Hydrophilic Contact Lenses

Hydrophilic contact lenses are generally excluded from Medicare coverage as they are treated as eyeglasses under §1862(a)(7), and are not covered for non-diseased eyes to correct spherical ametropia, refractive astigmatism, or corneal astigmatism. Coverage is available when lenses are prescribed as a prosthetic device for aphakia, and may also be allowed when used as a corneal bandage per §80.1; contractors may accept an FDA approval letter or FDA-published material as evidence of approval.

"Hydrophilic contact lenses are payable under the prosthetic device benefit when prescribed for an aphakic patient."

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