Medicare does cover some macular degeneration tests and treatments, including treatment with certain specific injected drugs.
As many as 11 million Americans have some form of age-related macular degeneration (AMD), and the condition is the leading cause of vision loss in people age 60 and over.1 Learn more about your Medicare coverage options for macular degeneration.
Join our email series to receive your free Medicare guide and the latest information about Medicare and Medicare Advantage.
By clicking "Sign me up!” you are agreeing to receive emails from MedicareAdvantage.com.
Speak with a licensed insurance agent
Medicare Part B (medical insurance) may cover your preventive or diagnostic eye exam for macular degeneration. In order for Medicare to cover your exam, your doctor must determine that your vision test is medically necessary to diagnose or treat AMD.
After you meet your Part B deductible ($185 per year in 2019), you will typically pay a Part B copayment for your exam. The Part B copay is 20 percent of the Medicare-approved amount for your doctor’s services.
Macular degeneration is most often treated with drugs that are injected into the blood or the eye itself.
Medicare Part B may help cover injectable treatments for beneficiaries who have AMD. These treatment options can include:
If your treatment is offered in an outpatient setting, you will typically pay the Part B copayment of 20 percent of the Medicare-approved amount for the treatment drug, after meeting your Part B deductible.
Medicare Advantage plans (Medicare Part C) provide the same benefits as Original Medicare (Part A and Part B), and most plans also offer additional benefits not covered by Original Medicare.
With a Medicare Advantage plan, your vision tests and treatment for macular degeneration will be covered the same way that they would be covered by Original Medicare. Plus, many plans will help cover the cost of routine eye exams, eyeglasses and contact lenses as well, which are not covered by Original Medicare.
Learn more about how a Medicare Advantage plan could help you save money on your health care costs. Plans that offer $0 premiums and $0 deductibles may be available where you live, though they may not be offered in all locations.
To compare your plan options, call to speak with a licensed insurance agent today.
Explore Medicare Advantage plan benefits in your areaCompare plans now
Or call TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!
Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. He currently lives in Raleigh, NC.
Where you've seen coverage of Christian's research and reports: