What You Need to Know About Retinal Care Medicare Coverage
The start of a new year is a great time to assess your health goals and discuss any important medical expenses, like prescriptions or procedures, that may be needed. It’s also smart to check on your insurance coverage and the benefits you are eligible to receive through Medicare.
At Austin Retina Associates, we believe your vision and retina health should always be a priority. Our team of retinal specialists treat a number of retinal conditions and perform thousands of sight-saving procedures each year.
If you are one of the patients who needs our care and services, we always want to help ensure that you get the best coverage you are entitled to.
What does Medicare cover in terms of retina health?
Our team of experienced billing specialists often receive questions about Medicare coverage for seniors. Andi Wilkinson, our billing manager, breaks down important information about what you can typically expect from your Traditional Medicare Part B coverage (not to be confused with Medicare Part C coverage which is the Medicare Advantage, MA, plan).
Does Medicare cover routine eye exams or vision services?
While Medicare doesn’t cover routine eye exams or vision services, Austin Retina bills as a specialist through your Medicare Part B benefits.
What does Medicare Part B cover with Austin Retina?
It covers services from our physicians, outpatient care, and in-office treatments.
Does Medicare cover diabetic retinopathy treatment and/or diabetic eye exams?
Yes, traditional Medicare covers diabetic retinopathy exams and treatment from a retina specialist under your Part B coverage.
Does Medicare cover treatment for macular degeneration?
Yes, traditional Medicare also covers macular degeneration treatment from a retina specialist under the Part B coverage.
Will Medicare cover treatment for a detached retina?
The treatment for a detached retina is an outpatient surgery at a hospital or surgical facility (ASC) and is covered under your Part B benefits (this should not be confused with Part A Hospital Insurance which is for inpatient hospital stays).
Will Medicare cover eye injections?
Traditional Medicare does cover eye injections for age-related macular degeneration and diabetic retinopathy through your Part B coverage. You will not need a referral or authorization to receive these treatments.
What are some other resources to learn about Medicare and retinal health coverage?
It is always important to keep in mind that you will need to meet your Part B deductible before Medicare will cover anything, and to also be aware that you will have a 20% coinsurance if you do not have secondary medical coverage.
Here are some additional guidelines that help address basic coverage for your retina health needs.
More information about Austin Retina Associates’ billing and insurance coverage can be found here.
Consult with Our Expert Retinal Health Specialists Today
If you suspect you are suffering from a retina condition, have experienced a retina/eye injury, or have been referred to us by another physician, please call 800-252-8259 or request an appointment online to meet with one of our experienced, board-certified retinal specialists in Austin.
Austin Retina Associates has several retina treatment centers located in Austin and throughout Central Texas.