Does Medicare Cover Eye Exams?

Does Medicare Cover Vision?

Did you know that Medicare doesn't include vision care? A common misconception is that Original Medicare covers all areas of health care, leading many people to overlook important coverage for their dental, vision, and hearing needs.

To address this gap in Medicare coverage, private insurance carriers offer add-on plans that complement Medicare Supplement and Original Medicare. Dental, vision, and hearing coverage is often grouped together and referred to as “DVH” plans.

Here are the most important factors to consider when looking for a DVH plan for you.

What are the benefits of a DVH plan?

The Centers for Medicare & Medicaid Services (CMS) does not have requirements for dental, vision, and hearing plans. As a result, DVH policies can vary significantly between insurance carriers and levels of coverage.

There are the various levels of coverage that should help you compare different plans:

  • Maximum Benefit / Maximum Allowable Amount: This type of plan puts a limit on what the plan will pay annually. The higher the limit, the higher the cost of the policy’s premium. If you anticipate needing to visit the doctor or dentist more often, you should consider a plan with a higher maximum benefit.
  • Escalating Benefits: Certain carriers encourage policy renewals by increasing your coverage the longer you’re on their plan. In your first year, contact lenses may be covered at 70%, then 80% in your second year, and 90% in your third year. This type of benefit reduces your out-of-pocket costs the longer you renew your policy.
  • Exclusions: DVH policies may exclude pre-existing conditions, meaning the insurer may refuse to cover things like replacement lenses. For example, if your old lenses were broken before your DVH plan started, they may not be covered.

How Much Does a DVH Plan Cost?

DVH plans typically can range between $35 and $75 a month. Depending on which DVH plan you choose, your total costs can come from premiums, deductibles, and/or copays.

If you plan to make several visits to the dentist, eye doctor, or ear doctor throughout the year, it may be more beneficial to pay a higher monthly premium in exchange for lower copays and deductibles. If you only go a few times a year and can handle paying a larger copay if needed, then taking lower premiums could be the way to go.

Think you don’t need vision benefits? Think again.

Eyesight often changes gradually — so gradually that you may not even realize it. Even serious vision problems can develop over time, so you may not notice symptoms in their early stages. You don’t want to be left without coverage when you discover an issue with your eyes!

Through regular visits, eye doctors can detect incremental changes that people miss over time. That's why it's critical to receive an annual eye exam – even if you don’t notice any changes in your vision.

Whether you require vision correction or not, DVH plans help you get eye exams, protect your health, and save money. If you’ve ever needed new glasses or are suddenly experiencing new vision problems, these benefits can play an important role in your peace of mind.

With so many options available, working with United Medicare Advisors can make your research and selection simple and stress-free. Don't let confusion hold you back from getting important health care coverage. Call us today at 1-888-665-9200.

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