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For many working Americans, vision insurance is a benefit commonly provided by their employers. Once they approach age 65 and begin applying for Medicare coverage, they should be aware that their vision coverage may not be what they were used to under their employer-provided insurance plan.

With Original Medicare, also known as Medicare Parts A and B, enrollees receive coverage on select vision treatments and tests. While Original Medicare provides an acceptable amount of coverage for many people’s health care needs, it may not be enough. However, there are ways to complement your Original Medicare coverage to obtain the vision coverage you need.

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Medicare Annual Enrollment Period Begins Oct 15.

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Does Original Medicare (Parts A & B) Cover Vision?

Under Medicare Parts A and B, navigating vision coverage can be challenging because some services are covered while others are not. Original Medicare does not cover routine eye exams, also known as eye refractions, for eyeglasses or contact lenses. This lack of coverage means you’ll be responsible for paying 100 percent of the cost.

If you suffer from an eye condition or injury that requires admittance to a hospital, then Medicare Part A may cover your stay. Also, Medicare Part B (Medical Insurance) will cover some preventative or diagnostic eye exams.1 These preventative treatments may include:

  • Yearly eye exams for diabetic retinopathy, which can cause vision loss for people with diabetes
  • Yearly tests for glaucoma
  • Some tests and treatments for macular degeneration
  • Some aspects of cataract surgery

What Are the Vision Benefits of Medicare Advantage (Medicare Part C)?

With a Medicare Part C insurance plan, also known as Medicare Advantage, provided by a private insurance company, you may be able to fill the gaps in your health care plan. Part C plans offer the same benefits of Parts A and B, but you’ll also gain the routine eye care coverage missing from Original Medicare. Your Medicare Advantage plan provides coverage2 for:

  • Routine eye exams
  • Eyeglass lenses and frames
  • Contact lenses

Regarding vision coverage, signing up for a Medicare Part C plan becomes an enticing option when factoring how many people need vision correction with glasses, contacts, or medical treatments. In 2015, more than 12 million Americans over the age of 40 had vision and eye problems, and that number is expected to double by 2050.3

What About Stand-Alone Vision Plans?

There is a way to get the vision coverage you need without signing up for a Medicare Advantage (Part C) plan. Many private insurance companies offer stand-alone vision insurance plans that work in conjunction with your Original Medicare plans. The benefits offered by these plans can vary, but you can expect help covering your eye exams, glasses and contact lenses.

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