Does Medicare Cover Vision Services? 👓

The Medicare Lady

Celebrating 10 years as a Medicare Specialist, October 2018

Medicare Made Simple, LLC

Theresa Cangemi CSA, CLTC

Office: 315-676-4933

Fax: 866-476-1211

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Greetings!

In this Newsletter, "Does Medicare Cover Vision Services?"

In the Health Corner, I share part of an article: Dementia and the inappropriate use of Antipsychotic drugs in nursing homes.

Keep reading!

Theresa Cangemi CSA, CLTC

"The Medicare Lady"

Insurance Corner

Does Medicare Cover Vision Services?

There are a lot of people unclear on what Medicare does and doesn't cover. Here’s a breakdown by Jim Miller found on 'The Morning Call' of what is and isn’t covered:

Eye exams and treatments: Medicare does not cover routine eye exams that test for eyeglasses or contact lenses. But they do cover yearly medical eye exams if you have diabetes or are at high risk for glaucoma. They will also pay for exams to test and treat medical eye diseases if you’re having vision problems that indicate a serious eye problem like macular degeneration, dry eye syndrome, glaucoma, eye infections or if you get something in your eye.

Eye surgeries: Medicare will cover most eye surgeries that help repair the eye function, including cataract surgery to remove cataracts and insert standard intraocular lenses to replace your own. Medicare will not, however, pick up the extra cost if you choose a specialized lens that restores full range of vision, thereby reducing your need for glasses after cataract surgery. The extra cost for a specialized lens can run up to $2,500 per eye.

*Eye surgeries that are usually not covered by Medicare include refractive (LASIK) surgery and cosmetic eye surgery that are not considered medically necessary.

Eyeglasses and contact lenses: Medicare does not pay for eyeglasses or contact lenses, with one exception: If you have had a conventional intraocular lens inserted during cataract surgery, Medicare will pay for eyeglasses or contact lenses following the operation.

Ways to Save

Consider a Medicare Advantage plan: One way you can get extra vision coverage when you join Medicare is to choose a Medicare Advantage plan instead of original Medicare.
Purchase vision insurance: If you get routine eye exams and purchase new eyeglasses annually, a vision insurance plan may be worth the costs.
Check veterans benefits: If you’re a veteran and qualify for VA health care benefits, you may be able to get some or all of your routine vision care through VA.
Shop around: Many retailers provide discounts – between 10 and 30 percent – on eye exams and eyeglasses if you belong to a membership group like AARP or AAA.
You can also save by shopping at discount retailers like Costco Optical or Walmart Vision Centers.
Or consider buying your glasses online. Online retailers all get top marks from the Better Business Bureau and offer huge savings. *To purchase glasses online you’ll need a prescription.
Look for assistance: There are also health centers and local clinics that provide free or discounted vision exams and eyeglasses to those in need.

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Health Corner

Dementia and Drugs:

Its’s up to us to change the conversation

An article by Walter O. Cofffey, MPA, MA goes into Dementia and Drugs, and the change of dementia care. A new paradigm is dramatically changing dementia care, turning a critical eye toward the conventional use of behavior-altering medications and increasingly considering the individual person.

About Antipsychotic Drugs

The inappropriate antipsychotic drugging of nursing home residents, particularly those with dementia, is a widespread, national problem. “Close to 20 percent of nursing home residents (over a quarter of a million people) are given powerful and dangerous antipsychotics despite a ‘Black-Box’ warning that they are associated with increased risk of death in older adults”.

Antipsychotic drugs are used as a quick fix to address and quell unwanted “behaviors” in people with dementia. In our society, we have developed the expectation of quick fixes. This is true in medical care as well. Physicians are expected to prescribe a drug to quickly address any problem. As people with dementia experience changes in their condition, often these commonly called “negative behaviors” become more evident and happen more frequently. This is especially true when the ability to verbally communicate changes. It can be frustrating for all care partners. Family members ask for drugs that will “control” their loved one’s “negative behaviors.” Staff in nursing homes and other congregate settings often do the same thing, especially when they have not been educated and empowered to try other approaches first.

Antipsychotic medications are highly potent drugs that work in the brain to block certain chemicals that can cause symptoms of psychosis, such as hallucinations and delusions. These drugs are most often used with illnesses like schizophrenia, bipolar disorder, Huntington’s disease, or Tourette syndrome. They include drugs such as Risperdal, Haldol, Abilify, and Seroquel.

These drugs are frequently used to treat so-called behavioral and psychological symptoms of dementia and are often used as a chemical restraint. The drugs sedate residents so that not only their behavior, but also the underlying causes for that behavior, do not have to be addressed by staff.

Suppressing behavior makes it impossible to uncover the root cause of what is actually producing the symptoms of distress. These drugs do not address memory problems. They also do not help people with dementia to:

stop yelling
stop repeating the same questions over and over
do more for themselves
interact better with others
stop saying inappropriate things
become less restless.

In 2005, the Food and Drug Administration (FDA) issued the “Black-Box” warning requiring drug companies to label antipsychotics with their side effects and potential dangers. In addition to “destroying social and emotional well being including the loss of independence, these drugs greatly increase risks of stroke, heart attack, diabetes, Parkinsonism, and falls. They are NOT clinically indicated for dementia related psychosis. They ARE associated with a significant increase in death when given to older people with dementia”

“BLACK-BOX” WARNING ISSUED BY FDA

WARNING: Increased Mortality in Elderly Patients with Dementia Related Psychosis. Elderly patients with dementia related psychosis treated with antipsychotic drugs are at an increase risk of death. { Name of Antipsychotic} is not approved for the treatment of patients with dementia-related psychosis

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* This article is for information purposes only. I don’t recommend, support, or diagnose any featured writer or article. I am not a doctor.

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