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It’s “Save Your Vision” Month – Here’s What Eye Care Medicare Covers

March is “Save Your Vision” Month, highlighting the need for eye health and regular vision exams, but access to that care for Medicare beneficiaries isn’t that simple.

Although vision care becomes increasingly important as we age due to its direct correlation with quality of life and cognitive function, original Medicare does not cover routine eye exams, treatments or glasses unless they’re in some way tied to a medical condition.

Part B will cover preventative and diagnostic vision care for beneficiaries at risk of developing diabetic retinopathy, glaucoma, macular degeneration or cataracts.

So, let’s discuss those: what should beneficiaries know about these conditions?

Diabetic Retinopathy

While diabetes is not a condition that is immediately associated with vision, diabetic retinopathy damages the retina in the back of the eye and is caused by diabetes mellitus. It impacts 80% of people that have had diabetes for over 20 years and is one of the leading causes of blindness in developed nations.

Medicare covers preventative care for diabetic retinopathy once a year for beneficiaries suffering from diabetes, as anyone with diabetes is at risk of developing the condition.

The same steps that can be taken to stop diabetes are also used to ward off diabetic retinopathy: lowering sugar, fat and salt intake, maintaining regular exercise, and cutting out smoking and alcohol consumption. Monitoring one’s blood sugar is also a great way to keep from developing diabetes.

Glaucoma

Glaucoma is a group of eye conditions that begin by impairing one’s peripheral vision and is currently covered by Medicare. Beneficiaries with a high risk of developing glaucoma are entitled to receive a glaucoma test every 12 months.

Glaucoma is caused by an accumulation of fluid in the eyes, leading to a build-up of pressure in the eye, culminating in damage to the optic nerve. The condition is often tied back to genetics, age or unnatural effects. It is best to receive regular eye exams to catch the condition early and begin treating it right away.

Sometimes, a simple daily workout can be helpful in reducing the pressure in one’s eyes but be sure to protect your eyes from any trauma that could come with physical activity.

Macular Degeneration

This visual ailment is very closely associated with aging. It is a condition that can cause blurry or no vision in the center of the visual field. Oftentimes vision will worsen over time in one or sometimes even both eyes. It likely will not lead to complete blindness but even mildly suffering from it can make the completion of everyday tasks incredibly difficult.

Medicare Part B will cover diagnostic testing for both wet and dry macular degeneration.

While more common in women, everyone over the age of 60 should be on the lookout for macular degeneration. But steps can be taken to help prevent it, including eating high vitamin C fruits, foods with omega 3 and dark chocolate.

Cataracts

This condition is characterized by the development of cloudy areas in the lens of one’s eye. It’s a very common condition for people as they age, with over half of Americans over 80 suffering or having had suffered from them.

There may be no symptoms early on but over time, vision becomes hazy, less colorful and blurry. This makes reading and everyday seeing difficult for many who suffer from the ailment.

Medicare covers cataract diagnostic testing and surgery to replace cataracts. After the surgical procedure, Medicare will assist in paying for corrective lenses. This includes one pair of eyeglasses with standard frames or one set of contact lenses.

One can take steps to ward off cataracts by regularly wearing sunglasses or wearing a brimmed hat to block the sun. Quitting smoking also helps stave off the ailment.

So, What About Everyone Else Looking for Routine Eye Care?

If you’re looking to receive eye care coverage but do not actively suffer from one of the aforementioned ailments, hope is not lost. Many Medicare Advantage plans include preventative and basic vision services.

Unlike original Medicare, some Medicare Advantage plans cover eyeglasses, an extremely common need for everyone as they age. Plans may also cover other eye care such as routine vision checkups, but if this is one of your primary medical priorities, be vigilant when selecting your Medicare Advantage plan to be sure it actively meets your specific eye care needs.

It should also be noted that Medigap plans cover cataract surgery and several other serious vision ailments, but do not cover routine eye care such as exams, glasses and contact lenses.

We all know how important our vision is to our day-to-day lives, so make sure you’re able to get the eye care you need through your Medicare plan. Be sure to speak with an insurance professional to find out what plan is right for you and the eye care you deserve.

Have you ever looked to Medicare for a vision-related health issue? Did you have any difficulty figuring out what was covered? What should people know based on your experiences?

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The Author

Lindsay Malzone is the Medicare expert for Medigap.com. She has been working in the Medicare space since 2017. Lindsay has a passion for sharing her expertise on Medicare to beneficiaries so they can be better prepared for healthcare costs after retirement. Her YouTube channel features various videos that help Medicare beneficiaries discover all their options.

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