Medicare's coverage of prescription glasses is limited
Original Medicare (Parts A and B) does not cover prescription glasses or contact lenses for most people. Medicare will only pay for glasses in one specific situation: after cataract surgery, when you need glasses as part of your recovery. Even then, the coverage is temporary and limited to one pair of standard frames and lenses in the when ready weeks after surgery.
If you have Medicare Advantage (Part C), some plans do include vision coverage that pays toward glasses, but the amount and rules vary widely by plan and by year. You need to check your specific plan's details to know what you would pay out of pocket.
For most seniors on Original Medicare who need prescription glasses for everyday use, the cost comes entirely from your own pocket. This is one of the larger out-of-pocket expenses many people face after turning 65.
Key Takeaways
- Original Medicare does not cover prescription glasses except for one pair after cataract surgery.
- Medicare Advantage plans sometimes include vision coverage, but the benefit amount and rules differ by plan and change year to year.
- You can buy glasses through a retail optometrist, online retailer, or warehouse club, and the cost does not depend on your Medicare status.
- If you cannot afford glasses, some nonprofits and community health centers offer reduced-cost or free eye exams and frames based on income.
- You should ask your eye doctor for a copy of your prescription so you can shop for the best price.
When Medicare does cover glasses after cataract surgery
After cataract surgery, your eye changes shape and your vision changes significantly. Medicare covers one pair of glasses or contact lenses as part of your surgical recovery, but only during a specific window. You must get the glasses within two weeks after the surgeon removes your stitches, and Medicare covers only standard frames and single-vision or bifocal lenses.
If you want designer frames, progressive lenses, or a second pair, you pay the difference yourself. Your eye doctor's office can tell you what Medicare will cover for your specific surgery and help you choose frames within that benefit. This coverage applies whether you have Original Medicare or a Medicare Advantage plan.
How Medicare Advantage vision coverage works
Some Medicare Advantage plans include a vision benefit that covers an eye exam, glasses, or contact lenses each year. The amount varies: one plan might cover $150 toward frames and lenses, while another covers $200 or nothing at all. Some plans cover the exam but not the glasses. Others cover glasses only if you buy them from an in-network provider.
You need to read your plan's Summary of Benefits and Coverage document, which lists exactly what vision services are covered and what you pay. This document is mailed to you each fall during the Annual Enrollment Period, and you can also find it on your plan's website or by calling the plan's customer service number on the back of your card.
If you are thinking about switching to a Medicare Advantage plan partly for vision coverage, remember that the benefit can change from year to year. A plan that covers glasses this year might reduce the benefit next year, or you might move out of the plan's service area.
Where to buy affordable prescription glasses
Once you have your prescription from your eye doctor, you have several options for where to buy. Retail optometrists and ophthalmologists' offices typically charge more but offer in-person fitting and adjustments. Warehouse clubs like Costco and Sam's Club often have lower prices on frames and lenses if you are a member. Online retailers like Warby Parker, Zenni, and EyeBuyDirect have significantly lower prices than traditional retail, though you cannot try frames on in person.
Ask your eye doctor for a copy of your prescription before you leave the office — they are required to give it to you at no extra cost. The prescription includes your lens strength, pupillary distance (the distance between your pupils), and other measurements the retailer needs. With this information, you can compare prices across different sellers.
If you are on a tight budget, some community health centers and nonprofit organizations offer free or reduced-cost eye exams and glasses based on your income. Your local health department or 211 (dial 2-1-1 from any phone) can tell you which programs operate in your area.
What to ask your eye doctor about glasses
Before you buy, ask your eye doctor these questions: Do I need single-vision lenses, bifocals, or progressive lenses? (Progressive lenses cost more but let you see at all distances without visible lines.) What is my pupillary distance? Can you write it on my prescription? Do I need any special coatings like anti-glare or blue light filtering? (These add cost and are optional.)
Also ask whether your prescription is stable or likely to change soon. If you are having cataract surgery, your prescription will change after surgery, so buying expensive glasses before surgery may not be worth it. If you are trying on frames, ask the optometrist to check that they fit properly — frames that sit too high or too low on your nose will not give you the best vision.
When to see an eye doctor
You should see an eye doctor if your vision has changed, you are having trouble seeing clearly at distance or up close, or you have not had an eye exam in the past year or two. An eye exam can catch serious conditions like glaucoma and macular degeneration early, when treatment works best. These exams are not covered by Original Medicare as a routine benefit, but some Medicare Advantage plans cover one exam per year.
If you suddenly lose vision, see flashing lights, or notice a new shower of floaters (small spots that drift across your vision), call your eye doctor or go to an urgent care or emergency room the same day. These can be signs of a serious problem like retinal detachment that needs when ready attention.
Frequently Asked Questions
Does Medicare cover contact lenses?
No, except for one pair after cataract surgery. If your Medicare Advantage plan includes vision coverage, check whether it covers contacts or only glasses. Most plans that cover vision cover glasses only.
Can I use my Medicare benefits to buy reading glasses at the drugstore?
No. Over-the-counter reading glasses are not covered by any Medicare plan. If you need reading glasses, you should have an eye exam first to make sure your vision problem is not a sign of something more serious.
What if I cannot afford glasses and I am on a fixed income?
Call 211 or visit 211.org to find nonprofits and community health centers in your area that offer free or reduced-cost eye exams and glasses based on income. Some organizations also accept donations of used glasses. Ask your eye doctor's office whether they know of local programs.
If I switch Medicare Advantage plans, do I keep the same vision coverage?
No. Each plan has its own vision benefit. If you switch plans, your new plan's vision coverage may be better, worse, or different in what it covers. Always compare vision benefits when you are deciding between plans during the Annual Enrollment Period.
Does Medicare cover the cost of an eye exam?
Original Medicare does not cover routine eye exams. Some Medicare Advantage plans cover one exam per year. If you have Original Medicare and need an eye exam, you pay the full cost out of pocket, though community health centers may offer exams on a sliding fee scale based on income.