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Does Medicare Cover Macular Degeneration?

Discover what Medicare does cover for macular degeneration including age-related risk factors, lifestyle changes and treatment options.

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Age-related macular degeneration (AMD) is a leading cause of vision loss in the U.S., and it’s most common in older adults. According to the American Academy of Ophthalmology (AAO), the risk of AMD increases from 2% for those ages 50 to 59 to nearly 30% for those over the age of 75.

In AMD, the macula — the center of the retina responsible for clear vision — thins, causing blurred or reduced central vision. It can develop in one or both eyes, eventually affecting both eyes over time. People with AMD won’t lose their sight entirely, as their peripheral vision typically remains intact, but they could lose their ability to do important things like reading, driving and recognizing faces.

Early detection with regular eye exams is considered key to preventing vision loss from AMD.

During an eye exam, your ophthalmologist may ask you to look at an Amsler grid. You can do this now by looking at the image. Call your ophthalmologist if the lines on this Amsler grid look wavy, blurry or dim. 

Amsler grid

AMD Risk Factors and How To Reduce Your Chances

Risk factors for AMD include:

  • A family history of AMD

  • Being caucasian

  • Smoking cigarettes

  • A diet high in saturated fat

  • Being overweight

  • Having hypertension or high blood pressure

  • Having heart disease and/or high cholesterol

  • Being over the age of 50

A visit to your doctor may be a good idea, according to the Mayo Clinic , if you notice changes in central vision or your ability to see colors and fine details.

A healthy lifestyle can help reduce the risk of developing AMD, and while there’s currently no cure, it is possible to slow the progression of the disorder.

Here are a few things you can do to prevent or slow the progression of AMD:

  • Quit Smoking

  • Exercise regularly

  • Eat a diet high in fruits, vegetables and fish

  • Protect your eyes from ultraviolet light with sunglasses and hats

How Does Medicare Cover Macular Degeneration?

Treatment for AMD depends on the stage of the disease, from the early-stage “dry” AMD or the more advanced “wet” form. 

For dry AMD, the AAO suggests taking nutritional supplements, which are not covered by Medicare.

If you have later-stage wet AMD, Medicare Part B may offer coverage for things like diagnostic tests and treatments , which may include drops or eye injections. The Part B deductible applies, and beneficiaries will still be responsible for the 20% of the Medicare-approved amount of the treatment.

Keep in mind, Original Medicare does not cover the cost of eye exams for eyeglasses or contact lenses .

For more details on these plans, you can speak with a licensed agent at Senior Healthcare Direct at 1-833-463-3262, TTY 711

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LEGAL DISCLAIMER: The above is meant to be strictly educational and not intended to provide medical advice or solicit the sales of an insurance product or service of any kind.