Do you need vision insurance if you have Medicare? Eyecare is one area of health seniors may need more of as they age. Unfortunately, most people lose their vision insurance coverage at retirement, which is right when they need it most. This fact leaves Medicare enrollees looking for ways to maintain coverage for eye exams, glasses, and other services.
Continue reading to learn what vision coverage Medicare offers and whether or not seniors should buy separate vision coverage.
Does Medicare Cover Vision?
Medicare recipients considering purchasing vision insurance first need to determine their existing coverage. Vision benefits vary widely between Original Medicare, Medigap, and Medicare Advantage plans. Depending on the type of Medicare coverage elected, seniors may have very few vision benefits or fairly substantial coverage.
Vision Benefits Under Original Medicare
Original Medicare (Parts A and B) does not include coverage for routine eye care, so needs like purchasing glasses or contact lenses would need to be paid for out of pocket. Still, Medicare Part B does cover eye exams for medical conditions, including screenings for diabetic retinopathy and glaucoma for those at risk. Part B will also cover most eye-related surgeries like cataract removal.
Vision Benefits Under Medigap (Medicare Supplement Plans)
Seniors who have Medigap plans (or Medicare supplement plans) also lack coverage for routine vision services. However, depending on the carrier and coverage area, some Medigap plans offer discounts for vision services through partnerships with vision providers.
Vision Benefits Under Medicare Advantage
Seniors should look to Medicare Advantage plans for Medicare vision coverage most similar to employer-sponsored vision insurance plans. Medicare Advantage typically offers additional coverage beyond services covered by Medicare, and vision is one of the most popular add-ons. Vision benefits through Medicare Advantage plans will usually cover routine eye exams, eyeglasses, eyeglass frames, and contact lenses. Notably, the cost-sharing percentages and limitations of the plan will vary between policies. Medicare Advantage vision benefits are included in the plan premium, so there is no additional cost for enrollment.
Stand-Alone Vision Insurance Plans for Seniors
Another option for vision coverage is purchasing an individual vision insurance plan. Seniors can buy a vision policy directly from a carrier and pay a monthly premium for coverage. Vision insurance plans offer the most comprehensive benefits, but are also the most expensive vision benefit option. These plans will have a network of providers, where the beneficiary can use their coverage. For those with an existing relationship with a vision provider, whether or not their doctor is in-network is an essential consideration when purchasing one of these policies.
Vision Discount Cards
Vision discount cards (or vision savings cards) are programs that allow members to access a set discount on vision services by paying an annual membership fee. Like vision insurance, these plans typically have a network of providers. The annual cost for membership in these programs is less than traditional insurance. However, out-of-pocket costs will generally be higher since these plans only offer cost reduction rather than actual coverage.
The need for additional vision insurance is different for every senior. Factors like existing coverage through their Medicare plan, ability to afford out-of-pocket costs for routine services, and specific vision needs will impact whether or not an enrollee would benefit from purchasing additional coverage. For seniors who can save a few hundred dollars a year to cover their vision expenses, vision insurance may not be necessary at all. If you are unsure whether vision insurance is right for you, the best option is to discuss it with a licensed insurance professional.
How Do I Learn More?
For more information about vision coverage, visit American Senior Benefits. Our affiliated agents will be happy to go over your coverage to ensure your unique needs are met.