Does Medicare cover vision services?
Also: Palliative care services explained
March 1, 2019
Dear Savvy Senior: I will be enrolling in Medicare in a few months, and would like to know how Medicare covers vision services? I currently have vision insurance through my employer but will lose it when I retire. - Looking Ahead
Dear Looking: Many people approaching 65 are unclear on what Medicare does and doesn't cover when it comes to vision services. The good news is that original Medicare covers most medical issues like cataract surgery, treatment of eye diseases and medical emergencies. But unfortunately, routine care like eye exams and eyeglasses are the beneficiary's responsibility. Here's a breakdown of what is and isn't covered.
Eye exams and treatments. Medicare does not cover routine eye exams that test for eyeglasses or contact lenses. But they do cover yearly medical eye exams if you have diabetes or are at high risk for glaucoma. They will also pay for exams to test and treat medical eye diseases if you're having vision problems that indicate a serious eye problem like macular degeneration, dry eye syndrome, glaucoma, eye infections or if you get something in your eye.
Eye surgeries. Medicare will cover most eye surgeries that help repair the eye function, including cataract surgery to remove cataracts, and insert standard intraocular lenses to replace your own. Medicare will not, however, pick up the extra cost if you choose a specialized lens that restores full range of vision, thereby reducing your need for glasses after cataract surgery. The extra cost for a specialized lens can run up to $2,500 per eye.
Eye surgeries that are usually not covered by Medicare include refractive (LASIK) surgery and cosmetic eye surgery that are not considered medically necessary.
Eyeglasses and contact lenses. Medicare does not pay for eyeglasses or contact lenses, with one exception: If you have had a conventional intraocular lens inserted during cataract surgery, Medicare will pay for eyeglasses or contact lenses following the operation.
Ways to save
Although original Medicare's vision coverage is limited to medical issues, there are ways you can save on routine care. Here are several to check into.
Purchase vision insurance. If you get routine eye exams and purchase new eyeglasses annually, a vision insurance plan may be worth the costs. These policies typically run between $12 and $20 per month. See http://www.Ehealthinsurance.com to look for plans.
Check veterans benefits. If you're a veteran and qualify for VA health care benefits, you may be able to get some or all of your routine vision care through VA. Go to Vets.gov, and search for "vision care" to learn more.
Shop around. Many retailers provide discounts – between 10 and 30 percent – on eye exams and eyeglasses if you belong to a membership group like AARP or AAA.
You can also save by shopping at discount retailers like Costco Optical, which is recommended by Consumer Reports as the best discount store for good eyewear and low prices – it requires a $60 membership fee. Walmart Vision Centers also offer low prices with no membership.
Or consider buying your glasses online. Online retailers like WarbyParker.com, ZenniOptical.com, and EyeBuyDirect.com all get top marks from the Better Business Bureau and offer huge savings. To purchase glasses online you'll need a prescription.
Look for assistance. There are also health centers and local clinics that provide free or discounted vision exams and eyeglasses to those in need. To find them put a call into your local Lions Club (see https://directory.lionsclubs.org/ ) for referrals.
Underutilized palliative care services can help relieve pain
Dear Savvy Senior: What can you tell me about palliative care? My husband suffers from lung disease and is receiving radiation for prostate cancer but is not terminally ill. I've heard that palliative care can help him with his pain and discomfort. What can you tell me? - Searching Spouse
Dear Searching: Palliative care is a very effective service that can help patients relieve the symptoms and stress that often comes with serious illness. But unfortunately, most people don't know about it, or don't understand how it can help them. Here's what you should know.
What is palliative care?
Most people hear the words "palliative care" and think "hospice," but they are different types of care. Hospice is reserved for when curative treatments have been exhausted and patients have less than six months to live.
Palliative care, on the other hand, is a medical specialty that focuses on providing relief from the symptoms such as pain, shortness of breath, fatigue, constipation, nausea, loss of appetite, trouble sleeping and even depression. It can also help patients deal with the side effects of medical treatment.
Anyone with a serious illness can benefit from palliative care, including those with cancer, heart disease, lung disease, kidney disease, Alzheimer's, HIV/AIDS, amyotrophic lateral sclerosis (ALS), multiple sclerosis, Parkinson's and more.
Palliative care is provided by a team including palliative care doctors, nurses, social workers and other specialists that work with your doctor to provide an extra layer of support and care. It is appropriate at any age and at any stage in a serious illness, and it can be provided along with curative treatment.
Palliative care teams are trained to help patients understand all their treatment options as well as the quality of life ramifications, so they can make informed decisions about what's best for them.
Often patients assume their doctors will take care of their pain and stress, but most doctors in our specialized medical system have not been well trained in pain and symptom management. That's why palliative care is invaluable.
Palliative care was developed in the United States in the 1990s but only became a formal medical subspecialty in 2008. Today, three-quarters of U.S. hospitals with more than 50 beds have a palliative care program, and 90 percent of hospitals with 300 beds or more offer it.
How to get care
There are around 6 million people in the U.S. that have a need for palliative care, according to the Center to Advance Palliative Care, but most patients don't know to ask for it. If you feel that a palliative care specialist could help your husband, start by talking to his doctor and ask for a referral.
If your doctor isn't helpful, go to http://www.GetPalliativeCare.org, where you can search for a specialist in your area.
Palliative care can be provided in in a variety of places, including hospitals, long-term care facilities, doctor's clinics and at your own home.
You'll also be happy to know that most private insurance plans, as well as Medicare and Medicaid, cover palliative care services.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit http://www.SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of "The Savvy Senior" book.