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Every once in a while, we all need to get an eye exam. Especially for those of us who are at risk of losing our vision or who have an eye disease such as glaucoma.
So a common question many people have is, “Does Medicare cover Visual Field Testing?” In this article, we answer that question in clear, plain English. You will also find the average costs of visual field testing and other helpful info.
Does Medicare Cover Visual Field Testing?
The short answer is it depends. Medicare may cover the cost of visual field testing. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your visual field testing. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for visual field testing costs.
Coverage for visual field testing falls under Medicare Part B. It provides this coverage when the visual field test is medically necessary. This generally means Medicare will cover it when it assesses visual fields in those who have glaucoma or other neuro-pathologic defects.
Medicare Part B also provides coverage for a glaucoma test once every 12 months. However, Medicare Part B will only cover the costs of a glaucoma test if you are at high risk of developing glaucoma.
For Medicare Part B to cover the cost of your glaucoma testing, there are some conditions to be met. It is usually for people in high risk categories such as those who:
- Have diabetes
- Have a family history of glaucoma
- Are African American and are age of 50 or older
- Are Hispanic and are age of 65 or older
Once approved by Medicare Part B, they will cover 80 percent of the cost of your visual field testing. You will pay for the remaining 20 percent.
Medicare Advantage plans (Medicare Part C) also provide coverage for visual field testing. They cover everything Original Medicare covers as well as offer some additional benefits. However, coverage and out-of-pocket costs will vary depending on the specifics of your plan.
How Much Does It Cost To Have A Visual Field Test?
The average national cost of having visual field testing is about $115. However, there are clinics that offer a lower price than the average.
In Walmart, for example, the cost of visual field testing is $50. One of the factors that may affect the costs of your visual field testing is the type of provider you go to and your region of the country.
What Is Visual Field Testing?
Visual field testing, commonly known as an eye test, measures how much vision you have in both eyes. It will measure how well we can see straight ahead as well as our peripheral vision. It can also measure how much vision you lost over time. In addition, through visual field testing, the doctor can tell if you have any blind spots.
Most of the time, an ophthalmologist or a doctor who specializes in eye diseases will perform the test.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover radiation?