Vision is often considered the most important of the five senses as it allows people to experience and navigate a complex world. Beyond that, having clear, healthy vision gives you the chance to enjoy everything from beautiful sunsets to family gatherings. With age, many people begin to experience a degradation in vision. Some people may develop diseases in the eye that can have a great impact on vision clarity or trauma to the eye that severely limits the ability to see clearly. Thankfully, there are a number of ways to improve vision today, including traditional glasses and contacts as well as corrective eye surgery.
While ophthalmologists are specialists who deal with complex diseases of the eye and surgical procedures related to vision care, optometrists are the medical professionals who specialize in examining vision health and prescribing corrective lenses. An optometrist is usually referred to as an “eye doctor,” but these professionals don’t typically treat diseases of the eye. Instead, optometrists evaluate vision and eye health, and if a disease is found, the patient will be referred to an ophthalmologist for further treatment.
If corrective lenses can treat declining vision, the optometrist can write a prescription that can be filled virtually anywhere that produces prescription glasses or contacts. Although they do not directly treat ongoing serious eye diseases, optometrists do often provide treatment for common vision problems, and some treatments may involve eye drops, ointments or salves.
Does Medicare Cover Optometry?
Medicare Part B provides insurance coverage for outpatient treatment, and even though you may visit your primary care physician to discuss eye problems, routine services rendered by an optometrist are not covered under Original Medicare. Medicare insurance does not generally cover traditional eye exams in an optometrist’s office or the cost of corrective lenses or frames.
An exception to this might be found when you receive surgery to treat an eye disease like cataracts. In these cases, it is possible that original Medicare Part B will provide coverage for corrective lenses during a recovery period in order to improve the healing process and reduce complications. Your physician will coordinate with your care team to meet your specific needs after surgery.
Do Medicare Advantage Plans Cover Optometry?
Medicare Advantage plans are required to include the same Part A and Part B benefits as Original Medicare, but many offer additional coverage, including vision care. Keep in mind that these plans may have limitations and restrictions regarding vision coverage, and you may have to visit vision care providers who are in the plan’s network. Compare Medicare Advantage plans before enrolling as costs and benefits can vary.
Are There Alternatives to Medicare for Optometry?
If you aren’t able to obtain optometry services through a Medicare Advantage plan, you might be able to find other supplemental programs that provide benefits as part of a membership. These types of programs may be things like cost-sharing health clubs or individual vision discount plans. In most cases, these types of plans are not considered insurance and do not qualify as a part of the Medicare program. You may also be required to pay a monthly or annual fee to take part in these programs, even if you don’t utilize your benefits, and discounts may only be applied when seeking out services from specific providers.
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