Important Medicare benefit updates

December 2024

New Medicare benefits go into effect Jan. 1, 2025, across all states, with expanded coverage in additional counties in Colorado, Idaho, Illinois, Kansas, Michigan, Mississippi, Montana, North Carolina, Oklahoma, Oregon, South Dakota and Utah.

Key updates

  • Exam, frame and lens frequencies: Updates have been made to exam, frame and lens frequency schedules
  • Frame allowances: Depending on a member’s product enrollment, frame allowances will range between $100 and $550
  • Lens coverage:
    • For non-D-SNP (Dual-Eligible Special Needs Plans) members, standard lenses are covered in full, all other lenses are covered at set copays
    • For D-SNP members, standard lenses are fully covered
  • Lens options: Members will pay the full retail cost for any lens options beyond the standard coverage

Important action

Remember to check member eligibility and specific benefit details before rendering services, as these updates may vary depending on the member’s enrollment plan.

Questions?

Please reach out to Customer Service at 800-638-3120.