Macular degeneration is a disorder that causes vision loss. Macular degeneration is the leading cause of vision problems for those 60 and older; which means that many who experience this ailment are on Medicare. Nearly 2 million Americans over the age of 60 have this disorder.
Those at highest risk of developing macular degeneration are Caucasians and current or former smokers. However, if there is a history of macular degeneration in your family, you are at higher risk as well.
Living a healthy lifestyle as you grow older is a good idea in general; also, it can specifically help to prevent you from developing macular degeneration. Especially important are keeping your blood pressure and cholesterol levels in check.
Does Medicare Cover Age-Related Macular Degeneration
Yes, Medicare covers most treatments for those diagnosed with age-related macular degeneration. Although, coverage is available for certain preventive and diagnostic exams to treating eye conditions under Part B.
Also, those with a macular degeneration due to age fall under the category of needing medically necessary treatments. Those medically necessary treatments are available under Part A and Part B.
Part A will cover macular degeneration if the condition causes hospitalization. However, Part B covers certain treatments the physician recommends.
It’s crucial for beneficiaries with diabetes, a family history of glaucoma, as well as those with an eye disease or injury to utilize these benefits.
Treatments for Age-Related Macular Degeneration Covered by Medicare
Medicare Part B covers treatment for beneficiaries with age-related macular degeneration, some treatments include:
- Lucentis – approved by the FDA in June 2006 for treating the more advanced or “wet” form of macular degeneration
- Avastin – a cancer drug that is considerably less expensive.
- Macugen – This treatment for AMD uses a therapeutic molecule to attack VEGF in the eye
- Eylea – Like Lucentis and Macugen, Eylea is designed to inhibit the action of VEGF in wet (neovascular) AMD.
- Verteporfin (Visudyne) – ocular photodynamic therapy only for those patients who have new blood vessel growth under the retina in a pattern known as “predominantly classic.“
- Implantable Miniature Telescope (IMT) – Treatment Medicare covers for eligible patients with central blindness in both eyes with no option for correction with eyeglasses, contact lenses, medication or other eye surgery.
- Aflibercept – recombinant protein treatment for wet AMD
- Pegaptanib – also used for treating wet AMD
Also, this list does not include all the treatment options covered by Medicare. New ones become available regularly, check with your physician and/or Medicare agent on coverage for any treatments not listed above.
The beneficiary pays 20 percent of the Medicare amount for any treatments or services. A Medicare Supplement Plan covers that coinsurance as well as many other out of pocket expenses.
Symptoms of Macular Degeneration
Symptoms can appear gradually or quickly. If symptoms are rapidly developing, then the patient may have wet macular degeneration; this can be a much more difficult disorder to manage and treat.
Symptoms of macular degeneration include:
- Distorted vision, including striation of pages when reading
- Blurred vision
- Sudden color blindness
- Dark patches in the field of vision
- A decrease in vision in dim lighting (continually needing brighter light to see)
- Color changes under the retina, which are painless
- A slowing of visual acuity (this comes later in the development of the disorder)
Diagnosis of Macular Degeneration
It’s essential to visit an ophthalmologist or optometrist for a complete eye examination if you suspect you may have macular degeneration. The doctor will perform a series of tests to get an in-depth look at your eye health.
Included in the exam are photos of the interior of your eyes, known as autofluorescence. Dilation is necessary for the doctor to look at the back of your retina, which is done with eyedrops.
Once dilation of the eyes occurs, a bright beam goes into your eye so the doctor can thoroughly examine and evaluate what’s happening.
The doctor measures the pressure in your eye and gives drops to numb eyes for the exam, or tomography. Your doctor may also ask you to monitor your eye health at home using an Amsler grid, which is similar to the graph paper.
If your doctor suspects macular degeneration, they want to observe the progress of the disorder. There are not many treatments available, but your doctor can determine which will work for you and has coverage through Medicare.
This combination of supplements is a recommendation by The National Eye Institute’s Age-Related Eye Disease Study (AREDS) for treatment of early onset macular degeneration. However, your physician can tell you if this treatment is right for you.
It can be especially helpful during the beginning stages of macular degeneration to take these supplements:
- 500 mg of vitamin C
- 400 IUs of vitamin E
- 10 mg of lutein
- 2 mg of zeaxanthin
- 80 mg of zinc
- 2 mg of copper
Get Additional Help for Medical Costs Not Covered by Original Medicare
Keep in mind, Original Medicare does NOT cover routine vision care. This is where a supplemental dental, vision as well as a hearing plan will come in handy.
Medicare does not cover everything, including vision benefits. Adding a Medicare Supplement plan, as well as a dental hearing and vision plan, to your Original Medicare benefits will give you peace of mind.
Give us a call today, or complete our online rate form to see a side by side comparison of supplement plans in your area that cover out of pocket costs.