Macular degeneration tests & treatment
Medicare Coverage Information
Overview
Medicare provides coverage for diagnostic tests and certain treatments related to macular degeneration, a leading cause of vision loss in older adults. Coverage typically includes diagnostic eye exams and medically necessary treatments, with potential variations depending on the specific Medicare plan.
- Medicare Part B covers diagnostic eye exams for macular degeneration
- Covers medically necessary treatments for age-related macular degeneration (AMD)
- Some diagnostic tests and treatments may require prior authorization
- Beneficiaries are responsible for standard Medicare deductibles and coinsurance
- Coverage may differ between Original Medicare and Medicare Advantage plans
- Medicare beneficiaries aged 65 and older
- Individuals with qualifying disabilities
- Patients diagnosed with or at risk for macular degeneration
- Coverage available through Original Medicare (Part B) and some Medicare Advantage plans
- Medicare Part B typically covers 80% of approved diagnostic tests and treatments
- Beneficiaries are responsible for 20% coinsurance after meeting the annual Part B deductible
- Additional costs may apply for specialized treatments or medications
- Must be deemed medically necessary by a healthcare professional
- Some advanced or experimental treatments might not be fully covered
- Frequency of covered tests may be limited
- Requires referral from a qualified healthcare provider
- Consult with an ophthalmologist or eye care specialist
- Get a comprehensive eye exam to assess macular degeneration risk
- Verify specific coverage details with your Medicare plan
- Call 1-800-MEDICARE for personalized coverage information
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicaremacular degenerationeye testsvision coverageage-related eye disease
Related Coverage Topics
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