Vision problems are a common side effect of living with diabetes. Even if you manage your condition well, you can still develop secondary conditions. Medicare recipients may need to follow certain protocols in order to establish medical necessity for care that qualifies for coverage with their benefits.
Health Risks Associated with Diabetes
Although diabetes is a disease that impacts how your body controls and uses blood sugar, it can cause secondary health issues to develop over time. These complications span a wide range of organs and systems within the body due to the important role blood sugar, or glucose, plays in fueling muscles, tissues and brain function.
The National Institute of Diabetes and Digestive and Kidney Diseases lists your nerves, feet, kidneys and eyes at heightened risk for developing diabetes-related diseases. Diabetics are also more likely to develop heart disease and disorders with their bones and joints. The risk of Issues involving oral health, skin, sexual function and gastrointestinal organs may also increase.
Symptoms of Diabetic Eye Diseases
It can be difficult to catch diabetic eye diseases early on, as there are few symptoms that occur in the beginning stages of development. If any of the following symptoms occur chronically, you should talk to your doctor about an eye exam:
- Frequent shifts in vision clarity.
- Desaturated colors.
- Blurry, wavy or shadowy vision.
- Spots, light flashes or dark strings.
Not all symptoms will cause pain or total loss of vision. If symptoms do cause pain or you experience sudden and severe vision loss, it may be a medical emergency, such as a detached retina, and you should see a doctor immediately.
Treatment for Diabetic Eye Diseases
Treatment options depend on which type of eye disease has been diagnosed. One or more treatments may be suitable, so a combination of procedures may be required to restore vision or prevent more loss from occurring.
Certain medications may be used to stop and reduce fluid in blood vessels of the eye which is a complication related to diabetic macular edema. Laser therapy can also be used as a way to treat this disease and stop it from worsening, though it is unlikely to restore vision.
Diabetic retinopathy can be treated with a surgical procedure known as vitrectomy, which can prevent the retina from detaching due to the bleeding and scarring that the disease can cause. Diabetics are also at risk of developing cataracts, so a cataract lens surgery that replaces the original lens with an artificial one can restore vision, but it can often result in a need to wear prescription eyeglasses afterward.
Medicare Coverage for Diabetic Vision Care
Once medical necessity is established, Medicare recipients can use their benefits to help cover the costs of eye exams and treatments for vision care as a diabetic. Because diabetes increases the risk of developing secondary conditions like eye diseases, Medicare Part B covers annual eye exams so that you can be regularly screened for symptoms. Outpatient procedures would also be addressed through Part B’s coverage.
Inpatient surgical procedures, such as a vitrectomy or cataract lens surgery, fall under Medicare Part A. If you require eyeglasses or contacts to help correct your vision after surgery, Medicare Part B may cover the cost of one pair of glasses or certain types of contacts.
Any copayments, coinsurance amounts or deductibles usually associated with Original Medicare are still your responsibility. Medicare Advantage plans are provided through private insurers approved by Medicare and must offer all the benefits of Original Medicare, but they have the freedom to offer additional coverage that goes beyond those coverage terms. These MA plans may include routine eye exams that can help you address concerns outside of Part B’s annual exam. They may also reduce certain out-of-pocket expenses related to co-pays and coinsurance amounts. Premiums for Medicare Advantage Plans are paid in addition to the Medicare Part B premium. If you are enrolled in a Medicare Advantage plan and are experiencing vision issues related to diabetes, you can contact your plan directly for more detailed information.