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One Easy Way to Protect Your Vision

Imagine someone hands you a map and says the X leads to a treasure. You get in your car — or ask a family member to drive you — and follow the directions.

When you arrive, you find yourself at your eye doctor's office.

Whether you think of it as a treasure or not, your vision is one of your most precious possessions. Surveys report that Americans are more afraid of vision loss than many other diseases. Yet one in five adults ages 50 to 80 say they have not had an eye exam in three or more years, according to the National Poll on Healthy Aging . That's even though older adults are at higher risk for diseases that lead to vision loss, including:

  • Glaucoma — damage to the optic nerve
  • Cataracts — a clouding of your eye's lens
  • Diabetic Retinopathy — damage to blood vessels in the retina because of high blood sugar
  • Age-Related Macular Degeneration — eye disease that can blur your central vision

Research also shows that eye care to address eye diseases and refractive error could help correct 50% of vision problems. And the American Optometric Association recommends annual eye examinations for everyone 65 and older.

“It Costs Too Much”

Cost and lack of insurance coverage are the main reasons people older than 50 don't get their eyes checked.

But guess what? In certain cases, Medicare covers care for eye diseases for which seniors are most at risk.

Glaucoma . Medicare pays for an annual glaucoma test if you're at high risk for developing the eye disease glaucoma. Your considered at high risk if at least one of these conditions applies to you:

  • You have diabetes
  • You have a family history of glaucoma
  • You're African American and age 50 or older
  • You're Hispanic and age 65 or older

After you meet the Part B deductible, you pay 20% of the Medicare-approved amount. In a hospital outpatient setting, you also pay a copayment.

Cataracts . Medicare pays for cataract surgery performed through traditional surgical techniques or lasers. It will also pay for either one pair of eyeglasses or one set of contact lenses if you have cataract surgery that implants an intraocular lens. You pay 20% of the Medicare-approved amount. And the Part B deductible applies. Note: Medicare will only pay for contact lenses or eyeglasses from a supplier enrolled in Medicare, no matter if you or the provider submits the claim.

Diabetic Retinopathy . Medicare Part B pays for an annual eye exam for diabetic retinopathy if you have diabetes. The exam must be done by an eye doctor who's legally allowed to do the test in your state.

Macular Degeneration. Medicare Part B may cover certain diagnostic tests and treatments (including treatment with certain injected drugs) of eye diseases and conditions if you have age-related macular degeneration. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for the drug and your doctor's services. In a hospital setting, you also pay a separate facility copayment.

“What if I Wear Glasses?”

Original Medicare does not cover eye exams for eyeglasses or contacts. It also does not cover the cost of the lenses themselves.

But Medicare Advantage (Part C) might. Check individual plans to see what kind of vision coverage may be available.

“How Else Can I Protect My Vision?”

Getting an annual eye exam is the single best way for people older than 65 to protect their vision. The National Institutes of Health says you can also:

  • Wear sunglasses that block UV radiation and a hat with a wide brim when you're outside
  • Stop smoking
  • Be smart about food choices
  • Be physically active and keep a healthy weight
  • Manage your blood pressure
  • Control your diabetes, if you have it
  • Follow the rule of 20 when you spend time on a computer or other screen: take a break every 20 minutes, look about 20 feet away and focus for 20 seconds to prevent eye strain

Your Eyesight Is Precious

Being able to see your family, read a book, enjoy the beauty of nature — life's simplest joys are often the most precious. And your insurance coverage could help you protect the treasure of your vision. Let our licensed insurance agents help you map out the coverage that's right for you.

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MR830 4/2023