Health Insurance With Optical Cover

Under Medicare, you’re eligible for a free eye test every three years until you turn 65. From then on, you can enjoy an eye test every year. The catch is you’ll need to visit a bulk-billing optometrist.

Unfortunately, Medicare doesn’t cover new glasses and contact lenses. But each state has a scheme to help subsidise the cost of eyewear for people who need it. Depending on your eligibility, you could be able to have your glasses subsidised or get a concession through your relevant state’s scheme.

In-hospital optical services, like surgery, are also covered by Medicare. However, to be treated as a public patient, you’ll need to attend a public hospital. There, you won’t be able to pick your doctor and you might need to wait a while for your surgery date. FYI: in 2023–24, the median wait time for a cataract extraction was 119 days, with 10% of patients waiting almost a year for their turn.²Australian Institute of Health and Welfare – Elective surgery waiting times 2023–24

Alternatively, if you have appropriate private health insurance, you can skip the queue and use a combination of Medicare and your health insurance fund to cover some of your bill. For private patients in 2023–24, Medicare covered an average of $810 for cataract surgery and $600 for retinal laser surgery, with insurers covering $860 and $640 respectively.³Medical Costs Finder – Cataract surgery; Retinal laser Note: These are the amounts patients typically paid for these services, rounded to the nearest dollar. They do not include hospital payments such as excesses, co-payments, or other payments. These fees may vary depending on your situation. Not all patients had out-of-pocket costs; those who didn’t aren’t included in these figures. Data retrieved August 2025.

Your total bill for a new pair of prescription glasses can certainly vary. Your choice in frames, the lenses you need and any customisation you add on like anti-reflective coating can all bump up the price.

The same goes for contact lenses. Higher-quality contacts and those you can wear for longer periods are likely to cost more.

If you’re concerned about what the cost could be for you, you can always speak to your optical provider to get a quote. Having a more solid figure can help you budget, as well as stick to any optical cover annual limits you’re dealing with.

If you’re happy to go public, you won’t have to pay a thing for your laser eye surgery, thanks to Medicare. However, it may mean waiting awhile, which might not be what you want if you’re already having trouble telling the TV remote from your phone.

With private health insurance, your fund and Medicare could help to cover the costs of your overall bill. In 2023–24, the typical total specialist bill was $1,700, with Medicare covering $600 on average while private health insurance handled $640. For patients who had out-of-pocket costs, these were $310 on average.⁴Medical Costs Finder – Retinal laser Note: These are the amounts patients typically paid for these services, rounded to the nearest dollar. They do not include hospital payments such as excesses, co-payments, or other payments. These fees may vary depending on your situation. Not all patients had out-of-pocket costs; those who didn’t aren’t included in these figures. Data retrieved August 2025. Of course, not all patients had out-of-pocket costs, since everyone’s situation is different.

When you go through the public hospital system, your cataract surgery doesn’t need to cost a thing – it’ll all be covered on Medicare. The bad news is, you could find yourself waiting up to a year to get in the door. If you’d rather get back to clearer vision sooner, you may want to investigate the private system.

By using your private health insurance, once you’ve completed the waiting period, you could be seen sooner at a private hospital. (But keep in mind that if your cataracts are considered a pre-existing condition, you might have to wait for up to a year before you can be treated.)

With hospital cover, your insurer and Medicare will help to foot the bill, but whether you have out-of-pocket costs will depend on your own unique situation. In 2023–24, the typical specialist fees for cataract surgery were $2,100. Just over half of private patients had an out-of-pocket cost, which was $480 on average.⁵Medical Costs Finder – Cataract surgery Note: These are the amounts patients typically paid for these services, rounded to the nearest dollar. They do not include hospital payments such as excesses, co-payments, or other payments. These fees may vary depending on your situation. Not all patients had out-of-pocket costs; those who didn’t aren’t included in these figures. Data retrieved August 2025.