What is and is not covered ?
First the bad news; Eye glasses are not covered. Yes, there is a technicality, pertaining to cataract surgery. One, and only one, pair of glasses for the entire duration of your coverage is available. However, they only pay a very limited amount. Our after cataract discount almost always beats the minimal discount. Medi-Cal recipients you don't have to worry as glasses are covered by Medi-Cal.
Now what is covered:
A comprehensive vision examination: Myths exist here, and even the Medicare website presents confusing information. We have followed the Medicare CMS rules for decades and all were covered.
Vision Field testing
Binocular vision testing
Vision processing testing
Treatment of vision fields(Light therapy), Binocular vision conditions(vision therapy), and Vision processing therapy
We accept Medicare as payment in full for all the above.
Almost all eye diseases including cataracts, glaucoma, and macular degeneration. We examine for and refer for these but have no control over the financial policies of the doctor to whom we refer .
Medicare recipients be ware
Carefully look at the difference between Medicare Supplementary insurance and the "so called," Advantage plans. Some of our patients have lost thousands of dollars in Medicare benefits their Advantage plan denied.
In an Advantage plan you have Medicare benefits in name only. The advantage plan (All are HMO's) manages your Medicare benefits as the plan sees fit. In other words, they deem whether you receive them. Remember these benefits are available to all Medicare recipients. Yet, their panel doctors are pressured to either declare you don’t have the diagnosis or don't need the treatment and deny the benefits
She did not tell us of the switch so we naturally scheduled her as a Medicare/Medi-Cal patient. We must submit to Medicare first. A month later Medicare informed us she was not a part of Medicare but an “advantage” plan. It took searching to find her “advantage” plan. Now a month later, the “advantage” plan refused her bill. The “advantage” plan had a very limited doctor panel that did not include us. She enjoyed no-cost visits the past 20 years. We accept Medicare/Medi-Cal reimbursements as full payment. Now she is stuck with a bill. Yes, we’ll help her with the bill. Just what advantage did she get?