What to know about UnitedHealthcare’s Medicare plans and vision coverage
UnitedHealthcare Medicare Advantage plans typically include coverage for vision care, such as routine eye exams and prescription glasses or contact lenses. There may be some out-of-pocket costs to consider.
The Centers for Disease Control and Prevention (CDC) reports that 93 million adults in the United States are at high risk for vision loss and predicts that over 8 million people over 40 will experience uncorrectable vision impairment by 2050.
Regular vision care helps prevent common eye diseases, including cataracts, diabetic retinopathy, and glaucoma, from causing permanent vision problems. The ability to see clearly is important for well-being.
This article explores the vision coverage that UnitedHealthcare (UHC) Medicare Advantage plans provide and the costs.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
UHC coverage
This article originally appeared on Medical News Today
Original Medicare coverage does not extend to routine vision care. Usually, it covers the diagnosis and treatment of eye diseases and injuries but does not cover routine exams or eyewear.
UHC Medicare Advantage plans offer vision and eye benefits that vary depending on plan type and a person’s location.
There are several types of Medicare Advantage plans. If an individual would like to join a UHC Medicare Advantage plan, they can choose from the following:
Vision coverage may include:
annual routine eye examination
allowance for eyeglass frames and prescription lenses
contact lenses
yearly diabetic retinal exams
Not all plans are available in all areas. To find UHC plans in a particular area, a person can search by their zip code in the UHC plan finder.
Alternatively, the Medicare plan finder tool will provide options, costs, and the plan providers’ contact information for all available plans in a person’s zip code.
For people with diabetes, Original Medicare Part B covers an annual eye exam for diabetic retinopathy. It also covers glaucoma screenings for high risk individuals.
Costs
When someone joins a UHC Medicare Advantage plan, they must pay certain costs, including both the Medicare Part B premium of $185 and the UHC monthly premium. If applicable, people must also pay a Medicare Part A premium of up to $518.
Deductibles, copayments, and coinsurance are also payable, but these costs differ by plan.
For example, for a person living in zip code 90210, Los Angeles, CA, the 2025 costs of the AARP Medicare Advantage from UHC (HMO-POS) plan are:
$0 monthly premium
$0 deductible
$0 specialist copay
$800 out-of-pocket maximum
Vision benefits and costs of this plan include:
one eye exam per year with a $0 copayment
up to $300 for frames or contact lenses every 2 years with a $0 copayment
full coverage for standard single, bifocal, trifocal, or progressive lenses
Different eye exams covered by Medicare
Comprehensive eye exams are the cornerstone of eye care. Regular eyesight tests to check for vision and eye conditions allow an eye doctor to catch signs and symptoms early.
The eye doctor can perform a vision exam with the pupil undilated or dilated. This exam may involve a range of tests, including:
a visual acuity test to determine how well someone can read an eye chart from 20 feet away
a gonioscopy, which uses a mirrored lens to examine the eye’s drainage angle
a visual field test, which measures peripheral vision and can indicate glaucoma risk
a tonometry, to measure the eye’s internal pressure, which can show glaucoma
a dilation test, in which the eye doctor uses medicated eye drops to increase the pupil’s size, allowing them to look at the back of the eye to see the retina, macula, and optic nerve
Dilation tests are particularly critical in preventing and treating eye conditions that could cause vision loss. These conditions include:
diabetic retinopathy
If a person needs vision correction, the eye doctor may perform a refraction test using different-strength lenses to determine the prescription needed for clear vision.
Other vision services that someone might need include:
cataract surgery
eye prostheses
ocular photodynamic therapy, for people with age-related macular degeneration
medications for infections or allergies that affect the eyes
Other benefits
UHC Medicare Advantage plans offer coverage beyond Original Medicare, in addition to their vision services. Each plan provides different benefits, but these may include:
prescription drug coverage
dental coverage
hearing coverage
online cognitive health program
By reading the details of different plans, a person can be confident in selecting the plan that best suits their healthcare needs.
Help with costs
Medicaid and Medigap may help someone pay their healthcare costs.
Medicaid
This joint state and federal program may help people with limited resources and income. Each state administers its Medicaid program differently, but they all use criteria that include a household’s income and assets.
The Medicaid website has eligibility and contact information that may help a person needing additional support.
Medigap
Instead of Medicare Advantage, if an individual has Original Medicare, they may prefer to enroll in Medigap supplementary health insurance. This helps pay out-of-pocket expenses that Original Medicare does not cover, such as copayments, deductibles, and coinsurance.
Private insurance companies, including UHC, offer 10 plans with varying coverage levels, although new enrollees may only choose from eight plans.
The plans cover the costs associated with cataract surgery and serious vision problems, but Medigap does not cover the routine costs of eye exams, eyeglasses, and contact lenses.
Medigap plans also commonly cover emergency medical treatment outside of the U.S.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Summary
UnitedHealthcare Medicare Advantage plans usually cover vision and eye care services.
Depending on a person’s chosen plan, coverage may be the same as Original Medicare or include comprehensive cover for eyewear and routine eye examinations.
A person can use Medicare’s plan finder tool to see the Medicare Advantage plans that UnitedHealthcare and other private insurers offer in their area.
View the original article on Medical News Today
