November 03, 2017
If you’re currently enrolled in Original Medicare, you may not realize that you’re not covered for routine vision services, such as yearly eye exams, glasses, or contacts. Without coverage, paying out of pocket for these services may quickly add up.
Does Original Medicare cover routine vision?
As mentioned, Original Medicare generally doesn’t cover routine vision services. You may be covered for certain preventive vision screenings or diagnostic exams if you meet certain eligibility requirements. For example, Medicare covers glaucoma screenings as a preventive service if you have a high risk for the disease and meet eligibility criteria. However, in most cases, you aren’t covered for most routine vision care, such as:
- Annual eye exams
- Fittings for glasses or contacts
Except in specific instances, you will usually pay the full cost for vision care unless you have other coverage.
The good news is that vision coverage is available to Medicare beneficiaries through many Medicare Advantage plans. As a Medicare-contracted private insurance company, Humana offers a wide range of Medicare Advantage plans to fit different needs and budgets. Here’s an overview of how you may be eligible to get vision benefits through a Humana Medicare Advantage plan.
Do Medicare plans from Humana cover vision?
Routine vision benefits may be included through some Medicare Advantage plans from Humana. Medicare Advantage, also known as Part C, is another way to get your Medicare Part A and Part B benefits. The difference is that instead of getting your Original Medicare coverage through the federal Medicare program, you’ll get them directly through a Medicare Advantage plan.
Humana’s Medicare Advantage plans, like all Medicare Advantage plans, are required to cover at least the same level of benefits as Original Medicare (except for hospice, which is still covered through Part A). However, they also may offer the option to get additional coverage for some benefits normally not covered by Original Medicare, including prescription drug benefits, hearing, and routine vision or dental benefits. Not every Medicare Advantage plan includes routine vision coverage, so if this is a benefit you’re interested in, make sure to enroll in a plan that includes it.
Remember that if you decide to enroll in one of Humana’s Medicare Advantage plans, you’ll still be responsible for paying the Part B premium, in addition to any premium required by the plan. You may have other plan costs, such as copayments, coinsurance, or deductibles. Depending on the type of plan, you may need to use certain network providers to be covered for vision services. Always make sure you understand and follow the rules of the plan.
How does vision coverage with a Medicare Advantage plan from Humana work?
Humana offers optional plans, known as Optional Supplemental Benefits (OSBs) that can be added to certain Medicare Advantage plans.. This includes an optional vision benefit, known as MyOption Vision, which covers routine vision costs like annual eye exams, glasses, frames, lenses, contacts, and discounts on vision care. When getting vision services, you may be required to use certain providers to be covered by the plan.
Keep in mind that specific benefits may vary by location and may change from year to year. Also, please note that these optional benefits may not be available in every location, so it’s important to browse Humana’s Medicare Advantage plan options for your specific service area and zip code.
If you’re ready to learn more and find a Medicare Advantage plan from Humana that covers vision, you can start browsing by entering your zip code into the tool on this page. For more personalized assistance, you are welcome to speak with an eHealth licensed insurance agent about Medicare plans from Humana: call 1- 888-323-1149, TTY users dial 711. Monday through Friday, 8AM to 8PM ET.
*Out-of-network/non-contracted providers are under no obligation to treat Humana members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
Humana is a Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal.
You must continue to pay your Medicare Part B premium.
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums, and/or member cost-share may change on January 1 of each year.
Humana MyOption optional supplemental benefits (OSB) are only available to members of certain Humana Medicare Advantage (MA) plans. Members of Humana plans that offer OSBs may enroll in OSBs throughout the year. Benefits may change on January 1st each year.
Enrollees must use network providers for specific OSBs when stated in the Evidence of Coverage (EOC); otherwise, covered services may be received from non-network providers at a higher cost.
Enrollees must continue to pay the Medicare Part B premium, their Humana plan premium, and the OSB premium.
Last Updated: 11/3/2017