Eye Care

Eye Glasses & Contact Lenses
- How Do I Qualify For Eyeglasses or Contact Lenses After Cataract Surgery?
  
  Normally, Medicare doesn't cover eyeglasses or contact lenses. However, following cataract surgery with an intraocular lens, Medicare helps pay for cataract glasses, contact lenses, or intraocular lenses provided by an ophthalmologist. Services provided by an optometrist may be covered if the optometrist is licensed to provide this service in your state.
  
  Important Note:
- Only standard frames are covered.
- Lenses are covered even if you had the surgery before you had Medicare.
- Payment may be made for lenses for both eyes even though cataract surgery involved only one eye.
- Medicare covers glasses or contact lenses for patients who have had cataract surgery and an intraocular lens implant. Medicare will cover these items even if the patient had surgery before Medicare benefits began.
- Medicare will cover one pair of glasses or contact lenses following cataract surgery. Medicare only covers standard frames.
- An order (prescription) must be on file with the supplier. It must be signed and dated by the treating doctor.
- Make sure your supplier is enrolled in Medicare and has a Medicare supplier number. Suppliers have to meet strict standards to qualify for a Medicare supplier number. Medicare won't pay your claim if your supplier does not have a number, even if your supplier is a large chain or department store that sells more than just durable medical equipment (DME).
- After you have paid your yearly deductible, you will pay 20% of the approved Medicare amount for the cost of the eyeglasses or contact lenses.
- You will pay less if you buy from a supplier who accepts assignment. A supplier who accepts assignment has agreed not to charge more than the Medicare allowed amount and will not charge more than the 20% copay.
- If you have a Medigap/Medicare Supplemental policy, you might not pay anything for your supplies.
- If you receive your Medicare through a Medicare Advantage Plan, you may owe little to nothing depending on the plan with which you have signed up and your benefits with the plan.
- It is important to do your homework. Read about the factors that affect how much coverage you will receive. Make sure all paperwork is completed correctly and that you buy your equipment through an approved supplier that accepts assignment.
- It is important to do your homework. Read about the factors that affect how much coverage you will receive. Make sure all paperwork is completed correctly and that you buy your equipment through an approved supplier that accepts assignment.
Prosthesis
- Eye Prostheses
  
  Does Medicare Cover Eye Prostheses?
  
  All eye prostheses for patients with shrinkage or absence of one or both eyes due to a birth defect, eye trauma or surgical removal are covered under Medicare Part B.
  
  There are restrictions that apply to coverage. They include:
- Polishing and resurfacing are covered twice every 12 months.
- Replacements of eye prostheses are covered every five years.
- Replacements needed in less than five years are only covered if the eye prostheses are irreparably damaged, lost, or stolen.
- Enlargements or reductions of the prostheses are covered once without documentation.
- Additional enlargements or reductions are only covered when medically necessary.
- The order for the prostheses must be kept on file with the supplier in the event it needs to be made available to the DMERC.