FREE ELECTRONIC LIBRARY - Dissertations, online materials

«Insuring Your Eye Health in Ohio Prevent Blindness Ohio 1500 W Third Ave, Ste 200 Most people require some kind of eye care throughout their ...»

Insuring Your Eye Health in Ohio

Prevent Blindness Ohio

1500 W Third Ave, Ste 200

Most people require some kind of eye care throughout their lifetime,

Columbus, Ohio 43212

but how do they pay for it? Insurance can be a confusing topic in any


circumstance but this is especially true when it comes to our eye health.

Insurance for eye health care can come from various sources. It may be

employer-sponsored medical or vision insurance, individually purchased

medical or vision insurance, Medicare, Medicaid, state children’s health insurance programs, or other public or private programs. This general overview of some key topics related to your vision insurance will help you navigate an increasingly complex arena and allow you to better care for your vision and eye health.

There are many distinctions between insurance plans, so check your plan documents carefully to determine what is covered, how often, and what your associated out-of-pocket costs may be.

Medical Insurance vs. Vision Insurance Vision insurance and medical insurance cover different services, but the distinction can be confusing.

Medical insurance (also commonly called “health insurance”) offers coverage for most services related to the health of the eye itself when provided by an eye care professional – an optometrist or ophthalmologist. For example, exams and tests associated with diagnosed cataracts, glaucoma, diabetic eye disease, and other conditions that require specific counseling, documentation, followup care, regular monitoring and/or referral to a surgeon, would be covered by your medical insurance. While many plans do not cover routine exams to determine if there is an eye problem in the general population, some may include regular dilated eye exams to check for signs of disease in individuals at high risk. However, there is a growing trend among medical insurance plans to cover a routine eye exam, so be sure to check with your insurance carrier about your plan’s benefits.

Medical insurance does not cover routine eye care related to refractive error to determine your eyeglass or contact lens prescription. It also does not generally cover the costs of eyeglasses or contact lenses.

Vision insurance is often sold as a supplemental insurance product to cover the cost of routine eye care. This generally includes a comprehensive eye exam, any associated refraction fee to determine your eyeglass prescription, and some allowance for glasses or contact lenses. A contact lens exam may be covered.

This publication is copyrighted. This sheet may be reproduced—unaltered in hard print (photocopied) for educational purposes only. The Prevent Blindness name, logo, telephone number and copyright information may not be omitted. Electronic reproduction, other reprint, excerption or use is not permitted without written consent. Because of the time-sensitive nature of the information contained in this publication, contact Prevent Blindness for updates.

2/19 © 2014 Prevent Blindness® All rights reserved.

Insuring Your Eye Health in Ohio—Continued Which Insurance Will Cover My Eye Care?

Both vision and medical insurance can be used in your optometrist or ophthalmologist’s office, but which insurance plan pays for your eye care generally depends on the reason for your visit. If your diagnosis for the visit relates to refractive error, such as astigmatism, nearsightedness, or farsightedness, it will be covered by your vision insurance. If the diagnosis for the visit relates to glaucoma, cataract, conjunctivitis, or other conditions that require medical care, it will be paid for by your medical insurance. “Medical care” in this case can be offered by any provider licensed to provide that care in Ohio; this usually includes both optometrists and ophthalmologists.

What If I Don’t Have Health Insurance?

There are many options for health insurance for your family. If you are unemployed, or if your employer does not offer health insurance, you may be eligible for subsidies to help you pay for insurance offered through the health insurance marketplace. Based on your household income, your child may be eligible for Medicaid. Go to benefits.ohio.gov to learn if you qualify for Medicaid or call 800.324.8680. Individuals up to 138% of the federal poverty level (annual income of about $16,000/year) may be eligible for Medicaid.

If you don’t qualify for Medicaid and need health insurance, visit the Health Insurance Marketplace at Healthcare.gov. Depending on your income, you may qualify for subsidies. Insurance offered through Marketplace is not required to include vision care for individuals aged 21+, however some plans may offer it as part of the plan and/or as a supplemental plan.

Vision Services for Children: The Affordable Care Act and Your Child’s Eyes Recent changes in federal law may impact the kinds of vision and eye health services your child has access to through health insurance.

Starting January 1, 2014, all individual health insurance plans, small group insurance plans, or plans sold in the new state-based health insurance marketplaces (exchanges) will have to include a set of “essential health benefits” (large group plans are currently excluded from this requirement). Included in this list of “essential” services is coverage for children’s vision.

