Healthcare Educators


Medicare and Glaucoma – How to Help Clients Protect Their Vision

by | Mar 4, 2020

Your clients may be suffering from glaucoma without realizing it. According to the CDC, glaucoma refers to a group of diseases that cause damage to the eye’s optic nerve, resulting in vision loss and even blindness. If people seek medical treatment early, however, it may be possible to prevent permanent eye damage and vision loss. Help your clients protect their eyes with Medicare-covered glaucoma screening services.

Diagnosing and Treating Glaucoma

The National Eye Institute warns that glaucoma doesn’t usually have any symptoms in the early stages. As a result, approximately half of people with the condition are unaware of it.

As the disease progresses, people may start to lose peripheral vision, but this can happen so slowly that many people don’t even notice until it progresses significantly. If glaucoma is not treated, blindness is possible.

Thankfully, an eye exam can reveal signs of glaucoma so a diagnosis can be made. If glaucoma is detected, it can be treated with eye drops, surgery or laser treatment. There is no cure, but treatment options can prevent serious vision loss.

Risk Factors for Glaucoma

Although glaucoma does not always prevent symptom in the early stages, some people may notice early signs of the disease. The National Eye Institute says that people who experience intense eye pain, nausea, red eye and blurry vision should seek medical care.

Certain groups have a higher risk for glaucoma. According to CMS, anyone who falls into one or more of the following groups is considered high risk:

  • People with diabetes
  • People with a family history of glaucoma
  • African Americans who are 50 or older
  • Hispanics who are 65 or older

Medicare Coverage for Glaucoma

Original Medicare does not cover eye exams for glasses or contacts. However, some medically necessary care is covered, and this may include screening for glaucoma.

If your clients fall into any of the four high-risk groups listed above, they should qualify for Medicare-covered glaucoma tests once every 12 months. Under Original Medicare, they will pay 20 percent of the Medicare-approved amount and the Part B deductible.

If a Medicare enrollee is diagnosed with glaucoma, coverage for medically necessary treatments may also be available under the different parts of Medicare.

Some Medicare Advantage plans provide additional vision benefits.

 Encourage Your Clients to Get Tested

If your clients fall into any of the high-risk groups for glaucoma, encourage them to get screened. Even if they don’t have symptoms, they may still have the eye disease, and early detection is essential.