January 24, 2019
By: The My Medicare
Matters Team
About 1.3 billion people in
the world live with some form of vision impairment. The reasons vary but the
fact is, your risk of developing vision problems drastically increases as
you age. Over 91% of people age
55+ use some form of vision correction, so having access to quality vision care
is critical as you get older. Issues with vision can increase the risk of
falls, driving incidents, and impacting quality of life.
Medicare plans cover a wide variety of
services including doctor visits, home health care, and a range of preventive
screenings and treatments, but when it comes to vision coverage, beneficiaries’
options are extremely limited. So, what are the available options when you
retire?
Original Medicare
(Part A and Part B)
Vision coverage through Original Medicare is
limited to mostly preventive and emergency services. Original Medicare
generally doesn’t cover routine eye exams for eyeglasses or contact
lenses. Medicare Part A covers medical emergency related to your
vision if you are admitted to the hospital and Medicare Part B covers
preventive treatments and screening related to your eyes.
Medicare Part B covers annual glaucoma test for
at-risk individuals which includes those with diabetes, African-Americans aged
50+, Hispanics aged 65+, and/or those with a family history of glaucoma. Annual
exams to test for diabetic retinopathy among diabetics, diagnostic tests and
screenings for macular degeneration, cataract surgery and one pair of
post-surgery eyeglasses or contact lenses are also covered. Medicare will only
pay for contact lenses or eyeglasses from a supplier enrolled in Medicare. For
each of these services, the out-of-pocket costs is the 20%
Medicare-approved amount, and Part B deductible.
Medicare Advantage
(Part C)
One of the easiest options for vision coverage
when you retire is Medicare Part C. Part
C includes the same emergency and preventive benefits included with Original
Medicare, but some Part C plans may also offer additional benefits that include
a yearly eye exam, eyeglass frames and lenses, or contact lenses. The cost and
coverage for these services vary from plan to plan. The best way to find
a Medicare Advantage plan that covers all the services you need is to
compare plans online or speak with a licensed benefits advisor.
Vision Programs
Enrolling in a Medicare Advantage plan to
receive vision coverage is not necessarily the best option for everyone, but
that doesn’t mean you should not be able to get adequate vision coverage. There
are national and local programs available that can provide vision care for
little to no cost, but there may be additional requirements to participate and
resources may be limited.
- EyeCare
America®, a service from the Foundation of the American Academy
of Ophthalmology, provides free eye exams and up to one year of care for
low-income individuals who qualify.
- Local Lions’ Club chapters often
have programs to assist those with severe vision impairment. Local chapters will be able to
provide more information on how to get assistance.
- Vision USA, a program of the American
Optometric Association and Mission
Cataract USA both offer vision services for those without
insurance including Medicare or Medicaid. Vision USA provides free
eye exams for low-income Americans and Mission Cataract USA offers free
cataract surgery to those who qualify.
As you begin to research your Medicare options
keep in mind the enhanced services you may need to maintain, or maybe even
improve your quality of life. Having yearly eye exams and updated prescriptions
or dental cleanings and fillings may not be the things you consider when
choosing a Medicare plan, but they should be.
To get help discovering a plan that covers
your needs try taking our Medicare Questionnaire,
which allows you to compare plans online or connects you to free professional
advice from licensed benefits advisors. You can also contact your local State Health
Assistance Insurance Program (SHIP) for access to
federally-funded Medicare counseling from trained staff members.
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