Understanding Medicare Vision Coverage: What's Covered and What's Not

Discover the ins and outs of Medicare's vision coverage. Gain insight into what services and treatments are covered, and get informed about what falls outside the scope of Medicare's vision benefits. Plan your eye care needs effectively with a clear understanding of Medicare's provisions.

Healthcare coverage is a major concern for many individuals, particularly those in need of specialized care such as vision services. Many insurance companies and healthcare providers offer varying degrees of coverage, each with its unique specifications and costs. This article will explore the specifics of vision care coverage offered by four different brands: medicare.gov, Aetna, Select Quote, and Trubridge.


Medicare.gov is a significant player in the healthcare industry, offering a wide range of services, including some vision care. However, it's important to note that Medicare Part B only helps pay for corrective lenses if you have had cataract surgery with an intraocular lens implantation. Notably, the coverage includes one pair of eyeglasses with standard frames or one set of contact lenses. However, there are limits, as patients are required to pay 20% of the Medicare-Approved Amount for corrective lenses after meeting the Part B deductible. Additionally, extra costs for upgraded frames are not covered. While some Medicare Advantage Plans offer extra benefits not covered by Original Medicare, the cost for these plans varies.


Aetna is another noteworthy provider in the healthcare industry. With Aetna, you can choose from thousands of retail and independent providers and even schedule your eye exam online. Their network includes a diverse mix of national, regional, and independent private practice locations. Plus, frames from top eyewear brands such as Ray-Ban and Oakley are available to customers. One significant advantage is that your benefit is applied during the visit, eliminating the need to file a paper claim for reimbursement. However, the cost for Aetna's services varies.


SelectQuote offers a nuanced approach to vision coverage. While Original Medicare does not cover routine vision care, Medicare Part A and B do provide some coverage based on the circumstances. For example, Part B covers annual exams for diabetic retinopathy, glaucoma tests for high-risk patients, macular degeneration tests and treatment, and corrective lenses following cataract surgery. However, these are not covered 100%. SelectQuote also offers supplementary vision insurance and Medicare Advantage plans with differing costs.


Trubridge, in collaboration with Humana, offers Medicare Advantage plans that may include routine vision coverage. This coverage extends to routine eye exams, eyeglasses, and prescription contact lenses, which are not typically covered by Original Medicare. Additional benefits such as dental care coverage, prescription drug coverage, and health & wellness programs may also be included with certain Humana Medicare Advantage plans. However, not all these plans offer eye care coverage, and the cost for Trubridge’s services varies.

Vision care coverage varies significantly across different brands. While Medicare.gov, Aetna, Select Quote, and Trubridge all offer some form of vision coverage, the extent and cost of this coverage can vary. Therefore, it is crucial for individuals in need of vision care to thoroughly research and understand the specifics of each plan before making a decision. It is always important to ask questions and ensure you understand what is and isn't covered by your healthcare plan.