Will Vision Insurance Cover Glasses? PPO, Medicare & More

Most private vision insurance plans cover glasses, though most have a limit on the amount that will be covered. For example, if you’re purchasing designer frames, you’ll have to pay for the difference in price from standard frames out of pocket.

PPO, HMO, and indemnity vision insurance plans generally offer this coverage. Original Medicare typically does not cover the cost of glasses.

Some providers offer higher-tier benefits plans, which may have a higher limit on the amount that is covered for glasses. In addition, certain add-ons, such as lens protection or UV coating, may be covered under these plans.

How Vision Insurance May Cover Glasses 

Vision plan coverage provides a specific set of benefits and discounts for individuals for an annual or monthly fee (with a possible copay). 

Basic vision insurance plans will typically include some coverage for prescription eyewear, such as one pair of eyeglasses per year. 

More comprehensive vision plans generally expand coverage and include certain specialty options. For instance, comprehensive vision plans might include anti-reflective coating for glasses in addition to photochromic lenses and progressive lenses. 

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Will Medicare Cover Glasses?

Original Medicare does not cover eyeglasses. If a patient needs glasses, they will more than likely end up paying all of the related costs out of their own pocket. But there are some exceptions to this. 

If you need eyeglasses after cataract surgery, the cost is covered under Medicare Part B. You’ll still have to pay 20 percent of the total cost of the glasses, but the bulk of the cost will be covered. 

This covered pair is limited to one pair for your entire life for each cataract surgery you have. Confirm that your eyeglasses provider is a Medicare-enrolled provider prior to purchasing the glasses.

There are also Medicare Advantage plans you can enroll in that have vision coverage, which may help pay for glasses. 

How FSA & HSA Can Offset the Cost of Glasses 

Flexible spending accounts (FSA) and health savings accounts (HSA) generally permit the purchase of prescription eyewear with these funds. However, non-prescription eyewear that is not classified as a medical expense is not covered. 

HSA contributions grow tax-deferred in an account. Individuals can withdraw funds tax-free as long as the funds are for eligible health care expenses. You should be able to pay for glasses or contacts with FSA or HSA funds as long as they are prescription corrective lenses. 

What Vision Plans Cover Glasses?

Standard health insurance plans generally do not offer vision coverage, so you’ll usually need to purchase a separate plan to cover your vision needs.

Among plans offered on the federal Health Insurance Marketplace, all plans for children include vision coverage, while some plans include vision coverage for adults. Standalone vision insurance plans are also available through a range of providers, such as these:

• VSP
• EyeMed
• Ameritas
• Humana
• UnitedHealthcare

Vision insurance plans may be PPO (preferred provider organization), HMO (health maintenance organization), or indemnity insurance plans. 

If you have low vision or compromised vision, it’s a good idea to make sure that your vision insurance plan has the coverage you need.

Costs of Vision Insurance Plans

The cost of vision insurance plans varies depending on the provider and chosen level of coverage. Vision care plans offer different benefits. While some plans only offer minimal services, others are available that cover treatments like eye surgery and even new therapies for vision correction.

Basic vision care packages will generally range from $5 to $35 a month in premiums, which is a smaller cost than medical and dental insurance. Be aware that you will also be responsible for paying copays and deductibles in addition to monthly premiums.

How to Pay for Glasses Without Insurance

If you don’t have vision insurance, there are still ways to offset the cost of glasses. Try these tips:

• New Eyes: This organization offers free eyeglasses to people with low incomes. To apply, you’ll need a prescription from an eye exam within the past two years.
• OneSight: This nonprofit also provides free glasses to people with low incomes. A Red Cross location, school, or church will need to refer you to this program.
• Discount retailers: There are a variety of online retailers offering discount eyeglasses, such as ZenniOptical, GlassesUSA, and EyeBuyDirect. You can find frames for less than $10 and lenses for less than $50 on these sites.

Vision Insurance Glasses Coverage FAQs

How much does insurance cover for prescription glasses? 

The amount covered varies according to the specific vision insurance plan. On average, most insurance plans cover about $150 for frames. If you choose frames that are more expensive than that amount, you’ll pay the difference out of pocket. 

The cost of basic lenses is usually covered. Confirm your specific coverage level with your provider.

How many pairs of glasses does insurance cover? 

Typically, vision insurance plans cover the cost of one pair of glasses per calendar year. Most vision plans also cover the cost of new lenses for glasses every year.

What type of insurance do you need for glasses?

You’ll need vision insurance to cover the cost of glasses. General health insurance doesn’t usually include vision coverage, although it does for children in some cases. You can choose from a PPO, HMO, or indemnity vision insurance plan to get coverage for glasses.

References

1. The Effect of Health Insurance Coverage on Medical Care Utilization and Health Outcomes: Evidence from Medicaid Adult Vision Benefits. (September 2019). Journal of Health Economics.

2. The Influence of Corneal Ablation Patterns on Prediction Error After Cataract Surgery in Post-Myopic-LASIK Eyes. (July 2022). Eye and Vision.

3. Knowledge and Understanding of Health Insurance: Challenges and Remedies. (July 2017). Israel Journal of Health Policy Research.

4. Can I Have a Health Savings Account and Medicare? (June 2022). American Association of Retired Persons.

5. The Impact of Low Vision on Social Function: The Potential Importance of Lost Visual Social Cues. (May 2022). Journal of Optometry.

6. New Therapies of Neovascular AMD Beyond Anti-VEGF Injections. (January 2018). Vision.

7. Vision Coverage. HealthCare.gov.