Turning 50 often brings shifting eyesight and rising healthcare expenses, yet original Medicare leaves older Americans completely on their own for routine vision care, glasses and contact lenses.
In a recent Retirement Coaches Association survey of 115 professional retirement coaches conducted in partnership with VSP Individual Vision Plans, 96% said poor vision can significantly threaten retirees’ independence and quality of life. Another 61% reported seeing clients scale back daily routines or social activities because of vision-related concerns. As with hearing loss , vision loss is a risk factor for developing dementia, according to the American Optometric Association .
The good news is that, with some research and planning, you can protect your eyesight without breaking the bank.
Standalone vision plans exist
The fact that original Medicare won’t pay for routine eye exams or glasses can be a huge blow for older Americans. But that doesn’t mean vision insurance is off the table.
Bob Laura , founder of the Retirement Coaches Association, says standalone vision plans exist for retirees.
“For individuals who need additional coverage beyond Medicare or employer-sponsored benefits, these plans are worth evaluating as part of an overall retirement budget,” he says. However, he continues, “Whether one provides value depends on an individual’s existing coverage, anticipated vision care needs, and potential out-of-pocket costs.”
Laura says many retirees value the combination of predictable healthcare costs , coverage for routine eye exams and eyewear, and access to a network of eye care professionals. It may be worth paying a premium for standalone coverage if that makes other vision-related costs easier to anticipate.
Dr. Don C. Railsback, O.D., CEO of Vision Care Direct , agrees: “The best way to determine a plan’s real value is to look beyond the monthly cost and see how it will benefit you annually.”
As he explains, some of the most expensive parts of vision care are exam fees and prescriptions.
“You should factor in the monthly fee, the exam copay, allowance for frames and lenses, and whether the plan covers any lens upgrades you might need,” Railsback says. “Most people over 50 need multifocal lenses, and a lot of plans will have set rates for progressives that can end up saving you money.”
Just as importantly, Railsback says, vision insurance encourages people to keep up with annual exams, which is key to catching issues before they threaten vision.
“When the exam is already paid for, people are more likely to go,” he says. “That’s how conditions get caught early, giving you more treatment options before it’s too far gone and your only options are expensive ones.”
Don’t bank too heavily on warehouse club discounts
Given the high cost of eyeglasses, you may be inclined to turn to a warehouse club like Costco for affordable eyewear. Railsback says that while that may be a way to get inexpensive glasses, you risk overlooking eye health issues if you take that approach.
“It’s important to remember that retail settings are built around selling products. Their primary goal is making sales,” he says.
“An independent eye care practice is there for one reason — caring for your eyes,” he continues. “Your eye exam should be focused on catching health issues and not just how well you can see. A quick check to simply update your prescription is not the same thing.”
Railsback notes that as people age, the risk of glaucoma, cataracts, macular degeneration, and diabetic eye disease can increase. He says these are typically first noticed during a comprehensive eye exam.
That doesn’t mean you should necessarily write off warehouse clubs or retail chains. Their optometrists are fully licensed Doctors of Optometry who perform standard dilated health screenings. However, they often lack equipment for more specialized diagnostics, so you may want to see an independent doctor, especially as you age.
Medicare Advantage may be an option
While original Medicare typically doesn’t cover eye exams and eyeglasses, Medicare Advantage plans often include vision benefits. But coverage can vary.
“Plans may offer limited allowances, network restrictions, or other benefit restrictions,” says Laura. “Gaps in coverage can lead to retirees postponing or skipping care altogether, potentially continuing to experience vision concerns that can affect everyday activities and independence.”
Railsback notes that for people with original Medicare, Medigap plans may help cover the cost for services it covers, including the 20% coinsurance for cataract surgery or glaucoma treatment.
“If you don’t have a Medigap policy, a standalone vision plan can be a better way to save money and make some of these things more affordable,” he says. These standalone vision plans, however, only cover hardware and routine exams, while Medigap or Medicare Advantage can cap out-of-pocket costs for medical eye conditions.
Don’t overlook the importance of routine care
Enrollees in original Medicare are often eligible for some coverage once an eye condition is suspected or diagnosed. As Railsback explains, Medicare typically covers an annual diabetic eye exam for people with diabetes, yearly glaucoma screenings for people at high risk, diagnosis and treatment of age-related macular degeneration, and cataract surgery. These services are typically subject to coinsurance and Medicare Part B’s annual deductible .
But as crucial as these services are, Railsback says, routine care is needed to get ahead of these issues.
“Routine eye care includes an annual wellness exam that checks for health problems,” he says. “An eye exam is also the only time doctors can see blood vessels and nerves directly without surgery, allowing them to spot signs of diabetes, high blood pressure, and other systemic issues outside of eye diseases. It’s during this exam when a lot of people first learn about a serious health issue.”
Railsback insists that routine and medical eye care need to work together.
“Annual preventive exams help catch problems early. Medicare helps pay to treat them,” he says.
Compare vision care costs and options
To get a sense of how much you might pay for eye exams and glasses, here’s a comparison chart. Note that figures are estimates and can vary based on location and other factors.
Options
Routine Eye Exam
Prescription Glasses and Lenses
Medical Eye Care (e.g., Cataracts, Glaucoma)
Typical Premium
Points to Consider
No Vision Insurance
Retail or warehouse club: $69 – $130
Independent Clinic: $100 – $250+
Costco: $75+
Warby Parker: $95+
Traditional Optical Shop: $350, but can be more or less
Fully out-of-pocket unless covered by Medicare Part B
$0 fixed premium
High flexibility; best if you don’t buy new frames yearly or prefer discount retailers
Standalone Vision Insurance
$15 copay
$106+ for single vision, $256+ for progressive
Routine care covered; medical issues typically paid for by Medicare Part B
$204+ annual
Predictable routine costs
Medicare Advantage
Often $0 copay for a single annual routine exam
Annual hardware allowance, typically $100 to $400
Covered under plan’s medical benefits (subject to plan copays and deductibles).
$168 annual for Medicare Advantage; enrollees must also pay for Medicare Part B
All-in-one coverage, but restricted to network providers and plan-specific caps
Original Medicare (Part B)
$0 coverage for routine exams
$0 coverage (except for one pair of standard glasses after cataract surgery)
Medicare pays 80% after deductible; enrollees pay 20% coinsurance.
$202.90 monthly for standard premium
Coverage for major eye issues, but no eye exam or vision coverage
Discount & Community Alternatives
$0+ depending on program
Discounted frames (varies)
Potentially $0 or sliding scale fees
$0 or low-cost membership fees
Safety net for lower-income and budget-conscious people; some programs require that eligibility be met
It’s crucial to do your own research based on your location and specific eye-related needs, and compare plan allowances before enrolling. Whether you buy a standalone insurance policy or set aside funds in a health savings account (HSA) , a clear vision plan helps you keep up with overall eye care.
Read More
Average Cost of Healthcare by Age and US State
In Your 50s? We Need to Talk About Long-Term Care
Is a Medicare Advantage Plan Right for You?
