Will Medicare Cover Glaucoma?

While Medicare does not cover routine vision care, Medicare Part B does cover glaucoma screenings for people at high risk for developing glaucoma and will cover the outpatient procedures necessary to treat the condition. To be covered for prescription medications used to treat glaucoma, you will need to be covered under a prescription drug plan through Medicare Part D or a Medicare Advantage Prescription Drug plan.

For routine vision coverage, look for a Medicare Advantage plan with vision benefits or purchase a supplemental vision insurance policy.

Medicare Part B Coverage

Your care to treat glaucoma will not likely involve an inpatient stay in a hospital, so Medicare Part A will not be involved. Medicare Part B, which covers medically necessary and preventive services, is the primary insurance at play for glaucoma screening and treatment. Medicare Part B covers outpatient treatments, including the glaucoma screenings and laser or eye surgery procedures needed to treat glaucoma.

Glaucoma screening is only covered once every 12 months for people Medicare considers to be at high risk for developing glaucoma. These are people who have diabetes, have a family history of glaucoma, are Black and over 50 years old, or are Hispanic and over 65 years old. These screenings must be performed by doctors who are enrolled in Medicare and legally licensed to perform glaucoma screenings in your state.

Medicare Part D Coverage

Treatment for glaucoma often includes prescription eye drops. Original Medicare covers only limited outpatient prescription drugs, so to avoid paying full price for these medications, you will need to have prescription drug coverage through a Medicare Part D plan or combined Medicare Advantage Prescription Drug plan.

Getting Vision Care

Original Medicare does not cover routine vision care. That means no coverage for annual eye exams, eyeglasses, or contact lenses. To get some of those benefits, you will need to purchase a supplemental vision insurance policy.

Luckily, Medicare Advantage plans are able to offer benefits packages in addition to Medicare Part A and Part B, including coverage for routine dental, vision, or hearing coverage. You need only pay an additional monthly premium for those benefits. With vision coverage through your Medicare Advantage plan, you will likely have access to purchase discounted glasses and regular eye exams.

To learn more about Medicare coverage or how to find the benefits you need in a Medicare Advantage plan, speak to the trusted Medicare Sharks. Our team will help you compare your coverage options to secure the right plan for your situation. Call us today.