The Benefits Improvement and Protection Act (BIPA) of 2000, Section 102 provides annual coverage for glaucoma screenings for eligible Medicare beneficiaries, effective January 1, 2002.
A leading cause of blindness, glaucoma affects close to 2.5 million Americans age 40 and older. Blacks are four to five times more likely to be blinded by glaucoma than Caucasians, and can develop it earlier with risk increasing by age 35.
The benefit stipulates that Medicare will cover 80% of the doctor’s examination fee. The patient or his/her secondary insurance must pick up the patient’s deductible and the remaining 20% balance. A minimum of 366 days is required between screening visits.
To qualify for this coverage you must be at high-risk, as described by the Department of Health and Human Services:
Individuals with a family history of glaucoma, with family defined as a blood parent or sibling;
Individuals with diabetes, whether it be diet- controlled, oral-agent-controlled, or insulin-dependent diabetes;
African Americans age 50 and older who meet eligibility requirements for Medicare.
The screening for glaucoma includes; 1) visual acuity; 2) dilated eye examination; 3) intraocular pressure measurement, 4) direct ophthalmoscopy.
This web resource is made possible through an unrestricted educational grant from Alcon.
Copyright © 2005 Prevent Blindness America ®
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