Glaucoma Medicare Coverage: What You Need to Know

close up of blue eye, Medicare and Glaucoma, Trusted Medicare Answers

Glaucoma is such a gradual deterioration that many people don’t detect this disease until it’s advanced stages. It is important to understand how to use your Medicare benefits when it comes to eye care. The best way to prevent and detect glaucoma and other eye diseases is to have regular comprehensive eye exams. While there is no cure for this damage to the optic nerve, there are many treatments that can slow the deterioration of the disease and preserve your vision. The good news is that most people who follow their treatment plan and have regular eye exams do not go blind. However, something to remember is that routine eye care services like regular eye exams, are not covered under Original Medicare unless you have a pre-existing condition. When deciding your Medicare coverage, it is important to consider your vision needs and desire for annual eye check-ups. In general, glaucoma check should be done every 6-12 months after the age of 65. If this is something you would like, ask your agent about a Medicare Advantage plan that comes with vision coverage.  

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The latest data shows that Glaucoma affects nearly 3 million adults in the United States. There are certain factors that might make you more susceptible to Glaucoma that is worth noting as you decide your Medicare coverage. You are more likely to get glaucoma if you:

  • are over 40 years old
  • use long term steroid medications, such as prednisone
  • have had trauma to the eye(s)
  • have high blood pressure or regular migraines
  • are of African, Hispanic, or Asian heritage

Original Medicare will cover glaucoma tests once a year if you at a higher risk. You are considered high risk if you:

  • have a family history of glaucoma
  • have diabetes
  • you’re African American and age 50+
  • you’re Hispanic and age 65+

Additionally, to prevent the onset or progression of glaucoma, you can:

  • exercise at a moderate level (such as walking or jogging) at least 3x/week
  • wear protective eyewear prevent possible injury
  • maintain blood pressure at or below the normal level
  • wear protective eye gear or sun hats to prevent overexposure to sunlight
  • get regular eye exams

Medicare coverage is not a one-size-fits-all approach. There are many factors that might influence your decision on the coverage you want. We can help you understand your coverage options so you can make an informed decision. Speak to a licensed representative. It’s free and there’s no obligation.


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