How Medicare Covers Your Eyes Many people are unclear with what Medicare does and doesnt cover when it comes to eye care. The good news is that Medicare covers most medical issues like cataract surgery, treatment of eye diseases and medical emergencies. But unfortunately, routine care like eye exams and eyeglasses are usually your responsibility. Heres a breakdown of how original Medicare covers your eyes. Exams: Routine eye exams (sometimes called eye refractions) that test for eyeglasses or contact lenses are usually not covered under Medicare, but you are entitled to a yearly medical eye exam if you have diabetes or are at high risk for glaucoma. People at high risk include diabetics, those with a family history of glaucoma and older Hispanics and African-Americans. Medicare will also pay for exams to test and treat medical eye diseases and other problems like macular degeneration, dry eye syndrome, eye infections or if you get something in your eye. Eyeglasses and contact lenses: Medicare does not pay for eyeglasses or contact lenses, with one exception: If you have had a conventional intraocular lens inserted during cata-ract surgery, Medicare will pay for glasses or contact lenses following the operation. Otherwise, you are on your own. Eye surgeries: Medicare covers most eye surgeries including cataract surgery to remove cataracts and insert standard intraocular lenses to replace your own. Medicare will not, however, pick up the extra cost if you choose a specialized lens that restores full range of vision, thereby reducing your need for glasses after cataract surgery. The extra cost for a specialized lens can run up to $2,500 per eye. Eye surgeries that are not covered by Medicare include refractive surgery and cosmetic eye surgery (such as eyelid surgery) that are not considered medically necessary. Supplemental Insurance Keep in mind that, of the medical eye care services that are covered by Medicare, youre still responsible for 20 percent of the cost (and possibly an additional 15%, on top of the 20%, if the doctor does not accept Assignment) - Medicare pays the other 80 percent. To help with this out-of-pocket expense, you may want to consider getting a Medigap supplemental policy which will cover these expenses, as well as many other expenses. Coverage may differ in you are enrolled in a Medicare Advantage Plan
Posted on: Mon, 02 Jun 2014 12:37:20 +0000
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