Are Glaucoma Screenings Covered by Medicare?

Published by: Medicare Made Clear

Medicare Part B covers one glaucoma screening test once every 12 months if you are at high risk. You’re at high risk for glaucoma if one or more of the following applies to you:

 

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

 

Some Medicare Advantage plans (Part C) offer vision coverage that may help pay for glaucoma screenings more often, even in the absence of risk factors.

 

IMPORTANT: In order for Medicare to cover a glaucoma test, it must be performed by a doctor who is legally allowed to do the test in your state, such as an ophthalmologist

 

 

How is a glaucoma test done?

 

During a glaucoma exam, the doctor puts drops in your eyes to dilate them. The doctor then uses instruments to do the following:

 

  • Measure your eye pressure.
  • Examine your optic nerve.
  • Test your peripheral (side) vision.
  • Inspect the angle where your iris and cornea meet.
  • Measure the thickness of your cornea.

 

 

How Much Does Medicare Pay for a Glaucoma Test?

 

With Original Medicare (Parts A & B), you pay 20 percent of the Medicare-approved amount for a glaucoma test. The Medicare Part B deductible applies. If you receive the test in a hospital outpatient setting, you may be responsible for facility charges as well. If you have a Medicare supplement plan (Medigap), it may cover some of your costs.

 

With a Medicare Advantage plan your costs depend on the specific plan you have. Call your plan provider to get detailed coverage and cost information.

 

 

Why Glaucoma Screenings Are Important

 

Vision loss due to glaucoma can happen gradually, so you may not notice anything until the damage is done. About 3 million Americans have glaucoma, but an estimated half of those who do are not aware of their condition.1 Therefore it’s important to consider vision health when choosing Medicare coverage.

 

 

1 https://www.glaucoma.org/glaucoma/glaucoma-facts-and-stats.php

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