Where to Buy Glasses That Medicare Will Help Pay For

How to find an optometrist or eyeglass store that takes Medicare

Medicare covers one pair of eyeglasses or contact lenses per year, but only after cataract surgery. The coverage comes through Medicare Part B, and you can fill the prescription at most optometrists, ophthalmologists, and eyeglass retailers — but not all of them accept Medicare assignment, which means they agree to accept Medicare's payment as full payment.

The fastest way to find a provider near you is to use the Medicare Provider Search tool on Medicare.gov. You can search by location and filter for "optometrist" or "ophthalmologist." This tool shows you which doctors and clinics have enrolled with Medicare and accept Medicare patients. You can also call your Medicare plan directly — the phone number is on your insurance card — and ask for a list of in-network eye care providers in your area.

Many large eyeglass chains like LensCrafters, Pearle Vision, and Warby Parker have locations that accept Medicare, but acceptance varies by individual store location. Call ahead before you go, because a chain's headquarters may accept Medicare while a specific store does not. Ask specifically: "Do you accept Medicare assignment for eyeglasses after cataract surgery?"

Key Takeaways

Medicare Part B covers one pair of eyeglasses or contact lenses per year only after cataract surgery, not for routine vision correction.
Use the Medicare Provider Search tool on Medicare.gov to find optometrists and ophthalmologists in your area who accept Medicare.
Not every location of a chain eyeglass store accepts Medicare, so call your specific store to confirm before your appointment.
When you call, ask if the provider accepts Medicare assignment, which means they will not bill you extra beyond what Medicare pays.
You will need a prescription from your eye doctor dated after your cataract surgery to use Medicare coverage for glasses.

What Medicare actually covers for eyeglasses

Medicare Part B pays for one pair of eyeglasses or contact lenses in the 12 months following cataract surgery. The coverage includes the frames and lenses, but only if you had the surgery covered by Medicare. If you had cataract surgery at a facility that does not accept Medicare, or if you paid out of pocket for the surgery, Medicare will not cover the glasses afterward.

The prescription must be written by the eye surgeon or your regular eye doctor and must be dated after your cataract surgery. Medicare will not cover glasses for routine vision problems like nearsightedness or farsightedness unless they follow cataract surgery. The coverage also does not include special add-ons like anti-reflective coating, photochromic lenses, or progressive bifocals — though you can pay out of pocket for these upgrades.

If you need a new pair of glasses before 12 months have passed since your last pair, Medicare will not cover the second pair. You will have to pay for it yourself or wait until the 12-month period ends and a new benefit year begins.

In-network versus out-of-network providers

An in-network provider is one who has agreed to accept Medicare's approved amount as payment in full. When you see an in-network provider, you typically pay nothing beyond your Part B deductible and coinsurance. An out-of-network provider can charge you more than Medicare's approved amount, and you may owe the difference.

If you use an out-of-network provider, Medicare will still pay its share (usually 80 percent of the approved amount after you meet your deductible), but you are responsible for the remaining 20 percent plus any amount the provider charges above Medicare's approved fee. This can add up quickly, especially if you choose expensive frames or specialty lenses.

Your Medicare Advantage plan (Part C) may have its own network of eye care providers that differs from Original Medicare's network. If you have a Medicare Advantage plan, check your plan documents or call the plan to find out which providers are in-network for you.

How to use your Medicare coverage at the time of purchase

When you arrive at the optometrist or eyeglass store, bring your Medicare card and your prescription. Tell the staff that you are using Medicare coverage for your glasses. They will verify your coverage and check whether you have met your Part B deductible for the year.

The provider will submit the claim to Medicare on your behalf if they accept Medicare assignment. You should receive an explanation of benefits (EOB) in the mail within two to three weeks showing what Medicare paid and what you owe. Do not be surprised if the EOB arrives after you have already picked up your glasses — this is normal.

If the provider does not accept Medicare assignment, you may have to pay the full cost upfront and then submit the claim yourself to Medicare for reimbursement. Ask the provider before you order whether they will bill Medicare directly or whether you need to pay and seek reimbursement.

What to do if your provider does not accept Medicare

If your preferred eye doctor or eyeglass store does not accept Medicare assignment, you have two options. You can pay the full cost out of pocket and then submit a claim to Medicare yourself for reimbursement of the approved amount. Keep your receipt and the itemized bill showing the cost of frames and lenses separately.

Alternatively, you can find a different provider who does accept Medicare. Use the Medicare Provider Search tool or call your Medicare plan to get a list of in-network providers near you. Many people find this faster than paying upfront and waiting for reimbursement.

If you choose to pay out of pocket and seek reimbursement, send your claim to your Medicare Administrative Contractor (MAC). Your EOB or Medicare.gov will tell you which MAC handles claims in your state. The reimbursement process typically takes four to six weeks.

Special situations: Medicare Advantage and other coverage

If you have a Medicare Advantage plan (Part C), your vision coverage for glasses after cataract surgery may differ from Original Medicare. Some Medicare Advantage plans offer additional vision benefits beyond what Original Medicare covers, such as coverage for routine eye exams or glasses for other reasons. Check your plan's summary of benefits or call the plan to find out what is covered.

If you have both Medicare and Medicaid (dual may be able to access), Medicaid may cover eyeglasses in some states even when Medicare does not. Contact your state Medicaid office to learn what vision services are available to you. If you have a Medigap policy, it does not typically cover eyeglasses, but it may help pay your Part B coinsurance.

Veterans with VA benefits should check with the VA directly about vision coverage, as the VA has its own eye care system separate from Medicare. Some seniors are covered by both Medicare and the VA and can choose which system to use.

Questions to ask your eye doctor or eyeglass store

Before you schedule an appointment or place an order, call and ask these questions to avoid surprises:

Do you accept Medicare assignment for eyeglasses after cataract surgery?
Will you bill Medicare directly, or do I need to pay upfront and seek reimbursement?
What is the cost of frames and lenses separately, and what is included in the Medicare-covered amount?
If I want add-ons like anti-reflective coating or progressive lenses, what will I owe out of pocket?
How long does it take to receive my glasses after I place the order?
What is your return or adjustment policy if the glasses do not fit properly?

Frequently Asked Questions

Can I use my Medicare coverage for sunglasses or a second pair of glasses?

No. Medicare covers one pair of eyeglasses or contact lenses per year after cataract surgery. The glasses must be for vision correction, not sunglasses. If you need a second pair within 12 months, you will have to pay for it yourself.

What if I had cataract surgery before I turned 65 and got Medicare?

Medicare will only cover glasses if the cataract surgery was performed after you enrolled in Medicare Part B and Medicare paid for the surgery. If you had the surgery before Medicare, the coverage does not explore retroactively.

Do I have to use the same eye doctor who performed my cataract surgery?

No. Any eye doctor or optometrist can write the prescription for your Medicare-covered glasses, as long as the prescription is dated after your cataract surgery. You do not have to return to the surgeon who performed the procedure.

Will Medicare cover the cost of my eye exam?

Medicare Part B covers one eye exam every two years if you have diabetes or are at high risk for glaucoma. For other seniors, Medicare does not cover routine eye exams. The exam is separate from the glasses coverage, so you may have to pay for the exam yourself.

What happens if I lose or break my Medicare-covered glasses before the year is up?

Medicare will not cover a replacement pair until 12 months have passed since you received the first pair. If you break or lose your glasses, you will need to pay for repairs or a new pair out of pocket, or wait until your benefit year renews.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.