In Ohio, this means that new insurance plans will cover one comprehensive eye exam and one pair of glasses each year for children up to age 21. Co-pays and deductibles may apply. Children, ages 0-20, living in families with annual income up to 200% of the federal poverty level (annual income of about $47,000/year for a Insuring Your Eye Health in Ohio—Continued family of four) may be eligible for Medicaid. A comprehensive eye exam, eyeglasses and other vision services are provided annually at no cost to the recipient.

Also starting January 1, 2014, insurance plans must cover certain preventive services without a copay or coinsurance; this includes vision screening for kids. This screening would likely be offered in your pediatrician’s office as part of a well-child visit.

To find out more, visit HealthCare.gov or call 800.318.2596.

Vision Services for Older Adults – Medicare and Your Eyes Medicare beneficiaries, especially those at risk for or diagnosed with a variety of diseases, are entitled to a number of vision-related services. It is especially important for people with diabetes, a family history of glaucoma, or those who have suffered an eye disease or injury to be aware of and utilize these benefits.

Below are details about medical benefits that may be available to you.

“Welcome to Medicare” Preventive Visit The “Welcome to Medicare” visit is an excellent way for you to get up-to-date on important screenings and vaccinations, as well as to talk with your health care provider about how to stay healthy. You can get this introductory visit only within the first 12 months you have Medicare Part B (medical). This visit is covered one

time. Your doctor will:

• Record and evaluate your medical and family history, current health conditions, and prescriptions.

• Check your blood pressure, vision, weight, and height to get a baseline for your care. Keep in mind the vision check is a screening for vision loss risk factors, not an eye exam through dilated pupil.

• Make sure you’re up-to-date with preventive screenings and services, such as cancer screenings and shots.

• Order further tests, depending on your general health and medical history.

Following the visit, your doctor will give you a plan or checklist with screenings and preventive services that you need. Ask about eye exams!

Routine Eye Exams Medicare does not generally cover the costs of routine eye exams, with some exceptions. Medicare does help cover the exam if you have diabetes, or are at risk for glaucoma. Keep in mind that Medicare does not cover refractions for eyeglasses or contacts even as a part of some otherwise covered exams. Check with your eye care professional for more information. Medicare does not cover eyeglasses or contact lenses, except immediately following cataract surgery. Medicare does cover an eye exam for medical reasons, such as in the case of injury or disease. Medicare Advantage plans, which are administered by private companies, often choose to offer vision coverage and traditional Medicare beneficiaries also have the option to purchase supplemental coverage (Medigap) in addition to their Medicare coverage that may cover routine eye care or help to cover the cost of deductibles and other fees.

Glaucoma Glaucoma is called “the sneak thief of sight” because often there are no warning signs, but there is treatment for glaucoma if detected early. A leading cause of blindness, glaucoma affects close to 2.7 Insuring Your Eye Health in Ohio—Continued million Americans age 40 and older. Medicare provides annual coverage for glaucoma screenings if you are

considered to be at high risk for glaucoma. High risk is defined as:

• Individuals with a family history of glaucoma – family defined as a blood parent or sibling;

• Individuals with diabetes - either diet-controlled, oral-agent controlled, or insulin-dependent;

• African Americans age 50; and • Hispanic individuals age 65 or older.

The covered exam for glaucoma includes a visual acuity screening; a dilated eye examination; intraocular pressure measurement; and direct ophthalmoscopy.

Medicare will cover 80 percent of the doctor’s exam fee. You or your secondary insurance must pick up the deductible and the remaining 20 percent balance. A minimum of 366 days is required between glaucoma screening visits.

Find out more about glaucoma: www.preventblindness.org/glaucoma-learning-center Diabetes If you have diabetes, you are at risk for developing diabetic retinopathy, glaucoma, and cataracts. Diabetic eye disease can affect anyone with diabetes. Often there are no symptoms, so it is important to see your eye care professional regularly for a comprehensive eye exam.

Medicare beneficiaries with diabetes qualify for the annual glaucoma screening benefit. This benefit includes a comprehensive eye exam. Because people with diabetes need to have an eye exam at least once a year, Medicare beneficiaries should be sure to make full use of the yearly glaucoma screening benefit (discussed above) to receive an eye exam that can check for both glaucoma and diabetic retinopathy.

Find out more about diabetes and your eyes: www.preventblindness.org/diabetes-and-your-eyes Cataract Surgery Cataract affects millions of Americans and is a leading cause of blindness worldwide. In the U.S., cataract surgery is the most commonly performed surgical procedure in those 65 and older.

