u/Cesar_sensei_418

my mom's 78 and on original medicare. she went for a routine eye exam last week because her glasses are from 2019. the optometrist office charged her $200 upfront and said medicare doesn't pay for "routine refractions" unless there's a medical condition like cataracts or diabetes. she paid it because she's too nice to argue, but now i'm wondering if that's right or if they just took advantage of her.

i thought medicare covered vision? or is that only if you have one of those advantage plans? she doesn't want to switch because she likes her current doctors and i get that, but paying out of pocket for something that feels basic just ticks me off.

has anyone else run into this? did you just pay it, or is there a way to get original medicare to cover annual exams that i'm missing?

my mom’s on original medicare, no advantage plan and went for a routine eye exam last month. the office billed her $180 upfront because they said medicare doesn’t cover "routine refractive exams". only stuff like cataracts or glaucoma screenings if you have a diagnosed condition. she just needed a new glasses prescription. now she’s confused and i’m annoyed because i told her it’d probably be covered.

is that really the rule? i know vision and dental are weird with medicare, but does any part of original medicare kick in for a standard eye exam if there’s no medical red flag? or is she just supposed to eat the cost every year?

she doesn’t want a full advantage plan because she likes her current doctors, but paying out of pocket for basic stuff feels dumb too. what do people usually do here?