Medicare is a federal insurance program for people age 65 or older and people younger than 65 with certain disabilities, permanent kidney failure, amyotrophic lateral sclerosis (ALS). Medicare helps with the cost of health care – it does not cover all medical expenses or cover the cost of long-term care.
Medicare Part A is HOSPITAL Coverage, covers some healthcare, skilled nursing and hospice. Some people pay nothing for Medicare Part A and some people pay a monthly fee called a premium.
*Original Medicare is Part A & B
Medicare Part B is MEDICAL Coverage, available for a fee – $185 in 2025. Covers medically necessary doctor visits, outpatient care, home health, some medical equipment, mental health, some medication and some preventative care, diabetes self-management
Medicare Part C is ADVANTAGE Plan, as an alternative to Medicare Part A&B with added benefits for a fee. May include deductible, co-payment or spend-down. Some people call this “bundled coverage” for hospital, medical, medication, hearing, dental and vision care. Medicare Advantage Plans are Medicare plans offered by private insurance companies.
Medicare Part D is MEDICATION Coverage, available for purchase. May include deductible or co-payment.
*Every person enrolled in Medicare Part B is eligible for the “Welcome to Medicare” visit – an excellent way for new Medicare beneficiaries to get up to date on important screenings (including vision) and vaccinations. *Must happen within first 12 months of Medicare Part B coverage.
Tip: Insurance plans all have different coverage and rules – check your insurance carefully to confirm what service is covered, how often you can receive care and if there are any out-of-pocket costs.
Tip: Insurance plans all have different coverage and rules – check your insurance carefully to confirm what service is covered, how often you can receive care and if there are any out-of-pocket costs.Original Medicare – Vision Care
- Provider Network Limitations: Restricted to Medicare Providers
- Cost: 20% coinsurance after deductible
Welcome to Medicare Visit
- Routine Eye Exam (Vision Checkup): Not covered
- Glasses/Contact Lenses: Not covered
- Eye Exam for Medical Condition: Covered
- Glaucoma Screening: Covered at 80% for high-risk patients
- Diabetic Eye Exam: Covered
- Cataract Surgery: Covered
Eyeglasses/contacts after cataract surgery – partially covered
- Post-Cataract Corrective Lenses: One pair covered
Macular Degeneration Treatment: Covered Eye exam related to diagnosed medical condition (diabetes, glaucoma) = covered under Part B
Medicare Advantage or Supplemental Insurance – Vision Care
- Provider Network Limitations: Restricted to plan’s network of providers
- Cost: Varies by plan for premium, deductible, and co-pay
- Routine Eye Exam (Vision Checkup): Often covered – verify with carrier
- Glasses/Contact Lenses: Often covered – with limitations
- Eye Exam for Medical Condition: Covered
- Glaucoma Screening: Covered
- Diabetic Eye Exam: Covered
- Cataract Surgery: Covered
- Post-Cataract Corrective Lenses: Covered
- Macular Degeneration Treatment: Covered
Medicare Assistance-Ohio Senior Health Insurance Information Program (OSHIIP)
Provides free health insurance guidance and information and one-on-one counseling for people covered by Medicare and their caregivers. They educate about: original Medicare, Medicare Supplemental Insurance, Medicare Prescription Drug Coverage (Part D), Medicare Advantage, as well as Extra Help and Cost Savings Programs.
1-800-686-1578 www.insurance.ohio.gov (OSHIIP)
Federal site www.medicare.gov 1-800-MEDICARE or 1-800-325-0778
Search for provider by Zip Code and specialty :https://www.medicare.gov/care-compare/?providerType=Physician
https://www.seniorimpact.com/columbus Senior Resource Guides (statewide)
