Vision benefits from Medicare and Medicaid

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Today, there is a large number of people who need regular eye care, proven by millions of cases of eye problems, diseases and even injuries. Fortunately, various services of vision care are included in Medicare and Medicaid programs. Before accessing to vision services, you should get a clear knowledge of what kind of health plans and what type of vision care are available.

A brief introduction of Medicaid and Medicare

In brief words, Medicaid is a governmental health program set especially for people and families with low incomes and resources. And Medicare is a social insurance program administered by the federal government. The target groups of Medicare include people who age 65 and over. These two programs have something in common that they are both managed by federal government and are supposed to serve special groups of people.

HI and MI cover basic services of eye care

There are four parts of vision care according to the Medicare’s policies. Hospital Insurance (HI) covers part of costs when you are in a hospital, rehabilitation facility or hospice. Sometimes homecare costs are also covered by hospital insurance. Vision problems like eye emergencies from trauma would be covered here. Medical Insurance (MI) covers part of costs of doctor visit and some medical services are not covered by HI. Those related eye diseases and vision problems would be covered by MI.

Medicare Advantage offers additional vision services

Medicare Advantage (MA) is usually for Medicare participants enrolled in HI and MI. MA charges more and provides more benefits including the coverage of routine eye exams, eyeglasses, contact lens and the like. Typically, MA always contracts with federal government. Eye drops for glaucoma treatments can be covered by coverage for prescription drugs.

Glaucoma screening and basic cataract surgery are covered

Both HI and MI do not cover the costs of routine eye examination. But Medicare policyholders who have enrolled in HI and MI can enjoy allowance for some types of vision coverage, such as glaucoma screening and cataract surgery. Some studies have shown that glaucoma is usually related to diabetes. As a comprehensive exam, Glaucoma screening includes dilation and intraocular pressure measurement. Cataract surgery will replace your eye’s natural crystalline with an intraocular lens. And Medicare will cover the basic costs of lenses. Of course, you can pay extra for new multifocal intraocular lenses if you don’t want to wear eyeglasses.

Medigap insurances cover the costs of eye diseases

Besides the above parts, you can also access to supplemental insurances such as Medigap policies. Since MI and HI don’t cover the expenses of Medigap, individuals who are enrolled in MI and HI can purchase a plan from 10 different Medigap insurance policies. Participants in MA plans do not need to purchase Medigap because their policies have paid the expenses for Medigap. Compared to MA, Medigap policies cover the costs of eye diseases but do not include eye exams and artificial lenses.