At Everett & Hurite, we regularly see patients who ask what Medicare will and will not cover. While we always recommend that patients talk to their doctors and providers directly to confirm how much of a specific test, item, or service will be covered by Medicare and/or insurance policies, there are some general Medicare rules and guidelines that you can expect to see in place at our practice:
- Medicare currently doesn’t cover routine eye exams – sometimes called “eye refractions” – for eyeglasses or contact lenses.
- Medicare – specifically Medicare Part B – currently does cover certain preventive and diagnostic exams. Test that are covered include yearly eye exams for diabetic retinopathy, glaucoma tests, and macular degeneration tests.
It’s important for patients to keep these limitations in mind when they schedule an appointment, particularly if they hope to use Medicare to cover their visit. Because of this, you will need to sign the document entitled "Advance Beneficiary Notice of Noncoverage" (ABN).
Additionally, we encourage patients to remember that doctors may sometimes recommend services that are NEVER covered by Medicare or by a patient’s insurance. For these services, it’s important to always ask questions and to communicate with your healthcare provider so that you are not surprised by any bills you receive after the visit or if payment is required at the time of the visit.
Finally, because a variety of factors can affect the final cost of a doctor’s visit, we encourage patients who are concerned about the cost of their visit to speak to their insurance providers and doctors about ways they can receive the care they need while also taking steps to reduce the cost of doing so.