Medicare beneficiaries have two choices for cataract surgery in addition to the cataract removal: receiving basic lens replacement (IOL), paid in full by Medicare up to $2,000, or applying the credit to new replacement lenses that can correct both near and farsightedness (multifocal IOLs). Patients are then responsible for paying the difference.

Medicare also covers corrective eyeglasses or contacts following cataract surgery with an implanted intraocular lens. Medicare pays 80 percent of the Medicare-approved amount for one pair of eyeglasses or contact lenses after each cataract surgery. The beneficiary pays any additional charges for upgraded frames and the Part B deductible.

Find out more about cataract: www.preventblindness.org/cataract

Age-related Macular Degeneration (AMD) AMD diminishes central vision that currently affects the vision of more than 2 million Americans age 50 and older and is a leading cause of blindness. AMD is a progressive disease that, if left untreated, can result in severe vision loss and even blindness.

Insuring Your Eye Health in Ohio—Continued Medicare Part B covers treatment for beneficiaries with age-related macular degeneration, including Avastin, Eylea, Lucentis, pegaptanib, and ocular photodynamic therapy with verteporfin (Visudyne). The beneficiary pays 20 percent of the Medicare-approved amount for the drug and the doctor’s services or a co-payment if the treatment is offered in a hospital outpatient setting.

Find out more about AMD: www.preventblindness.org/age-relatedmacular-degeneration-amd Prescription Drug Benefits All Medicare beneficiaries, no matter how they get their health care today or whether they have existing drug coverage, are eligible for drug coverage under a Medicare prescription drug plan (also known as a Part D plan). This includes eye medications.

There are penalties for people who miss the below enrollment deadlines:

• October 15 – annual open enrollment period begins • December 7 – annual open enrollment period ends • January 10 – new choices take effect Medicare prescription drug plans will vary depending on where you live, and each plan is different. Contact the Centers for Medicare and Medicaid Services (800.633.4227 or www.medicare.gov) to better understand your choices.

Financial assistance is available for those who meet certain income and resource limits. Contact the Social Security Administration (800.772.1213 or www.socialsecurity.gov) to learn more.

Medicare Advantage Medicare Advantage plans are Medicare plans administered by private insurance companies. They are available to all Medicare eligible individuals and must cover all the services covered by traditional Medicare. However, these plans have the option to structure themselves in unique ways and most offer additional services, such as coverage for vision or dental care. Many of these plans cover routine eye exams and offer a glasses or contact lens benefit.

Similar works:

«NOT-SO-ORDINARY JUDGES IN ORDINARY COURTS: TEACHING JORDAN V. DUFF & PHELPS, INC. J. Mark Ramseyer∗ Everyone loves a brawl. And all the more so when the brawlers are smart, biting, literate debaters who routinely take wildly out-of-fashion positions. For a casebook editor trying to maximize adoptions, that makes Jordan v. Duff & Phelps, Inc.1 an easy call.2 Jordan juxtaposes at-will employment with corporate fiduciary duties. The plaintiff, employee-shareholder James Jordan, argued that his...»

«INTRODUCTION TO MEDICAL ACUPUNCTURE STUDY GUIDE EAST TENNESSEE STATE UNIVERSITY JAN 7TH-9TH 2011 DR. CARLOS A. SUAREZ MD, DABMA Table of Contents Cover 1 Table of Contents 2 Welcome letter 3 An Overview of Medical Acupuncture 4 Acupunture Theory 16 The Chinese Perspective of Health and Disease 17 An Introduction to Chinese Measurements 28 Acupuncture Meridian Points 29 2 October 2010 WELCOME LETTER Introduction to Medical Acupuncture Course Study Guide Dear Participants: I want to thank you for...»

«Training Programme for Public Health Nurses and Doctors in Child Health Screening, Surveillance and Health Promotion Unit 2 Vision Screening January 2005 Acknowledgments The Programme of Action for Children wishes to thank Mr John McCance, Senior Orthoptist, NWHB Ms Eileen Buckley, Senior Orthoptist, NWHB Dr Joanne Kearney, Community Ophthalmic Physician, NWHB Ms Bronagh McAuley Orthoptist NWHB Ms Clare Hannigan Senior Orthoptist NWHB for their work in the development of this Training Module....»

