Do Medicare Plans from Humana Cover Routine Vision Services?
Last Updated : 10/21/20185 min read
Original Medicare, Part A and Part B, doesn’t generally cover routine vision services. If you have an injury or a medical condition that affects your eyes or vision, you may be covered for medically necessary care to diagnose and treat your condition, but routine vision exams are generally not covered.
However, if your doctor considers you to be at risk for glaucoma, Medicare Part B may cover an annual glaucoma screening.
If you are covered by a Medicare Advantage plan through Humana, you may be eligible for routine vision care benefits. Here are answers to your questions about Medicare vision coverage under Humana’s Medicare Advantage plans. Read here for general information on Medicare Advantage plans.
What is routine vision care?
It’s important to know what routine vision care might typically entail. This may include annual eye exams to check for vision impairment or underlying health issues, which may include the use of dilating eye drops to evaluate the lens, retina, and optic nerve, and a glaucoma screening test even if you’re not at risk for the disease. Other eye care services, such as fitting prescription eyewear or contact lenses to treat vision impairment, may also be considered routine vision care.
As mentioned above, Original Medicare doesn’t cover routine vision services, although Medicare Part B may cover an annual glaucoma screening if you’re at risk for the disease. Original Medicare may cover eye surgery, but coverage details are different depending on whether you’re admitted as an inpatient, or you have outpatient surgery. If you have cataract surgery and receive an intraocular lens, Medicare Part B usually covers one pair of corrective glasses or contact lenses.
What vision coverage is available with Medicare Advantage plans from Humana?
Medicare Advantage, Part C of the Medicare program, is administered by private companies like Humana that are contracted with Medicare to provide health-care benefits to enrollees. All Medicare Advantage plans must provide at least the same coverage as Original Medicare (except for hospice care, which is still provided under Part A), but companies are allowed to offer additional benefits with their Medicare plans.
Some of Humana’s Medicare Advantage plans give you an option for routine vision care in the form of a MyOptionSM Vision plan. The MyOptionSM Vision plan includes benefits such as
- A set dollar allowance to be used toward an annual eye exam at the provider of your choice. If you use Medicare providers in your Humana plan’s network, the allowance will cover the full cost of your routine eye exam.
- An annual allowance toward prescription eyeglasses and/or contact lenses.
Please note that you will be responsible for any costs above the plan-approved amount for your care and you must pay an additional monthly premium for your MyOptionSM vision plan. There is no special enrollment period; you may request MyOptionSM coverage at any time during the year.
Other things to keep in mind about Medicare Advantage plans offered by Humana:
- You must continue to pay your Part B premium plus any additional premium required by your plan.
- Not all plans may be available in all locations, and plan benefits and premiums may vary depending on where you live.
- Depending on the plan you choose, you may be required to get care from Humana’s network of Medicare providers in order to be covered (except in the case of medically necessary emergency treatment). Some plans also require copayments, coinsurance, and/or annual deductibles.
Do you have questions about Medicare plans offered by Humana? Humana makes it easy to learn about these plans. You can also simply click the “Find plans” link on this page.
Humana MyOptionSM optional supplemental benefits (OSB) are only available to members of certain Humana Medicare Advantage (MA) plans. Members of Humana plans that offer OSBs may enroll in OSBs throughout the year. Benefits may change on January 1st each year.
*Humana is a Medicare Advantage [HMO, PPO and PFFS] organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. [Benefits, premiums and/or member cost-share] may change on January 1 of each year. The [Formulary, pharmacy network, and/or provider network] may change at any time. You will receive notice when necessary.
**Out-of-network/non-contracted providers are under no obligation to treat <Plan/Part D Sponsor> members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
***Insured by Humana Insurance Company, The Dental Concern, Inc., Humana Insurance Company of New York, Humana Health Benefit Plan of Louisiana, Inc. For Arizona residents: Insured by Humana Insurance Company. For Texas residents: Insured by Humana Insurance Company.
****Humana Inc. and its subsidiaries (“Humana”) do not discriminate on the basis of race, color, national origin, age, disability, or sex.
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