Glaucoma is a group of eye diseases in which damage to the nerve located in the back of the eye (the optic nerve) leads to vision loss. Screening can help determine if you need medical treatment for glaucoma.
Medicare Part B covers an annual glaucoma screening if you are considered at high risk for glaucoma. This means you:
- Have a family history of glaucoma
- Have diabetes
- Are African-American and age 50+
- Or, are Hispanic-American and age 65+
The screening must be performed or supervised by an eye doctor who is licensed to provide this service in your state.
If you qualify, Original Medicare covers glaucoma screenings at 80% of the Medicare-approved amount. When you receive the service from a participating provider, you pay a 20% coinsurance after you meet your Part B deductible. If you are enrolled in a Medicare Advantage Plan, contact your plan for cost and coverage information for glaucoma screenings. Your plan’s cost-sharing may apply when seeing in-network providers.
During the course of your glaucoma screening, your provider may discover and need to investigate or treat a new or existing problem. This additional care is considered diagnostic, meaning your provider is treating you because of certain symptoms or risk factors. Medicare may bill you for any diagnostic care you receive during a preventive visit.