Medicare Guidelines for Eye Care Services

Here at Lickteig Family Eye Care, we help all patients understand their insurance benefits.

Although we are a Medicare provider, there are strict protocols we must follow to continue being a provider. The following are some of the Medicare Guidelines for Eye Care Services.

We only accept Part B Medicare.

We do not accept Part A. Part B beneficiaries must pay an annual deductible toward any qualified health care (currently $162) before Medicare will pay for any services. After the deductible has been met for the year, Medicare will pay 80% of the contracted fee and the patient pays 20% as co-insurance plus any non-covered fees. If the patient has supplemental insurance (such as Blue Cross/Blue Shield) it may cover the cost of the deductible and co-payment.

Our office will bill Medicare and accept payment directly from them if the services qualify for Medicare coverage (see exceptions below). Any charges that Medicare will not cover will be due at the time of your visit.

Special Exceptions:

  1. Medicare does not cover eyeglasses or contact lenses unless you have had cataract surgery, and then only the first pair.
  2. Medicare does not cover the refraction part of an eye exam, which is the test that determines one’s prescription.
  3. Medicare does not cover any routine services unless we make a medical diagnosis. If your ONLY diagnosis is myopia, hyperopia, astigmatism, or presbyopia, Medicare will not pay for any services.

Electronic Signature for Acceptance of Medicare Guidelines

  • I have read and understand the above and I agree to pay for services and materials which I order, but which Medicare does not cover. YOUR SIGNATURE ON THIS FORM WILL SERVE AS YOUR “SIGNATURE ON FILE” FOR PROCESSING MEDICARE FORMS: