The vision examination is very essential as you grow older. This can be easily done with the help of a Medicare optometrist which means that you have to cover your vision care with them. They have many benefits as per the plan that you have opted for. This is basically a hospital insurance that covers vision care facilities.
This is done when the condition of vision becomes a medical problem. In cases when the patient is going through a medical emergency or any traumatic injury, then the insurance will be covered. This insurance coverage does not cover routine checkups but is only applicable for special cases like eyeglasses, contact lenses or cataract surgery.
Rules of the insurance
The eye examinations under Medicare optometrist are subsidized for the permanent patients. This insurance will be for testing your visual fitness but may not be for contact lens fitting consultations. The optometrist will direct the bill to the government on your behalf. This is known as bulk-billing. This can also be done on behalf of pensioners, children or for those who have limited financial means. As a result, you can easily access quality eye care without paying from your pockets immediately.
How to claim from the insurance policy
If there is a bulk billing for an eye examination to Medicare optometrist, then you actually do not pay anything for the examination of the eye. The rule is that Medicare will pay the optometrist about 85% of the examination fee. This is accepted by the optometrist as a full payment. If your optometrist recommends some additional tests like for example digital retinal photography, then you are not eligible for the treatment. You can submit a claim to the Medicare insurance if the optometrist does not give you a bulk bill. Then you have to pay the difference between the account and the refund which usually is about 15% but may be higher. You should have a Medicare card and always take it when you visit the optometrist. This card will have a specific number and that is your proof that you are eligible for the benefits.
List of eye care benefits
- Medicare optometrist covers the costs that are associated with cataract surgery and also includes the cost of intraocular lens on a standardize basis. If you choose to opt for a premium intraocular lens, that will reduce the need for reading glasses, then you have to pay an additional cost.
- The insurance also covers eyewear after the cataract surgery. But it pays for one pair of eyeglasses or contact lenses. Here also you will find that only standard eyeglasses frames are covered.
- The advantage with Medicare optometrist is that it covers glaucoma screening especially for persons with high risk of glaucoma. The patient suffering from diabetes or a family of glaucoma is also taken into consideration. The screening consists of a comprehensive examination of the eye. This will also include dilation and intraocular pressure measurement.
- The ocular prostheses or artificial eye is also covered by the Medicare optometrist. They pay for the replacement and the maintenance of such cases. There is also a provision of supplement insurance. This will give you some extra policies that will cover routine eye exams, eyeglasses and contact lenses.
Most of the people prefer Medicare optometrists over the original insurance only because their plans have additional benefits. Of course, the specific benefits may vary as per the plan that is available in a particular area. If you want to get detailed information, then you can visit the site that will explain to you the advantage plan. There are varied options as per your interest and requirement.