Does Medicare Cover Glaucoma?

Medicare Bob
Medicare General Info
For people at high risk, Medicare Part B does cover glaucoma tests. Find out if Medicare covers you, five common tests, and what Medicare does and does not cover.
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About 3 million Americans have glaucoma, and it’s the second-leading cause of blindness worldwide. What’s more, half of the people with glaucoma don’t know they have it.

Glaucoma occurs when fluid buildup causes gradual damage to the eye’s optic nerve, resulting in increased eye pressure. The most common form of glaucoma — open-angle glaucoma — often has no early symptoms.

Who Can Get Glaucoma, and What Should I Look Out For?

Anyone of any age can get glaucoma, but high-risk populations include:

  • People over age 60

  • African Americans over age 40

  • People with a family history of glaucoma

  • People who have diabetes

The American Academy of Ophthalmology urges anyone experiencing the following symptoms  to call an ophthalmologist right away:

  • Sudden blurry vision

  • Severe eye pain

  • Headache

  • Nausea and vomiting

  • Rainbow-colored rings or halos around lights

There’s no cure for glaucoma, but if you take steps to preserve your eyesight and catch it early, it is possible to prevent future vision loss.

How Can I Find Out if I Have Glaucoma?

The only way to diagnose glaucoma is with a full eye exam — not just a glaucoma screening. While a glaucoma screening checks eye pressure, drainage, peripheral vision and your optic nerve, a complete eye exam does all this and more.

At a complete eye exam, your ophthalmologist can perform five common tests to detect glaucoma:

  • Tonometry: Using drops to numb the eye, a tonometer will apply a small amount of pressure or a warm puff of air to measure the inner pressure of your eye.

  • Ophthalmoscopy: This dilated eye exam uses a small device to shine light into your eye to measure the shape and color of the optic nerve.

  • Perimetry: During this visual field test, you’ll be asked to respond to a light placed in different areas of your peripheral vision. Once glaucoma is diagnosed, you may have a visual field test once or twice a year to detect any change in vision.

  • Gonioscopy: This exam uses eye drops to numb the eye, as a contact lens with a mirror is placed on the eye to allow your doctor to see the angle between your iris and cornea.

  • Pachymetry: In this simple test, a pachymeter is placed on the front of your eye to measure the thickness of the cornea.

What Will Medicare Cover for My Glaucoma?

Once you have glaucoma damage, it can’t be reversed, but certain medications or surgery can halt further damage.

Original Medicare and Medicare Advantage plans both cover glaucoma tests for high-risk beneficiaries, as well as some eye health prescriptions, laser therapies and surgeries.

Medicare Part B covers annual glaucoma tests for high-risk individuals who have a family history of glaucoma, have diabetes, are Black and over 50 or are Hispanic and over 65.

While Medicare Part A covers inpatient treatment in a hospital, Part B pays for outpatient medical services, like a laser procedure or eye surgery where you typically go home the same day.

Original Medicare doesn’t pay for routine eye exams or glasses, but a Medicare Part C (Medicare Advantage) plan may, along with all the other coverage provided by Original Medicare.

Medicare Part D plans cover eye drops and other glaucoma-related prescriptions.

A Medigap, or Medicare supplement plan, such as Plan G, can pay 100% of your Part B coinsurance and copayment costs. All Medigap plans are different, with some paying deductibles and other excess charges, as well.

To learn more about the right coverage for you, call 1-833-463-3262, TTY 711 to speak with a licensed agent at Senior Healthcare Direct.

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LEGAL DISCLAIMER: The above is meant to be strictly educational and not intended to provide medical advice or solicit the sales of an insurance product or service of any kind.

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