Updated
As you approach retirement age, you may be thinking about how Medicare will cover your healthcare needs. Medicare is a federal program that helps people over 65 and other Americans with certain conditions or disabilities pay for their medical coverage. While Medicare offers a wide range of health benefits, one area that often causes confusion is vision care. Understanding what Medicare covers—and what it doesn’t—can help you plan for your eye health as you age. Below you'll find answers to:
- Does Medicare cover vision?
- What are Medicare Advantage Plans?
- Does Medicare Advantage (Part C) cover vision?
- How do I make sure I’m covered for what I need?
- How do I keep my eyes healthy as I age?
- How do I know what coverage to get?
Medicare and Vision Coverage
Original Medicare, which includes Part A (Hospital Insurance) and Part B (Medical Insurance), does not cover routine vision care. This means that services like annual eye exams, eyeglasses, and contact lenses are not included. If you need these services, you’ll typically have to pay out of pocket.
However, Medicare Part B does provide coverage for some vision-related services. For example, if you have a chronic eye condition like glaucoma, cataracts, or macular degeneration, Medicare Part B will cover medically necessary eye exams and treatments. If you need cataract surgery, Medicare may also cover the cost of a basic lens implant and one pair of corrective eyeglasses or contact lenses following the procedure.
Medicare Advantage and Vision Coverage
For those looking for more comprehensive vision coverage, a Medicare Advantage Plan (Part C) might be a better option. These plans are offered by private insurance companies and include all the benefits of Original Medicare, and may have additional coverage, like vision, dental, and hearing. Vision benefits under Medicare Advantage plans often include routine eye exams, discounts on eyeglasses and contact lenses, and even coverage for prescription sunglasses.
How to get Vision Coverage with Medicare
Since Original Medicare doesn’t provide routine vision care, many seniors look for additional options to ensure comprehensive coverage. Here are three ways to enhance your Medicare plan:
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1. Medicare Advantage (Part C) Plans:
Many Medicare Advantage plans, offered by private insurers, bundle extra benefits like vision, dental, and hearing coverage. These plans can include routine eye exams, coverage for eyeglasses or contact lenses, and discounts on services like LASIK. Coverage specifics vary by plan, so it’s important to research thoroughly. -
2. Vision Plans for Seniors on Medicare:
If you need routine eye exams or corrective lenses, consider buying a standalone vision insurance plan. This is often the best vision insurance for seniors on Medicare who need more comprehensive coverage than what is offered by Medicare Advantage. In partnership with VSP®, Delta Dental of Washington offers two vision benefit plans great for retirees who want to supplement their Medicare coverage called DeltaVision® Brilliance 200 and DeltaVision® Essential 150. They are designed for people who want to have vision coverage but whose Medicare plan doesn’t include the kind of eye health coverage they’re looking for. Our DeltaVision® plans fill in the gaps in Medicare vision coverage by offering frame or contact allowances with minimal copays which keeps out-of-pocket costs for basic vision needs low. -
3. Vision Discount Plans:
Another option is to sign up for a vision discount plan. These plans provide savings on services such as eye exams, frames, and lenses for a small monthly fee, but they are not considered insurance plans.
Why is Vision Coverage Important for Seniors?
While Original Medicare doesn’t cover routine vision care, there are options available to ensure your eye health is taken care of. Consider whether a Medicare Advantage plan fits your needs or explore standalone vision insurance plans to supplement your Medicare coverage. By planning ahead, you can protect your vision and avoid unexpected out-of-pocket expenses.
Routine eye exams are especially important as we age because they can catch early signs of common eye problems before they become serious. Seniors are more likely to experience conditions such as:
- Cataracts – clouding of the eye’s lens that can blur vision
- Glaucoma – increased eye pressure that can lead to vision loss if untreated
- Macular degeneration – damage to the central part of the retina, da leaing cause of blindness in older adults
Regular eye exams can help detect these conditions early, when they are most treatable, and also monitor overall health by revealing signs of systemic issues like diabetes or hypertension. Learn more about the benefits of vision coverage here.
Here are some key factors to keep in mind when evaluating your vision coverage options:
- Eye health If you have ongoing eye conditions or a family history of vision issues, look for a plan that offers comprehensive care.
- Frequency of eye exams: If you see an eye doctor regularly, investing in a plan with routine vision coverage can save money over time.
- Cost and premiums: Compare the costs of Medicare Advantage plans, standalone vision insurance, or discount plans with the out-of-pocket cost of routine eye care.
Supplementing Medicare with a Delta Dental of Washington Individual and Family Plan for Your Vision Coverage
As we’ve already covered, in most cases, Medicare won’t cover many of your eye health needs so it could be helpful to enroll in a vision plan that supplements the coverage you get from Medicare. Delta Dental of Washington’s DeltaVision® is designed for just this kind of scenario. Anyone who enrolls in a new Delta Dental of Washington Individual and Family dental plan has the option to enroll in DeltaVision® as well when they check out. If you already have an Individual and Family dental plan, but would like to add a vision plan, please give us a call at 844-764-5250 or mail us a paper application. You may enroll in an Individual and Family dental plan or vision plan at any time.
Overall, for those looking at Medicare plans, consider rounding out your healthcare with an affordable Delta Dental of Washington dental and vision plan to cover the gaps in healthcare coverage from Medicare.
Start your vision coverage with Delta Dental of Washington today.
