Your Medicare Coverage
Is my test, item, or service covered?
How often is it covered?
Medicare Part B (Medical Insurance) covers a glaucoma test once every 12 months for people at high risk for glaucoma. An eye doctor who's legally allowed to do this test in your state must do or supervise the screening.
All people with Part B who are at high risk for glaucoma are covered. You're at high risk if one of these applies:
- You have diabetes.
- You have a family history of glaucoma.
- You're African American and 50 or older.
- You're Hispanic and 65 or older.
Your costs in Original Medicare
- You pay 20% of the Medicare-approved amount, and the Part B deductible applies.
- In a hospital outpatient setting, you also pay a copayment.
To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:
- Other insurance you may have
- How much your doctor charges
- Whether your doctor accepts assignment
- The type of facility
- Where you get your test, item, or service
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.