Medicare Coverage of the
Glaucoma Screening Benefit
(Printable page)

Through intensive efforts by the American Academy of Ophthalmology and other medical societies, Medicare has initiated coverage of a Glaucoma Screening Benefit, starting 1/1/2002. Glaucoma is a common vision threatening disorder, especially in blacks and diabetics. Many cases go undiagnosed, since physical symptoms of elevated eye pressure are usually unnoticed, and visual loss from the disorder is usually slow. In order to reduce the possibility of vision loss from undiagnosed glaucoma, Medicare now allows individuals at "high risk" for glaucoma to have a glaucoma screening evaluation with an ophthalmologist once a year. "High risk" individuals that qualify for the benefit are those:
 

• With a Family History of glaucoma (parent, brother, or sister).
• With diabetes, including diet controlled diabetes, as well as insulin and non-insulin dependent diabetes.
• African-Americans over the age of 50 (and who are eligible for Medicare).

The examination includes checking the visual acuity, the intraocular pressure (eye pressure), examination of the eye before and after dilation, and especially examining the optic nerve, which is affected by glaucoma. If glaucoma is suspected, a visual field test is usually performed on a subsequent day to determine if there is any loss of peripheral (side) vision. This is covered by Medicare as well, but is not part of the screening benefit. Refractions (determination of a glasses prescription) and treatment of other conditions of the eye are not covered as part of the screening benefit.

The patient is responsible for the Medicare deductible and the 20% not covered by a secondary insurance, as usual.  The patient cannot have had an eye examination within the past year that would screen for glaucoma.

Richmond Eye Associates
804-270-0330
Glaucoma Screening Online at www.richmondeye.com