Because Medicare Part B doesn’t cover vision care, you will need to look for other options to obtain the right insurance. Here are some guidelines.
According to the Centers for Disease Control and Prevention, more than 12 million people aged 40 and over have vision impairment. As the baby boomers age, this number will likely double by 2050. Gregg Ratkovic is president of Medicare at eHealth. He says that vision acuity declines as we age. “That’s normal and that’s why vision insurance [is] for].
Traditional Medicare Part B covers only vision care if it is a medical condition such as dry eye, cataracts, glaucoma, or vision health related with diabetes. After cataract surgery, Medicare Part B will pay for eyeglasses. If there is no underlying medical condition, however, you are on your own. There are many options for vision coverage. However, the cost of your vision coverage will depend on what eyewear you wear and how much you pay. Private insurers have restrictions about where you can get care.
Ratkovic states that most vision insurance plans cover an eye exam once per year. A fixed dollar allowance is available to pay for eyeglasses and contacts once a year or twice a year. An optometrist, or an ophthalmologist, will perform the eye exam. This comprehensive examination can screen for all conditions that could cause reduced vision, according to Dr. Michael Repka at the Wilmer Eye Institute’s Baltimore medical school.
Monthly premiums can range from $11-$40 and the insurer usually pays $120 to $150 towards a pair of contact lenses or eyeglasses, according to Barbara Davis, principal at Health Benefit Advisors, Bluffton, S.C. Ratkovic states that most plans have copays and deductibles. Davis states that vision plans don’t require you to wait before benefits start. However, some plans may require you pay premiums for a period of time, up to one year.
It may be cheaper to have a comprehensive plan that covers all your insurance needs. DVH plans are $30-$45 per month, do not require a waiting period for vision or dental preventive care, and typically delay hearing coverage or major dental services until the second calendar year. This is according to Elite Insurance Partners (the insurance brokerage behind MedicareFAQ).
The plans typically offer graduated coverage for vision care. In the first year, the insurer will typically cover 60% of the cost of eyewear and eye exams. The second year will cover 70% of the costs. The third year covers 80%. MedicareFAQ states that the maximum amount of coverage is $200. DVH plans can only be offered in some states.
According to the Kaiser Family Foundation, nearly 99% of Medicare Advantage beneficiaries had vision benefits last year. Nearly all beneficiaries had their coverage cap set at $160. This means that the plans paid only $160 for vision care expenses. Beneficiaries are responsible for the remainder. A majority of these plans covered only one eye exam per year.