Your Medicare Coverage
Is my test, item, or service covered?
How often is it covered?
Generally, Medicare doesn't cover eyeglasses or contact lenses. However, following cataract surgery that implants an intraocular lens, Medicare Part B (Medical Insurance) helps pay for corrective lenses (one pair of eyeglasses with standard frames or one set of contact lenses). Medicare covers the surgery if it’s done using traditional surgical techniques or using lasers.
Medicare will only pay for contact lenses or eyeglasses provided by a supplier enrolled in Medicare. This is true no matter who submits the claim (you or your supplier).
All people with Part B are covered.
Your costs in Original Medicare
- You pay 20% of the Medicare-approved amount for one pair of eyeglasses or one set of contact lenses after each cataract surgery with an intraocular lens.
- Medicare will only pay for contact lenses or eyeglasses from a supplier enrolled in Medicare, no matter who submits the claim (you or your supplier).
- You pay any additional costs for upgraded frames.
- You pay 100% for non-covered services, including most eyeglasses or contact lenses.
- The Part B deductible applies.
To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:
- Other insurance you may have
- How much your doctor charges
- Whether your doctor accepts assignment
- The type of facility
- Where you get your test, item, or service
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.