Medicare Coverage for Contact Lenses (2024)

• Original Medicare doesn’t pay for contact lenses under most circ*mstances.
• Some Medicare Advantage plans may offer vision services.
• In some cases (such as after cataract surgery), Medicare may cover contact lens costs.

Original Medicare covers medical and hospital costs, but vision, dental, and hearing care aren’t usually covered. This means you likely won’t get financial help from Medicare when it comes to paying for your contact lenses. However, there are few exceptions, especially when you have Medicare Advantage.

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While Medicare covers some vision services, it doesn’t usually pay for eye exams or contact lenses. Some of the vision services original Medicare (parts A and B) may cover include:

• annual glaucoma test for people at high risk (including those with diabetes or a family history of glaucoma)
• annual exam to test for diabetic retinopathy for those with diabetes
• cataract surgery
• diagnostic testing or screenings for macular degeneration

Medicare Part B coverage

Medicare Part B is the portion of Medicare that covers most medical services, such as doctor’s visits, durable medical equipment, and preventative services. It doesn’t usually cover contact lenses.

However, there is one exception. If you have cataract surgery, Medicare Part B will cover one pair of corrective contact lenses after your surgery.

When you have cataract surgery, your eye doctor will insert an intraocular lens, which can sometimes change your vision. As a result, you’ll likely need new contact lenses or eyeglasses to correct your vision. Even if you wear glasses already, chances are you’ll need a new prescription.

It’s important to know that Medicare will pay for new contact lenses after each cataract surgery with an intraocular lens insertion. Normally, eye doctors will only perform surgery on one eye at a time. If you have surgery to correct a second eye, you can get another contact lens prescription at that time.

However, even in this situation, the contact lenses aren’t totally free. You’ll pay 20 percent of the Medicare-approved amount, and your Part B deductible applies.

Also, you’ll have to make sure you order contacts from a Medicare-approved supplier. If you usually order your contact lenses from a certain supplier, be sure to ask if they accept Medicare. If not, you may need to find a new supplier.

Part C coverage

Medicare Advantage or Medicare Part C is an alternative to original Medicare that combines Part A and Part B. To attract subscribers, many Medicare Advantage plans will offer dental, hearing, vision, and even fitness benefits.

Medicare Advantage plans can vary greatly in the vision coverage they offer. According to a 2016 study, those with Medicare Advantage vision coverage still paid for 62 percent of the out-of-pocket costs for vision care.

Examples of services Medicare Advantage plans may cover related to vision include:

• routine eye exams
• exams for fitting frames or contact lens prescriptions
• costs or copayments for contact lenses or eyeglasses

Medicare Advantage plans are often region-specific because many involve the use of in-network providers. To search for available plans in your area, visit Medicare.gov’s Find a Medicare Plan tool.

If you find a plan you are interested in, click on the “Plan Details” button, and you will see a list of benefits, including vision coverage. Often, you’re required to purchase your contacts from an in-network provider to ensure the plan will cover them.

The average cost of contact lenses can vary. Contacts range in features from daily disposable lenses (which are more expensive) to those that correct astigmatism or act as bifocals. A basic pair of soft contact lenses you replace every 2 weeks usually costs about $22 to $26 for a box of six pairs. When you consider costs per eye, you’ll usually spend about $440 to $520 for contact lenses alone per year.

You’ll also pay for accessories that help you take care of your contacts. These can include contact lens cases, contact lens solutions, and eye drops if you have dry eyes.

We’ll be honest: It’s a little harder to get help paying for contacts compared to eyeglasses when you have vision needs. Because glasses last longer than contacts and can be used and reused from donated materials there are more organizations that may help you get a pair of free or low-cost eyeglasses. However, you can save money on your contacts through these approaches:

• Order online. Many online contact lens retailers offer cost savings compared to ordering at a retail store. Just make sure you’re using a reputable online source. You can also ask your retail store of choice if they will match online prices.
• Purchase an annual supply. Although there’s a hefty upfront cost, purchasing an annual supply of contacts often offers the lowest cost in the end. This is particularly true when ordering from online retailers.
• Check into Medicaid eligibility. Medicaid is a federal and state collaborative program that offers financial assistance for a number of medical costs, including vision and contact lenses. Eligibility is often income-based, and you can check your eligibility or learn how to apply on the Medicaid website.

Safety tip for wearing contact lenses

When you do get your contacts, it’s important that you use them as directed. Wearing them longer than recommended can increase your risk for eye infections, which can be both costly to treat and painful.

• Original Medicare won’t pay for contact lenses unless you’ve just had cataract surgery.
• Medicare Advantage plans may offer vision coverage that pays for all or a portion of your contacts.
• If you qualify, Medicaid may help pay for your contact lenses as well.

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