Original Medicare (Parts A and B) does not cover routine vision care, such as eye exams for prescription glasses and contact lenses. However, Part B does cover eye care specifically related to medical conditions. For example, if you have diabetes, Medicare will cover an annual eye exam for diabetic retinopathy or to screen for glaucoma. Because cataracts—cloudy areas that form in your eye’s lens—can lead to vision loss, they are categorized as a medical condition. Part B will pay 80 percent of the approved Medicare amount for surgery to remove the cataract and replace your lens with an intraocular lens—a small, clear disk that helps your eye focus. After surgery, Part B will cover one pair of eyeglasses or contact lenses. If you require separate cataract surgery for each eye, this service will be covered twice.

To order your Part B-covered glasses or contact lenses after surgery, you must use a Medicare-approved supplier. You can search medicare.gov/supplier to find one near you. Unless you have supplemental coverage, you will pay the standard 20 percent coinsurance and deductible in Part B for these services.

Medicare Advantage plans must cover cataract surgery, and they may offer nonmedical vision care as well. In 2024, virtually all MA plans provide some sort of benefit related to routine eye exams and eyewear. Check with your plan to understand the costs and what’s covered.

The income-related monthly adjustment amount, or IRMAA, is an additional monthly charge that people with high incomes pay for Part B and Part D coverage. In 2024, IRMAA ranges from an extra $69.90 to $419.30 a month on top of the standard $174.70 Part B premium, and an extra $12.90 to $81 per month added to the Part D prescription drug plan premium.

IRMAA is based on the modified adjusted gross income (MAGI) amount from your tax return two years prior (so, for 2024, it is based on your 2022 return). You will receive a letter from Social Security if IRMAA applies to your Medicare coverage.

You can appeal the IRMAA determination if your income has changed from what it was two years ago. You’ll need proof, such as a more recent tax return or other evidence of a life-changing event, such as the death of a spouse or divorce. Call Social Security at 800-772-1213 or visit ssa.gov/forms to download form SSA-44 to file an appeal.

Remember that, unlike late enrollment penalties, which last as long as you have Medicare, IRMAA is not permanent. Each fall, Social Security uses updated IRS tax information to redetermine who is subject to IRMAA. So even if you must pay the extra amount in a given year, you may not have to in later years if your income decreases.