«handouts and resources | additional resources TM Parents as sexuality educators recommended reading list “Sexual knowledge, like all knowledge, is powerful. Used carefully and deliberately, it is the cornerstone of safe, healthy, moral conduct.” —from But How’d I Get in There in the First Place? by deborah roffman for families All About Sex: A Family Resource on Sex and Sexuality Ronald Filiberti Moglia, Ed.D. and Jon Knowles, Editors. Three Rivers Press, 1997. This book, published by...»

«MOLECULAR MECHANISMS OF LTBP4-RELATED CUTIS LAXA by Chi-Ting Su M.D., School of Medicine, Kaohsiung Medical University, Taiwan, 2003 MPH, University of Pittsburgh, 2012 Submitted to the Graduate Faculty of the Graduate School of Public Health in partial fulfillment of the requirements for the degree of Doctor of Philosophy University of Pittsburgh 2014 UNIVERSITY OF PITTSBURGH GRADUATE SCHOOL OF PUBLIC HEALTH This dissertation was presented by Chi-Ting Su It was defended on April 9, 2014 and...»

«INTRODUCTION TO THE STUDY OF ENTOMOLOGY Takumasa Kondo Corporación Colombiana de Investigación Agropecuaria (CORPOICA), Centro de Investigación Palmira, Valle del Cauca, Colombia. Keywords: apiculture, applied entomology, arthropoda, arthropod-borne diseases, basic entomology, biogeography, bugs, Chagas disease, ecological genetics, entomology, entomophagy, entognathology, entognathologist, forest entomology, Hexapoda, Insecta, insect anatomy, insect physiology, insect color pigments, insect...»

«American Journal of Research Communication www.usa-journals.com Assessment of nutritional composition and antioxidant ability of pearl millet (Pennisetum glaucum) Odusola K B1, Ilesanmi F F2*, Akinloye O.A3 1 Federal Colleges of Animal Health and Production Technology, Moor Plantation, Ibadan., Nigeria 2 Nigerian Stored Products Research Institute, Ibadan Nigeria. 3 Department of Biochemistry, Federal University of Agriculture Abeokuta, Nigeria. *Corresponding Author; Ilesanmi FF E-mail:...»

«Investigation into the etiology of decline of Raywood ash in Northern California Principal Investigator: Thomas R. Gordon Department of Plant Pathology, UC Davis, One Shields Ave., Davis, CA 95616 Report to the Elvenia J. Slosson Endowment Fund. This is a final report for work performed from July 1, 2003 to June 30, 2004 (year 2 of a 3-year study).SUMMARY OF ACCOMPLISHMENTS The objective of our continuing study is to clarify the contributions of Botryosphaeria and water stress to the dieback...»

«Wealthier But Not Much Healthier: Effects of a Health Insurance Program for the Poor in Mexico Rodrigo Barros∗ Stanford University November 2008 Abstract In 2002 the Mexican government began a very large expansion of government-funded healthcare for the poor specifically, people not employed in the formal sector. The program, Seguro Popular (SP), was rolled out sequentially across different areas in Mexico. This paper uses the variation in program intensity over time and space induced by...»

«Letters to a third-year Student From The Class of 2010 School of Medicine UT Health Science Center at San Antonio Editor: David L. Henzi, Ed.D Director Office of Academic Enhancement [ ] “There’s always the possibility that we will come to a new understanding and to perceive the body as a primal mystery and therefore sacred. Again and again, in patients deformed or ravaged by disease, we are stunned by a sudden radiance. This is not always comforting; there is terror in occasions that lift...»

«North American Institute of Medical Herbalism http://naimh.com Medical Herbalism Journal http://medherb.com Boericke's Tinctures by Paul Bergner In the period between 1880 and 1920, the practice of medical herbalism in North America was influenced by the homeopathic school of medicine, and in turn, influenced the practice of homeopathy. The homeopaths engaged in formal experimental provings of the effect of remedies at crude undiluted doses, and discovered some indications this way. They also...»

«The Traditional Roles of Caring for Elders: Views from First Nations Elders Regarding Health, Violence, and Elder Abuse A Dissertation Presented for The Graduate Studies Council The University of Tennessee Health Science Center In Partial Fulfillment Of the Requirements for the Degree Doctor of Philosophy From The University of Tennessee By Eileen A. Owen-Williams May 2012 Copyright © 2012 by Eileen A. Owen-Williams. All rights reserved. ii DEDICATION This dissertation is dedicated to the...»

<<  HOME   |    CONTACTS
2016 www.dissertation.xlibx.info - Dissertations, online materials

Materials of this site are available for review, all rights belong to their respective owners.
If you do not agree with the fact that your material is placed on this site, please, email us, we will within 1-2 business days delete him.