Senior Eye Care and Medicare


 

In most cases Seniors become eligible for Medicare after the age of 65 and a commonly asked question of Eye Doctors is Does Medicare cover eye exams and vision care? The answer is that under Medicare (parts A and B), routine eye exams and eyeglasses are not covered items but certain parts of common Senior Eye Care are covered by Medicare. If, however, the patient has a diagnosed condition then some types of eye exams may be covered. For those with Medicare Advantage Plans some form of vision benefits are likely.

What Senior Eyecare Treatments does Medicare (A/B) Cover?

Diabetes: Diabetic Retinopathy is the leading cause of blindness among adults and is the most common eye complication in diabetic patients. Eye Doctors can detect this condition by performing a comprehensive eye exam and this is the key to slow the progression and early detection. If a patient is diagnosed with Diabetes, Medicare will cover eye exams to detect diabetic retinopathy once per year.

Glaucoma: Glaucoma is the name for a group of eye diseases that develop when increased fluid pressure in the eyes damages the nerve fibers in the optic nerve and retina. This damage can lead to irreversible vision loss.  The good news is if glaucoma is detected and treated early, its progression can be slowed or stopped. Medicare covers tests for glaucoma once every 12 months if the patient is at a high risk for developing glaucoma. High risk includes:

  • Family history of glaucoma
  • Diagnosed with Diabetes
  • Hispanic and aged 65 or older
  • African American and aged 50 or older

Macular Degeneration: Simply described as blurred vision—is a leading cause of vision loss among people 50 and older, affecting more than 10 million Americans.  Age-related macular degeneration (AMD) is a disease associated with aging that can gradually destroy sharp, central vision. Central vision is needed for seeing objects clearly and for common daily tasks such as reading and driving. If the Macular Degeneration is related to aging, Medicare may cover some diagnostic tests and treatments such as eye injections.

Cataracts: Cataracts are the leading cause of vision loss in the United States each year and are most commonly treated with surgery. Over 3.5 million cataract surgeries are performed every year making it the most common surgical procedure. A cataract is the clouding of the eye’s internal focusing lens. If the lens is clouded, light is scattered and is no longer able to be focused properly. Treatment involves the replacement of the clouded lens by way of cataract surgery. Medicare covers some aspects of cataract surgery, including:

  • Implantation of a replacement intraocular lens (IOL). Medicare only covers the placement of a conventional IOL and not Premium IOLs.
  • Eyeglasses or contact lenses used during the recovery period after Cataract Surgery.
  • Surgical costs associated with the Cataract surgery.

What Eyecare does Medicare Advantage (Part C) Cover? 

Voluntary Medicare Advantage plans are likely to cover routine eye exams and prescription eyewear in the same way as conventional Vision Insurance plans do. Individual vision insurance plans are also available for seniors through traditional Vision Insurance carriers such as VSP, EyeMed and United Healthcare with rates around $5-10/month.

SoCal Eye Consultation:

SoCal Eye representatives will be happy to assist with questions and eligibility on Medicare and Medicare Advantage. The American Ophthalmology Association and SoCal Eye Ophthalmology highly recommends an annual eye exam for all patients over 60 years of age.  A number of these conditions can be caught early through a Comprehensive Eye Exam and the progression can be slowed dramatically. SoCal Eye doctors are the Senior Eye Care Specialists in Long Beach. Schedule an Appointment today at  LAKEWOOD (562) 531-2020   |   LOS ALAMITOS (562) 598-7728 or send us an Online Consultation Request