There are a lot of misunderstandings about vision coverage through Medicare. Some people believe that it only covers basic eye exams. Other people think that it pays for all vision care needs. The truth is that Medicare offers several different types of vision coverage, depending on the type of plan you have. In this blog post, we will discuss what vision services. As well as how to get the most out of your benefits.
Part A Vision Benefits
Medicare Part A is hospital insurance. Part A covers vision if it is a result of a medical condition. This could be a medical emergency. Medicare Part A does not cover routine vision exams and eye refractions. Beneficiaries must pay 100% of the cost unless they have other vision coverage.
Will Part B Cover Vision Benefits
Medicare Part B is medical insurance. Medicare Part B covers some vision care, but not routine vision exams. There is no coverage for vision correction such as eyeglasses or contact lenses under Medicare. Part B unless you need vision correction after cataract surgery. Medicare Part B also does not cover eye refractions.
Medicare Part B covers yearly glaucoma screenings for people who are at high risk. High-risk patients include those with a family history of glaucoma. African Americans age 50 and older, Hispanic Americans age 65 and older, and people with diabetes. State-approved vision care specialists are the only providers that may perform yearly vision screenings for glaucoma. You pay the 20% Medicare coinsurance for the vision care costs approved by Medicare, subject to your annual Medicare deductible.
Additional Part B Coverage
Medicare Part B vision benefits cover cataract surgery. Medicare covers the cost of the artificial lens you would need to replace. The lens that is affected by cataracts, as well as the cost for vision correction products. Such as glasses with standard frames, following cataract surgery. You pay the 20% Medicare coinsurance for the amount approved by Medicare, subject to your annual Medicare deductible.
Medicare Part B vision benefits cover eye prostheses. Only for patients with absence or shrinkage of the eye due to birth defect, trauma, or surgical removal. Medicare Part B also covers the polishing and resurfacing of vision prostheses twice per year. As well as one enlargement or reduction in the size of prostheses without documentation. There are some things that are only covered if medically necessary. For instance, enlargements and reductions. Medicare covers the cost of vision prosthesis replacement. Only if the vision prosthesis is lost, stolen, or irreparably damaged within the first five years. Part B covers ocular photodynamic therapy with verteporfin. This is a treatment for patients with macular degeneration, a vision problem associated with age.
Vision Coverage Through Medicare Advantage
Medicare Advantage offers an alternative way to receive your Original Medicare benefits. Medicare Advantage plans are offered by private, Medicare-approved insurers. All private insurers must offer at least the same benefits as Original Medicare. But they may include other benefits, such as routine vision, routine dental, and Medicare prescription drug coverage. When routine vision benefits are available through a Medicare Advantage plan. Your premiums could be higher than those charged by Medicare Advantage plans that do not offer routine vision benefits.
Some Medicare Advantage plans include full coverage for routine vision exams, vision correction products, and other vision care. Review the specific Medicare Advantage plans vision benefits to be sure.
Do Medicare Supplement Plans Help With Vision?
No. Medicare supplement plans, also called Medigap, only cover expenses not paid by Medicare. This includes the Medicare Part B deductible and coinsurance, as well as other out-of-pocket costs not covered by Medicare.
Routine vision exams are considered preventive care and are not covered under Medigap plans. However, if you have a Medigap plan that includes Part B coverage. You may be able to get some vision care coverage through your plan. For example, if you have a Medigap Plan G, the plan will cover the Medicare Part B deductible. This means that if you need a routine vision exam and it costs are more than the deductible. Your Medigap plan will help pay for the exam. Review your specific Medigap plans benefits to be sure.
Stand-Alone Vision Plan
You may also want to consider a stand-alone vision insurance plan. These plans are offered by private insurers and can help you cover the costs of routine vision exams. Vision correction products, and other vision care. Some stand-alone vision plans have networks of optometrists and ophthalmologists, which could help you save money on vision care. If you need help getting vision coverage, please give us a call.
We hope this blog was helpful with your vision concerns.