How often are Eye exams covered?

Medicare and You 2020 #10050  
Everything you want to know 

Medicare and you

Different Parts of Medicare 

A = Hospital
B = Doctor Visits - Out Patient
C = Medicare Advantage or Medi Gap
D = Part D Rx

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Is  your test, service, or item covered?
Original Medicare Parts A & B
Medicare Advantage Plans & Part D Rx
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Medicare doesn’t cover routine eye exams (sometimes called “eye refractions”) for eyeglasses or contact lenses. Medicare Part B (Medical Insurance) covers some preventive and diagnostic eye exams:

 

Medicare Part B (Medical Insurance) covers a yearly eye exam for diabetic retinopathy

ICD 10

Web MD

by an eye doctor who’s legally allowed to do the test in your state.

Who’s eligible?

All people with Part B who have diabetes are covered.

Your costs in Original Medicare

You pay 20% of the Medicare-approved amount for the doctor’s services, and the Part B deductible applies. In a hospital outpatient setting, you pay a copayment.

Note

To find out how much your specific test, item, or service will cost, talk to your doctor or other 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, and the location where you get your test, item, or service. medicare.gov yearly-eye-exam

cms.gov/VisionServices_FactSheet

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ICD billing codes

92012 Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient

92083 — extended examination (eg, Goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 degrees, or quantitative, automated threshold perimetry, Octopus programs G-1, 32 or 42, Humphrey visual field analyzer full threshold programs 30-2, 24-2, or 30/60-2).

92083 — extended examination (eg, Goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 degrees, or quantitative, automated threshold perimetry, Octopus programs G-1, 32 or 42, Humphrey visual field analyzer full threshold programs 30-2, 24-2, or 30/60-2).

To get immediate quotes, information and enroll ONLINE, click here for Blue Cross 

 

Related Pages in Preventative Care  Section

Medicare Preventative Services # 10110

Medicare Prevenative Services

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Medicare & You
Heart Disease - Screenings under Part B

Medicare – Glaucoma

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