It is one of the most common misunderstandings in Australian healthcare. Many patients arrive at our Auburn clinic expecting Medicare to cover their new glasses or contact lenses, the same way it covered their eye test. Unfortunately, that is not how the system works.
The short answer is: Medicare covers the eye examination. It does not cover glasses, frames, lenses, or contact lenses. Here is a clear breakdown of what is covered, what is not, and what your options are.
What Medicare Does Cover at the Optometrist
Medicare covers the clinical consultation, the eye test itself. At Prime Optometrists Auburn, we bulk bill all eligible patients, which means the examination costs you nothing out of pocket. This includes the full assessment of your vision, eye health, eye pressure, and screening for conditions like glaucoma and macular degeneration.
For a full explanation of who qualifies and how often, read our guide to bulk billed eye tests in Australia.
What Medicare Does NOT Cover
Medicare does not contribute toward any of the following:
- Spectacle frames
- Prescription lenses (single vision, bifocal, or progressive)
- Prescription sunglasses
- Contact lenses (daily, monthly, or extended wear)
- Contact lens fitting fees
- Lens coatings such as anti-reflection or blue light filter
These costs are entirely separate from the bulk-billed consultation and are not part of the Medicare Benefits Schedule for optometry.
So How Do People Pay for Glasses and Contact Lenses?
Private Health Fund Optical Extras
For most Australians, private health fund optical extras are the primary way to offset the cost of glasses and contact lenses. Most mid-level and top-tier extras policies include an optical benefit that resets annually, typically on 1 January.
Depending on your fund and tier, this benefit usually ranges from around $150 to $300 per year toward frames and lenses, and can often be used for contact lenses and fitting fees as well. At Prime Optometrists, we have HICAPS on site, so you can claim your benefit instantly at the time of purchase. No paperwork, no waiting.
We accept all major funds including BUPA, Medibank, HCF, NIB, AHM, CBHS, Teachers Health, and Police Health, among others.
For tips on getting the most from your optical benefit, read: How to Use Your Health Fund for Glasses Before It Resets
No-Gap Glasses
At Prime Optometrists Auburn, we offer no-gap glasses options. This means that if your health fund optical benefit covers the full cost of a selected frame and lens package, you pay nothing out of pocket. Not every frame in our range qualifies, but we will always show you what is available within your benefit before you choose.
Paying Without Private Health Insurance
If you do not have private health extras cover, you pay for glasses or contacts directly. Prices vary depending on frame choice and prescription complexity. We will always walk you through your options clearly and transparently, with no pressure to spend more than you need to.
The NSW Spectacle Subsidy Scheme
If you hold a current Pensioner Concession Card, Health Care Card, or another qualifying government concession card, you may be eligible for the NSW Government Spectacle Subsidy Scheme. This provides a set subsidy toward the cost of a pair of prescription glasses each two years. The subsidy does not cover the full cost of frames and lenses in most cases, but it does reduce the out-of-pocket amount significantly for eligible patients.
Ask us at your appointment whether you qualify. We will check your eligibility and apply the subsidy directly if you do.
Department of Veterans' Affairs (DVA)
Eligible veterans and war widows holding a DVA Gold or White Card may have glasses and contact lenses covered through the Department of Veterans' Affairs, subject to clinical need and DVA approval. If you hold a DVA card, let us know when booking and we will confirm what applies to your situation.
Can I Use My Health Fund and Medicare Together?
Yes, and this is actually the most common scenario at our clinic. Medicare bulk bills the eye test at no cost to you. Your health fund then covers part or all of your glasses or contact lenses at the same visit. The two benefits cover different things entirely, so there is no conflict between them.
For a full explanation of how this works in practice, read our guide: Can I Use My Health Fund AND Medicare for an Eye Test?
Book Your Bulk Billed Eye Test in Auburn NSW
At Prime Optometrists Auburn, your eye test is bulk billed with a valid Medicare card. We stock a wide range of frames and lenses to suit every budget, and our HICAPS terminal means health fund claims are processed on the spot.
Book your appointment online or call us on (02) 9761 0005. We see patients from Auburn, Lidcombe, Berala, Granville, Parramatta, and Merrylands. No referral needed.