Different kinds of vision care are included in the Medicare program that the U.S. government funds for those aged 65 years and older, individuals with specific disabilities, and people with low income.

To access vision services, you first need to understand what kind of Medicare plan you have and exactly what types of vision care are associated with each individual plan.

 

Medicares policy has four parts for qualified citizens who participate in the program, as well as access to supplemental insurance. These aspects of Medicare coverage include:

Part A, Hospital Insurance: This covers part of the costs incurred while staying in a hospital, a rehabilitation facility, or a hospice. It also pays for some of the costs of homecare. Vision problems that are considered medical conditions, such as traumatic eye emergencies, would be covered under Part A.

Part B, Medical Insurance: This covers part of the costs of visits to the doctor and some other medical services not included in Part A. Again, medical vision problems such as conditions relating to eye diseases would be covered in Part B.

Part C, Known as Medicare Advantage (MA): This gives Medicare participants enrolled in parts A and B of the program an option of joining one of a variety of health plans (typically not available in every area) that have contracted with the federal government to provide health care. Typically, MA plans provide more benefits than Parts A and B. They also charge higher premiums. But these premiums can include entitlement to extra vision benefits including at least some coverage for routine eye examinations, eyeglasses or contact lenses.

Part D, Coverage for Prescription Drugs: As with any medical condition, you likely would qualify for coverage for eye diseases such as glaucoma requiring eye drops to control internal (intraocular) eye pressure.

Medigap Policies: Individuals enrolled only in Medicare Parts A and B also can opt to purchase a plan from among about 10 different Medigap insurance policies. Medigap is a supplemental insurance policy that pays expenses not covered by Medicare Parts A and B. Members of Medicare Advantage (MA) plans do not need to purchase Medigap because their policies already fill the gaps associated with Medicare Parts A and B. Unlike Medicare Advantage (see Part C above), Medigap policies may cover medical conditions such as eye diseases but do not include extra vision benefits for eye exams and artificial lenses.

Medicare policyholders enrolled in Parts A and B (the original Medicare program) are eligible for these types of vision coverage:

Glaucoma screening can be obtained once every 12 months for individuals with diabetes, with a family history of glaucoma, who are African American over age 50, and who are Hispanics aged 65 and older. Glaucoma screening consists of a comprehensive eye exam, including dilation and intraocular pressure measurement.

Cataract surgery may be needed for one or both eyes, involving implantation of an intraocular lens that is an artificial replacement for your eyes natural crystalline lens. Medicare will cover the basic costs of lenses. But you also can choose personally to pay extra for the difference in cost for new artificial lenses that can often restore your sight at all distances, meaning that you may no longer need to wear eyeglasses. Cataract surgical procedures can allow persons a second chance at seeing clearly. The payment for this surgery can be handled in many ways, but one of the most common for persons over 65 is Medicare. Medicare payments paid by the government over the past year has and is making dramatic changes.

To qualify for Part B Medicare (thats the portion that allows for the doctors billing), a person must be at least 65 years of age or have received Social Security Disability Benefits for a 24 month period. For those individuals 65 years of age and older and still working or qualifying for a group insurance plan, they may select Medicare to be the secondary insurance. Medicare allows for cataract extraction, either one or both eyes, and there are no restrictions on the time period between doing the first eye and the second eye. The decision to have cataract surgery may involve additional testing by a doctor. The costs you incur for these test are allowed by Medicare. Eyeglass frames and lenses after cataract surgery, if necessary, may be covered under Medicare also. Artificial eye replacement also is listed among Medicare procedures eligible for coverage.