Vision Coverage Explained

Vision is an aspect of Medicare that lacks coverage. Medicare does not cover glasses or contacts, and unless you have an eye disease, Medicare will not cover eye exams. Medicare Advantage (Part C) plans will fill in these gaps, but if on a Medigap plan (Plan N/G/F) you will pay out of pocket. 

On average, without insurance, a person will pay:

• $95 for the annual eye exam

• $335/year for contacts

• $200 for frames

• $70 for lenses

So, how do these out-of-pocket expenses compare to what you would pay with vision insurance? On average the most basic vision insurance will cost between $5 and $15 each month. With this basic coverage, annual eye exams can cost between $0 and $15 with discounts toward contacts, frames, and lenses. Discounts are typically 35% for frames, 15% for contacts, and a general copay of $70 for lenses. Some plans will have an allowance of $100 to $200 for frames and lenses rather than discounts. 

To put this in perspective, annual costs for a person with stand-alone vision insurance will be about:

• $60/yr for plan (minimum)

• $15 for annual eye exam

• $323/yr for contacts

• $130 for frames

• $70 for lenses

With Medicare Advantage plans, where vision is included, annual eye exams are typically $0 and there is an allowance of about $100 to $200 for frames, lenses, and contacts. 

*These are the overall average cost but can vary depending on the type of frames, contacts, and lenses that you use. 

Sources:

https://www.visioncenter.org/blog/eye-exam-without-insurance/

https://www.visioncenter.org/contacts/cost/

https://www.visioncenter.org/eyeglasses/cost/

https://www.visioncenter.org/eyeglasses/cost/