Medicare does not cover contact lenses or eyeglasses

Original Medicare (Parts A and B) does not pay for contact lenses, eyeglasses, or the eye exams needed to fit them. This applies whether you need them for distance vision, reading, or any other reason. If you wear contacts or glasses, you will pay the full cost out of your own pocket under Original Medicare.

Medicare Part B does cover one thing related to vision: a dilated eye exam once every two years if you have diabetes or a history of eye disease. That exam checks for conditions like diabetic retinopathy or glaucoma. But even if Medicare pays for that medical exam, it will not cover the contacts or glasses you might need afterward.

Some Medicare Advantage plans (Part C) do offer limited vision coverage, including a small allowance toward contacts or frames each year. The amount and what it covers varies widely by plan and by region.

Key Takeaways

  • Original Medicare does not cover contact lenses, eyeglasses, or routine eye exams for vision correction.
  • Medicare Part B covers a dilated eye exam every two years if you have diabetes or eye disease, but not the contacts or glasses you need afterward.
  • Some Medicare Advantage plans include a yearly vision benefit of $100 to $200 toward contacts, glasses, or both, though coverage details differ by plan.
  • If you need contacts or glasses, you can buy them from any provider — you are not limited to a specific network or store.
  • Standalone vision insurance, a Walmart or Costco membership plan, or a discount vision program can reduce what you pay out of pocket.

What Original Medicare covers for eye care

Original Medicare covers two types of eye services: treatment for eye disease and surgery for conditions like cataracts. If you have glaucoma, macular degeneration, diabetic retinopathy, or another medical condition affecting your eyes, Medicare Part B pays for the office visit and tests to diagnose and treat it. If you need cataract surgery, Medicare covers the procedure and one pair of glasses or contacts afterward to correct vision caused by the surgery itself.

The one preventive exam Medicare covers is the dilated eye exam for people with diabetes or a history of eye disease. This exam is meant to catch disease early, not to check whether you need new glasses. If the exam shows you need contacts or glasses for everyday vision, Medicare will not pay for them.

You pay 20 percent of the cost for these covered services after you meet your Part B deductible. If you have a Medigap or Medicare Advantage plan, your out-of-pocket cost may be lower.

Vision coverage in Medicare Advantage plans

About 90 percent of Medicare Advantage plans include some vision coverage. Most offer a yearly allowance of $100 to $200 that you can use toward contacts, eyeglasses, or both. Some plans cover an eye exam for vision correction (not just disease screening) once a year. A few plans cover a larger allowance or cover both an exam and frames or contacts.

The catch is that coverage varies by plan and by region. Two plans in the same county may offer different vision benefits. You need to check your specific plan's summary of coverage to know what you get. If you are thinking about switching plans during open enrollment, vision coverage is one thing worth comparing.

Even if your Medicare Advantage plan covers contacts or glasses, you usually have to use a provider in the plan's network. The plan will tell you which eye doctors and optical retailers are in-network. If you go out of network, you may pay the full cost.

How to find and pay for contacts or glasses

You can buy contacts or glasses from any optical retailer — an independent optometrist's office, a chain like Pearle Vision or LensCrafters, or a big-box store like Walmart or Costco. You do not need a referral from Medicare or your plan. You just need a current prescription from an eye doctor.

If you do not have a recent prescription, you will need an eye exam first. An exam at an independent optometrist or ophthalmologist typically costs $75 to $150. Chain retailers and big-box stores often charge less, sometimes $50 to $100. Some offer free or low-cost exams if you buy your contacts or glasses from them.

Contact lenses themselves cost $200 to $500 per year depending on the type and brand. Eyeglasses range from $100 to $400 or more for frames and lenses combined. If cost is a concern, Costco and Walmart tend to have lower prices than independent optometrists or chain retailers.

Standalone vision insurance and discount programs

If you do not have vision coverage through Medicare Advantage, you can buy a standalone vision insurance plan. These plans are separate from Medicare and cost $10 to $25 per month. They typically cover an eye exam once a year and offer a yearly allowance of $100 to $150 toward contacts or glasses. Some plans also cover a portion of the cost of contact lens fittings.

Discount vision programs are another option. Organizations like VSP, EyeMed, and Aarp offer membership plans that give you a discount at participating eye doctors and retailers. These are not insurance — you pay a membership fee (usually $60 to $120 per year) and then get a percentage off the retail price of exams, contacts, and glasses. If you buy contacts or glasses infrequently, a discount program may cost less than insurance.

Costco and Sam's Club memberships also include vision discounts. Costco members can use Costco's optical center or get discounts at outside providers. The membership fee ($60 to $130 per year depending on membership level) covers other benefits too, so the vision discount is a bonus.

What to do if you cannot afford contacts or glasses

If cost is a barrier, start by checking whether your Medicare Advantage plan includes vision coverage. If it does, use your yearly allowance. If you have Original Medicare and no vision plan, call 211 or visit 211.org to find low-cost vision clinics in your area. Many communities have federally may have access to health centers (FQHCs) that offer eye exams and glasses on a sliding fee scale based on income.

Some nonprofits also help older adults pay for vision care. The National Eye Care Project, run by the American Academy of Ophthalmology, connects uninsured and underinsured seniors with volunteer eye doctors who provide free exams and treatment for eye disease. You can reach them at 1-800-222-3937 or neyecare.org. This program does not cover contacts or glasses, but it can cover the exam and treatment if you have an eye condition.

If you wear contacts and cost is the issue, switching to eyeglasses may be cheaper. Glasses are usually less expensive per year than contacts, especially if you need multiple pairs of contacts or frequent replacements.

Frequently Asked Questions

Does Medicare cover the eye exam I need to get a contact lens prescription?

Original Medicare does not cover routine eye exams for vision correction. Medicare Part B covers a dilated eye exam once every two years if you have diabetes or eye disease, but only to screen for disease, not to check if you need new contacts. If you have a Medicare Advantage plan with vision coverage, check whether it includes an exam for vision correction — some do, some do not.

If I have cataract surgery, does Medicare pay for contacts afterward?

Yes. Medicare covers one pair of contacts or eyeglasses after cataract surgery to correct the vision change caused by the surgery. You pay 20 percent of the cost after your Part B deductible. If you need a second pair or different type of contacts, Medicare will not cover that.

Can I use my Medicare Advantage vision benefit at any eye doctor?

Usually only at in-network providers. Your plan will give you a list of eye doctors and optical retailers in your network. If you go to an out-of-network provider, you may have to pay the full cost yourself. Check your plan's provider directory or call the plan before you schedule an appointment.

What if I switch to a different Medicare Advantage plan — do I lose my unused vision allowance?

Yes. Vision allowances do not roll over from year to year or from plan to plan. If you switch plans, any unused allowance from your old plan is gone. Your new plan's vision benefit starts fresh on January 1 of the next year.

Are prescription contacts cheaper than eyeglasses?

Not usually. Contacts cost $200 to $500 per year because you need new ones regularly. Eyeglasses cost $100 to $400 upfront and last several years, so the yearly cost is lower. If you wear both, glasses are often the more affordable option for everyday use.