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Q: Does Insurance Cover Contact Lenses?

Asked by Anonymous on October 11, 2017

Hal Levy October 11, 2017

If you’re wondering whether your health insurance covers contact lenses: it probably doesn’t. Whether you purchased insurance yourself or through an employer, the chances are very slim that your plan will cover contacts. However, your plan may offer a prescription lens discount at select retailers.

Plenty of carriers offer surprisingly affordable vision-only insurance policies that are separate from your main health insurance. These will work like traditional health insurance, but will only cover vision care. You’ll want to compare them to see which one offers the best contact lens coverage.

Medicare, Medicare Supplement, and Medicare Advantage

If you’re covered by Medicare, Original Medicare (Parts A and B) does not cover the cost of contact lenses. If you have have a Medigap plan, there are no Medicare Supplement plans that add vision coverage either.

One exception to this: you may receive contact lenses as a Medicare benefit following cataract surgery or other medically necessary vision procedure.

Some Medicare Advantage plans (Medicare Part C) come with vision insurance. You can see if any Medicare Advantage plans in your area cover contact lenses and exams by using our Medicare Advantage plan comparison tool.

Medicaid

No Medicaid programs cover contact lenses unless they’re medically necessary. However, all but 10 states offer eyeglasses under Medicaid.

Your Medicaid program may have partnered with a vision provider that offers a discount on contact lenses and related eye exams.

Veterans’ Benefits

Contact lenses are only provided to veterans through Veterans Affairs when medically necessary. However, VA-eligible veterans may still qualify for discounts elsewhere.

Flexible Savings Accounts (FSA) + Health Savings Accounts (HSA)

Virtually all medically appropriate vision care qualifies as an eligible FSA or HSA expense. Unlike FSAs, money in your HSA accumulates from year to year, allowing you to save toward the cost.

Taking the Next Steps

Some carriers offer great standalone vision-only care, and different Medicare Advantage plans offer coverage for some vision care. Search our database of individual health insurance plans or look through your Medicare Advantage options to find the right plan for you.

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