Do Medicare Supplement Policies Cover Vision?

What is Medicare Supplement insurance? And does it cover regular vision exams?

Medicare is a program of the Federal Government that provides health benefits to seniors and to those with disabilities in some instances. It is typically called Original Medicare.[1] Original Medicare is fee-for-service health coverage that has two parts: Part A (which is hospital insurance) and Part B (which is medical insurance). After you pay a deductible, Medicare pays its share of the Medicare-approved amount, and you pay your share (which includes coinsurance and deductibles).

Medicare Supplement insurance is also commonly known as Medigap insurance. Since Medicare does not pay all your health expenses, Medicare Supplement insurance fills in some of the coverage gaps by covering all or a portion of your cost-sharing including: coinsurance, deductibles, and copayments. Medicare Supplement insurance is issued by a private health insurance company.

You must have Medicare Part A and Part B in order to purchase Medicare Supplement insurance.

Medicare Part B insurance, in most cases does not cover routine expenses:

• Vision or dental services
• Eyeglasses
• Hearing aids

And subsequently, Medicare Supplement insurance provides no benefits for these services.

Some Medigap insurance plans will cover for limited emergency care when you travel outside the U.S.

What does Medicare Part B and Medicare Supplement cover for eye care?

• Specific risk factors for disease
• Non-emergency coverage

Medicare Part B covers specific risk factors related to eye diseases including glaucoma, cataracts, diabetic retinopathy, and macular degeneration. In addition, glaucoma screening tests is covered every 12 months if you are at high risk.

Visual fields testing is also deemed medically necessary if there are conditions such as retinal damage, glaucoma, history of a cerebral aneurysm, and pituitary or occipital tumor potentially affecting the visual fields. [2]

Medicare Part B also covers non-emergency eye treatments such as floaters and flashers that appear in the eyes. Dry Eye is an affliction that needs medical attention and a registered M.D. Ophthalmologist may treat Medicare patients. Depending on your Part D (pharmacy coverage), drops and eye injections may be covered. [3]

Since Medicare B covers these, Medicare Supplement insurance generally provide cost-sharing benefits, including deductibles and coinsurance. It is important to check with the insurance agent and understand the policy coverage you are buying.

Knowing what Medicare Part B covers for your vision services is important. It won’t pay for routine eye care, but Medicare Part B will pay to diagnose and treat a number of conditions that can affect your vision. Likewise, a Medicare Supplement insurance policy with cost-sharing amounts such as deductibles and coinsurance will perhaps give you peace of mind. [4]

Medicare Supplement insurance has definite advantages. Contact an agent today who can go over all these advantages and ensure you coverage for important medical needs.

Are there other ways to save money for your routine annual vision checkup?

Yes! The alternatives are plenty:

1. You can buy an individual vision plan;
2. Enroll in discount memberships and cards;
3. Buy from discount eyeglass retailers; or
4. If enrolled, use money from your Health Savings Account Fund.

Individual vision insurance is quite affordable with low co-pays and savings on examinations, frames, contacts, and lens. You pay monthly for an annual plan.

Organizations specializing in retirement age brackets may give discounts on frames, contacts, and lenses. There are pharmacy and vision discount cards for the general public that help save money. Always verify what may be covered by discount cards, and note these are non-insurance benefits.

Many retailers specializing in eyeglasses give discounts.

And if you have enrolled and participated in an HSA fund, the money saved can be used when you retire for any of your medical expenses. 

Sources:

1. Social Security Benefits
2. CMS Visual Testing
3. MedicareSources.org
4. MedicareSources.org