Medicare and Glaucoma: What’s Covered?

medicare and glaucoma

It is widely known that Medicare does not cover much when it comes to vision care. What about Medicare and glaucoma though?

What is Glaucoma?

Glaucoma is a disease that damages your eye’s optic nerve. It often happens when there is a fluid build-up in the front part of your eye. The extra fluid puts pressure on your eye and damages the optic nerve. There are two major types of glaucoma.

Primary open-angle glaucoma is the most common type of glaucoma and happens gradually. It happens when your eye doesn’t drain fluid like it’s supposed to and the pressure starts to cause damage to the optic nerve.

Angle-closure glaucoma happens when the iris is close to the drainage angle. The iris can block the drainage angle, which causes the eye pressure to rise quickly. It’s referred to as an acute attack and it considered an eye emergency.

Medicare and Glaucoma

Medicare does cover certain services when you have a chronic eye condition such as glaucoma.

Medicare will cover services like surgical procedures to repair the function of your eye due to a chronic eye condition and an eye exam to diagnose vision problems. If you’re at risk for glaucoma or have diabetes, Medicare will cover an annual eye exam.

Medicare Part B covers a glaucoma test once every 12 month for those who are at high risk. Those who are qualified as high risk are people who:

  • Have diabetes
  • Have a family history of glaucoma
  • Are African American and at least 50 years old
  • Are Hispanic and at least 65 years old

You will be required to pay 20% of the Medicare-approved amount and with any hospital expenses, you’ll be required to pay your copay. For more information on how much will you have to pay or what the total cost will be, talk to your doctor.

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