Does Medicare Cover Scleral Lenses?
Fair Square Medicare

Does Medicare Cover Scleral Lenses?

scleral lenses

By Daniel Petkevich

Dec 5, 2022

Typically not but there are exceptions

Typically, scleral lenses are not covered by Medicare. There might be some circumstances when your doctor deems them medically necessary, in which case you would get coverage. And there might be some Medicare plans that offer extra vision coverage. Read more to find out which plans might provide coverage.

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What are Scleral Lenses?

Scleral lenses are large, custom-made contact lenses designed to rest on the white part of your eye (the sclera). They have a comfortable fit and are used to treat conditions such as dry eyes, keratoconus, and post-surgical complications.

How do Scleral Lenses work?

Scleral lenses are different from regular contact lenses. Instead of fitting on the cornea, they rest on the sclera, which helps provide a more comfortable fit and better vision stability for those with complex eye conditions. The back surface of these lenses is designed to vault over the entire corneal surface and provides a tear-filled space between the lens and the eye. This helps to keep the cornea well-hydrated and comfortable all day long.

What are the benefits of using Scleral Lenses?

The use of scleral lenses allows for better vision and comfort in people with certain eye conditions. They also provide superior protection against infections and irritations, as the vaulting over the corneal surface helps to protect it from dust and debris. Additionally, these lenses can help reduce or eliminate other symptoms like dryness and light sensitivity.

Does Medicare cover Scleral Lenses?

Medicare does not currently cover scleral lenses. However, you might get coverage if your doctor says that your scleral lenses are medically necessary. Some Medicare Advantage plans may provide coverage for these specialized lenses. Be sure to check with your provider to see if there are any available benefits for you. Additionally, many eye care centers offer financial assistance programs or payment plans that can help make scleral lenses more accessible and affordable.

If you have any questions about scleral lenses and whether or not your insurance will cover them, don’t hesitate to reach out to your eye care provider for more information. They can help you explore all your options to get the best possible vision care for your unique needs.

How to get a prescription for Scleral Lenses?

If you think scleral lenses are right for you, it’s important to start by getting a comprehensive eye exam from an optometrist or ophthalmologist. They will be able to assess your vision needs and provide you with a prescription for the appropriate type of lens.

Once the doctor has recommended scleral lenses, you’ll need to get a fitting with an experienced contact lens specialist. This is important since scleral lenses are custom made and require a precise fit for the best vision and comfort. During the fitting process, your eye care professional will measure your eyes, evaluate your vision needs, and make necessary adjustments to ensure that the lenses fit properly.

Where to find affordable Scleral Lenses?

If you’re looking for more affordable scleral lenses, there are a few options available. Many eye care centers offer discounts and payment plans that can help make these lenses more accessible and affordable. You can also ask your provider if they accept any insurance or discount programs that could help reduce the cost of your lenses. Finally, you may be able to find scleral lenses online from certain retailers. However, it’s important to make sure that the lenses you purchase are of good quality and are properly fitted by a qualified eye care professional.

Takeaway

Medicare does not currently cover scleral lenses; however, some Medicare Advantage plans may provide coverage. To see if scleral lenses are right for you, have a conversation with your doctor or optometrist. This content is for informational purposes only. For questions about your Medicare plan, give us a call at Fair Square Medicare.

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Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.


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