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Let's talk Insurance for Eyeglasses and Contact Lenses

Writer: Path 2 Self WellnessPath 2 Self Wellness

Oh boy, is this a great topic.......and even though it is so dreaded and awful, it is absolutely necessary to understand your options to cover your needs.


Medicare - Medicare does not cover eyeglasses. They will cover part of a pair after cataract surgery, but you are hard pressed to find a provider that participates in the program. The program is called "post cataract coverage". When looking for a provider, you must ask if they participate in this plan with Medicare. Once you find one, make sure to know your costs up front, because there isn't much coverage and you do not want to be misled into thinking your selection will be covered completely.


There are options to Medicare for eyeglass coverage. You can get a supplemental or advantage plan that will give you a benefit towards to cost of eyewear. They typically give an allowance for one frame yearly, some plans offer a frame every other year. They also typically offer lenses with different copays and also copays for your lens options such as anti-glare, transitions, thinner lenses. etc.


Private insurance - there are many plans and companies that offer routine vision coverage, some of them are VSP, EyeMed, Davis Vision, Blue View Vision, or Spectera. All of which give coverage for one pair yearly. Typically one frame every other year, and one set of lenses yearly, with copays, of course.


CT Medicaid- this plan typically offers one pair of glasses (certain frame and basic lenses) every other year for adults, and yearly for children under 21. Now, often times, children are eligible for replacements if they have lost or broken their glasses. Just call your eye doctor and ask if they have coverage for replacements, don't let your child go without their glasses.


What do you do if you need more than one pair of glasses yearly, and you only have insurance for one pair? You have to pay out of pocket for the rest. Thankfully, if you have a FSA or HSA, you can use those cards to cover your eyewear. You can shop sales and deals, reuse your own frame, wait until next year when your benefit rolls over again, or shop online.


Soon- Optical will be open at Path2Self Wellness - I am happy and excited to help you with your eyeglass and vision needs. Just bring your prescription in to me and we will chat.



 
 
 

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