Medicare, Social Security, and Insurance

5/25/2022 | By Jackie Stewart

Jackie Stewart of Kiplinger’s Personal Finance examines vision care options for retirees, including individual plans, bundled plans, and Medicare Advantage.

Question:

I’m eligible for Medicare now, which doesn’t cover vision care. What insurance options do I have for eye care?

Answer:

Traditional Medicare’s Part B only covers vision care when it’s a medical condition, such as cataracts, dry eye, glaucoma or vision health related to diabetes. Medicare Part B will even pay for a pair of eyeglasses after cataract surgery. But if there’s no underlying medical condition, you’re on your own.

Related: Tips for preventing cataracts

Although you have several ways to get vision coverage, whether it’s cost effective depends on the eyewear you need and your provider because private insurers restrict where you get care.

Here are some vision care options:

Individual plans

Most vision insurance plans cover one eye exam a year, with a fixed dollar allowance going toward eyeglasses or contacts either once a year or once every two years, says Gregg Ratkovic, president of Medicare at eHealth, an online insurance marketplace.

woman having an eye exam. Photo by Gligatron Dreamstime. Jackie Stewart of Kiplinger’s Personal Finance examines vision care options for retirees, including individual plans, bundles plans, and Medicare Advantage.

Monthly premiums range from $11 to $40, and the insurer typically pays either $120 or $150 toward a pair of eyeglasses or contact lenses, says Barbara Davis, principal at consulting firm Health Benefit Advisors in Bluffton, S.C. Most plans will also have copays or deductibles you’ll be responsible for, Ratkovic says.

A low-cost plan may be all you need, and for some people, self-insuring may be more cost-effective. Davis suggests comparing the plan’s annual cost with your estimated vision costs for the year.

She recommends keeping the monthly premium under $17. “That will give you a decent plan that the majority of individuals will find comprehensive enough for their annual needs,” she says. “I wouldn’t get into a $40 plan that has a lot of bells and whistles no one uses.” The main difference between more and less expensive plans are the allowances provided toward eyeglasses and contact lenses.

Related: Is Lasik eye surgery for seniors worthwhile?

Bundled plans

If you have multiple insurance needs, it may be more cost-effective to choose a comprehensive plan that bundles dental, vision, and hearing none of which traditional Medicare or a supplemental Medigap plan covers into one package.

Medicare Advantage

Last year, 99% of beneficiaries in a Medicare Advantage plan had some vision benefits, according to the Kaiser Family Foundation. Almost all of those beneficiaries had the coverage amount capped, at $160 on average. That means the plans only paid for up to $160 of vision care expenses, leaving beneficiaries to shoulder the rest. The majority of these plans also covered one eye exam a year.

© 2022 The Kiplinger Washington Editors, Inc. Distributed by Tribune Content Agency, LLC.

Related: Tips for coping with vision problems

Jackie Stewart

Jackie Stewart is a senior editor at Kiplinger’s Retirement Report. For more on this and similar money topics, visit Kiplinger.com.