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4 Reasons To Get Vision Coverage With Medicare

Woman receiving vision exam

Your sight plays a major role in your overall health and quality of life, so it’s important to pay attention to how your vision changes over the years. Survey data suggests that by the time they hit 71, more than a quarter of U.S. adults have visual impairments that can’t be corrected to 20/20. 

However, Original Medicare — the federally administered health insurance program for U.S. citizens and residents over 65 or who have certain disabilities — doesn’t cover routine eye care. Under Medicare Part B, which is the part of Original Medicare that provides medical insurance, you can receive coverage for only specific services under certain conditions like: 

  • Diagnostic tests and treatment for people living with age-related macular degeneration (a problem in the eye’s retina that causes blurred vision). 
  • Surgery for cataracts (cloudy areas in the eye’s lens).  
  • Screenings every 12 months for people who are considered at high risk for glaucoma (a type of eye condition that damages your eye’s optic nerve and can cause blindness). 

For help with costs of eye exams and prescription glasses or contact lenses, you have a few options:  

  • Purchase standalone vision insurance.  
  • Explore whether there’s a Medicare Supplement plan available to you that offers vision benefits or discounts. Medicare Supplement plans, also called Medigap, are purchased from private insurance carriers and help with out-of-pocket costs not covered by Original Medicare. Certain plans may include additional benefits.  
  • Enroll in a Medicare Advantage plan from a private insurance carrier, which substitutes for Original Medicare. These plans may include coverage for vision and other services like dental and hearing. In 2023, nearly all Medicare Advantage plans featured some vision benefits, according to the health policy nonprofit KFF, but the coverage details and costs vary by plan. 

If you’re considering whether you should find coverage for your eyes, here are four reasons to take a close look at your options. 

1. Keep Your Prescriptions Up to Date 

If you wear glasses or contact lenses, you likely need to update your prescription every few years. Even for people who had excellent vision in the past, regularly checking your eyes becomes especially vital to spot emerging problems as you get older. For example, people over 40 often find it increasingly hard to focus on objects at close range, and they may need more light to read or work.  

By helping with the cost of annual checkups and providing an allowance for glasses or contacts, vision insurance makes it easier to keep up with any changes to your needs. When considering plans, find out how often you can receive a covered exam, your out-of-pocket costs for the visit, and how much money you’ll have available when buying frames, lenses, and contacts. Keep in mind that factors like a strong prescription, certain lens materials, and any protective coatings could drive up your expenses. 

If you’re interested in Lasik eye surgery to correct your vision, you will likely need to cover all or most of the cost out of pocket. Insurance plans don’t generally cover laser surgery unless it’s considered medically necessary. Some vision coverage will provide a discount, however. 

2. Catch Health Issues Early  

Problems with your vision are sometimes warning signs for serious medical conditions. Receiving a professional exam with your eyes dilated at least once a year could reveal issues that you need to address with your primary care provider.  

Some of these health concerns include:  

  • Diabetes sometimes causes a condition called diabetic retinopathy that damages the blood vessels in your eye’s retina and can eventually result in vision loss.
  • Blurry or distorted vision might mean you’re going through macular degeneration. 
  • An inflammation in your optic nerve can be caused by a viral infection, but it is sometimes an early indication of multiple sclerosis. 
  • The autoimmune disorder myasthenia gravis weakens your muscles, including the ones that control your eyes and eyelids, which can make your eyelids droop or cause you to see double.

3. Stay Safe Behind the Wheel

According to the Centers for Disease Control and Prevention (CDC), 20 U.S. adults over 65 die in car crashes every day, and another 540 are injured. Age-related change to your vision may be among the factors that make it more difficult and dangerous to drive: 

  • You may have a harder time seeing at night or in other low-light conditions. 
  • You might struggle to cope with glare from the sun, approaching headlights, or streetlights. 
  • You may not be able to read street signs, the gauges on your dashboard, or GPS directions as easily. 

By getting your eyes checked regularly and ensuring you have a current prescription, you can avoid putting yourself, passengers, and others on the road at risk. If necessary, you’ll be able to identify dangers and take appropriate precautions, such as not driving at night or around sunrise. 

4. Protect Your Mental Health 

Impaired vision can affect you psychologically and emotionally as well as physically. A report from the CDC found that, among adults who had difficulty seeing even with glasses or contacts, a quarter reported feeling psychological distress. Living with the challenges of vision loss can make people fearful, anxious, and lonely. 

Meanwhile, patients who are undergoing mental health treatment should be on the lookout for potential side effects in the eyes from their psychiatric medications. For example, certain antipsychotics may cause damage to the retina when taken in high doses or lead to cataracts over a long period of time. 

Taking proactive steps to care for your eyes can make a real difference in your overall well-being. If you’re currently on Medicare or will become eligible soon, make sure to consider your vision when making decisions about your coverage. 

About GoHealth 

GoHealth is a leading health insurance marketplace and Medicare-focused digital health company. Enrolling in a health insurance plan can be confusing for customers, and the seemingly small differences between plans can lead to significant out-of-pocket costs or lack of access to critical medicines and even providers. GoHealth combines cutting-edge technology, data science, and deep industry expertise to build trusted relationships with consumers and match them with the healthcare policy and carrier that is right for them. Since its inception, GoHealth has enrolled millions of people in Medicare plans and individual and family plans. For more information, visit GoHealth.com.