We welcome Medicare recipients and accept Medicare services as paid in full, except for a l $30.00 fee for the initial eye exam. The only other charge you may have is in the beginning of year to cover your deductible.

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. The advantage plan also takes over your part A portion of Medicare(Hospital visits). A law says the advantage plan must offer the same benefits as regular Medicare.  The advantage plans either ignore the law or get around it by pressuring panel doctors to either declare you don’t have the diagnosis or don't need the treatment.

Yes, a Supplement often costs more, but is it worth the thousands in denied services to select an advantage plan?

If you have Medi-Cal be VERY careful determining an Advantage plan as Medi-Cal picks up your deductible and Medicare part B co-pays.

The Advantage plans may tout extra services like eyeglasses and dental. Most we have seen are poor quality. The most unscrupulous of Advantage plans offer you a vision plan of exam only that Medicare would have covered anyhow.

However, some Supplements also offer extra services.

A supplement keeps you signed up as a Medicare recipient with its vast benefits and a private supplement insurance picks up the 20% co-pay for office visits.

A Medi-Cal/Medicare recipient patient who has been a part of our office more than 20 years is an example of a loss in benefits. A salesman convinced her to abandon her Medicare and Medi-Cal plans to become an “advantage” plan member.

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?

We have found Medicare to be an excellent program for our eligible patients.

It is a shame  deceptive advertisements appear during renewal time. Health insurance is confusing enough.

These are our observations within our practice and limited to eye care benefits, but I imagine the same may exist in other care.