medicare. For example, if you have diabetes and are at risk for diabetic retinopathy, Medicare will cover annual exams. If you’re at high risk for glaucoma, Medicare will also cover annual screenings. For eye diseases like macular degeneration, certain diagnostic tests and treatments may be covered. However, in some cases, you will have to meet the Part B deductible and pay 20% of the Medicare-approved amount for the drug and your doctor’s services.
What is clear is that routine eye exams for eyeglasses or contact lenses, as well as the frames or lenses themselves, are not covered under original Medicare. There is one exception: Medicare Part B will help pay for corrective lenses following a cataract surgery that implants an intraocular lens.
Medicare Advantage privately-administered plans, on the other hand, do tend to have some vision coverage. About 90% of enrollees in Medicare Advantage plans have access to some coverage for vision, dental or hearing exams or medical supplies, but most of the plans have annual dollar limits on coverage. Here’s how it breaks down.
Original Medicare does not cover routine vision exams, eyeglasses or contact lenses unless you have a pre-existing health condition like diabetes or cataracts. It will also provide coverage if you are at risk for glaucoma. Lasik surgery isn’t covered either, as it is considered an elective surgery. You’re on the hook for the full cost unless you have secondary insurance like Medicaid or one of the previously stated conditions. We’ll cover that in more depth shortly.
Nearly all Medicare Advantage plans — which are administered by private insurance companies like United Healthcare and Cigna — include some routine vision coverage.
However, vision benefits are pretty modest — plans offer about $100 to $200 of coverage.
Medicare Advantage plans often also restrict the vision benefits they offer, including:
For example, plans limit beneficiaries to one pair of eyeglasses every one to two years in most cases, with the most common limit being one pair per year. Eye exams are also most commonly limited to no more than once per year.
Finally, to get these vision benefits, you will need to use certain eye care professionals and services within your specific Medicare Advantage plan network, which can sometimes be limited.
By law, both Original Medicare and Medicare Advantage must cover the same basic vision services for eye diseases and chronic conditions.
If you have an eye disease that causes low vision, such as macular degeneration or glaucoma, Medicare Part B will cover screening tests and standard treatment.
You’ll pay 20% of the Medicare-approved amount for these covered treatments and services after meeting your Part B deductible.
Medicare Part B covers 80% of the cost for:
Some diseases and conditions — such as lupus and shingles — can affect your vision, even though they aren’t traditional eye diseases. Medicare Part B covers treatment for your eyes if you have one of the many conditions on this list from the U.S. Centers for Medicare & Medicaid Services.
Eyeglasses and routine vision exams are pricey for Original Medicare beneficiaries.
Fortunately, several programs and organizations offer free or discounted eyeglasses and exams for older adults.
Here are some of the best ways to reduce your out-of-pocket costs on routine vision care when you’re enrolled in Medicare.
While eye exams can vary in cost from around $50 to $200, insurance provider VSP puts the average cost of a comprehensive eye exam at between $75 and $200 for patients without vision insurance.
Here are a few ways to keep more money in your pocket without forgoing important eye care.
AAA and AARP members can receive discounts at participating LensCrafters and other retail locations nationwide.
Members of AAA and AARP can get the following discounts at LensCrafters:
AARP members also receive these discounts through other providers:
Retailers like Costco and Walmart offer optical centers with affordable pricing on eye exams and glasses.
At Walmart, eye exams average about $75, but prices vary by location.
Like Walmart, Costco’s eye exam costs vary, but you can expect to pay anywhere from $70 to $100 for one. Appointments at Target also range between $70 and $100 for an exam.
All three retailers also offer a wide selection of eyeglasses that start around $60.
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EyeCare America is the public service arm of the American Academy of Ophthalmology.
Its Seniors Program provides comprehensive eye exams and up to one year of follow-up care for any eye condition diagnosed during the initial exam.
These services are free to qualifying older Americans. It’s one of the only national programs that offers free eye exams for people on Original Medicare.
To qualify for the EyeCare America Senior Program, you must:
Just a heads-up: This program does not cover the cost of eyeglasses.
You can see if you qualify and apply for the program by filling out this form.
The Lions Club can pay for eye care and eye exams at local club locations and community events through their vision grant program. Some locations also provide eyeglasses.
For more information, reach out to your local Lions Club chapter.
Students at optometry schools sometimes provide free or discounted eye exams during clinics.
These undergraduates are closely supervised by faculty members, so it can be a cheap way to score a routine vision test.
You can use this tool to search for schools in your area — although the eye exams and care provided vary from school to school.
Another option is asking local vision care providers if they offer any senior discounts or in-house financing plans. Make sure to call ahead and ask before scheduling an appointment.
Older people with low incomes may also qualify for free or reduced eye exams at their local county health department.
Finally, numerous local nonprofits offer free eye exams throughout the year. Call United Way’s 211 service to see if a program exists near you or Google “free eye exams near me.”
Affordable eyeglass lenses and frames are easy to find online or at large retail stores like Walmart and Costco.
There is also a program that provides free eyeglasses to those who qualify — but be prepared to jump through some hoops first.
The OneSight Vision Voucher program helps people in need receive free eyewear if they’re not able to cover the cost of eyeglasses with insurance.
Here are the steps you need to take:
Check out OneSight’s website to learn more about its vision voucher program.
Buying eyeglasses online is a cheap alternative to paying hundreds of dollars for a fancy pair at your optometrist’s office.
People who bought glasses online paid a median of $111, while those who shopped in-store spent $215, according to a 2022 survey from Consumer Reports.
Some online retailers, like Zenni Optical, offer single-prescription glasses starting at just $7. You’ll pay more for special coatings, progressive lenses and other add-ons.
Many of these sites offer virtual “try-on” features and come with convenient return policies so you can find frames and lenses that work for you.
Medicare beneficiaries can purchase private vision insurance to help offset the cost of eyeglasses and routine eye exams.
Plans are generally inexpensive — the average cost of a standard plan across six companies is about $5 to $30 a month — and premiums usually don’t increase with age like other types of health insurance.
However, private insurance copayments and deductibles may not make it worthwhile.
You should carefully examine any private vision insurance plan benefits and costs before signing up. Make sure the plan actually saves you money on eyeglasses and routine exams.
Medicare may not be your only form of insurance.
If you are also enrolled in Medicaid or Veterans Affairs health benefits, you may qualify for free or low-cost vision care.
Medicaid will cover eye exams for adults ages 21 and older in most states — but not all.
Medicaid is a federally funded health insurance program for people with low incomes. It’s administered at the state level, so each state determines its own vision benefits and limitations.
In states that do provide vision benefits, basic eye exams are covered. Prescription glasses with basic frames are also usually covered, but each state has specific caps.
Copays for eye exams with Medicaid are affordable, usually $15 or less.
Research your specific state’s Medicaid vision coverage or contact your local Medicaid office for more information. Speaking with a local Medicaid office and your individual plan provider is the best way to understand your specific vision benefits.
Once you’re clear on your coverage, make sure your eye doctor accepts Medicaid before scheduling an eye exam.
If you have VA health care benefits, the program will cover your routine eye exams and preventive vision testing.
Talk to your VA primary care provider or contact your nearest VA medical center or clinic for more information.
Veterans can also qualify for free eyeglasses or contact lenses by meeting one of the following criteria:
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Rachel Christian is a Certified Educator in Personal Finance and a former senior writer for The Penny Hoarder.Freelancer Elizabeth Djinis contributed to this report.
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