What is considered medically necessary for contact lenses?

If contact lenses are the only method that can improve your vision then contact lenses are usually considered as medically necessary. Conditions such as keratoconus, dry eye syndrome, corneal scarring, and irregular astigmatism will qualify for medically necessary contact lens benefits.

Does Medicare cover medically necessary contact lenses?

If you need contacts simply to improve your vision, Medicare generally does not recognize it as medically necessary. Medicare Advantage plans cover at least the same Part A and Part B benefits as Original Medicare, but many offer additional coverage, such as vision and dental services.

What is the difference between medically necessary and elective contacts?

Non-elective contact lenses, also called medically necessary contact lenses, are prescribed by your optometrist to correct these types of eye problems, whereas elective contacts are chosen by the patient to correct an eye condition that eyeglasses or sometimes laser surgery can also correct.

Do contact lens need a prescription?

No, under U.S. law the purchase of all contact lenses requires a valid contact lens prescription written by a qualified eye care practitioner. This includes plano, or “non-prescription,” colored contact lenses or special-effect lenses that are worn for cosmetic purposes only.

Do you need insurance to get contact lenses?

Thankfully, vision insurance can easily be applied to your contact lens purchase. Doctors and online companies allow you to apply your vision insurance right to your account. It may seem like an arduous hassle but only two things are necessary: your contact lens prescription and your vision insurance information.

What are medically necessary contact or glasses?

Medically necessary contact lenses are prescribed to provide vision superior to glasses or soft contact lenses. The higher the prescription in glasses, the quality of vision provided by your glasses can begin to decrease.

Are contact lens exams covered by Medicaid?

In states that opt to provide coverage for optometry services, vision prescription eye exams are covered. Other eye exams covered by Medicaid include routine, comprehensive, and contact lens prescription exams (when deemed medically necessary). Medicaid provides health and vision coverage for qualifying individuals and their families.