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Medicare Vision Care
A complete guide to your medical vision benefits, covered services,
and specialized co-management at Westwood & Montrose Eye Center.
Medical Eye Care vs. Routine Vision
It is a common misconception that Medicare does not cover eye exams. Medicare does cover comprehensive eye exams when there is a medical diagnosis or a medical chief complaint.
If you have been diagnosed with an age-related ocular condition (such as cataracts, dry eye syndrome, diabetes, or glaucoma), or if you come in with a medical symptom (like eye pain, flashes, or sudden blur), we bill Medicare directly for these vital health evaluations to protect your vision
Visit Frequency
How often can you be seen? As often as medically necessary! If you have an active condition like glaucoma or macular degeneration, Medicare covers your required follow-ups, diagnostic testing, and treatments throughout the entire year.
Medicare Guidelines
Understanding The $35 Refraction Charge
Medicare is designed to cover the health and medical evaluation of your eyes, but it explicitly excludes the "Refraction" portion of the exam.
What is a Refraction?
A Refraction is the clinical test performed by Dr. Fouladian using a phoropter (asking "which is better, 1 or 2?") to determine your exact glasses prescription.
Why isn't it covered?
According to federal Medicare guidelines, determining a glasses prescription is strictly considered a "Non-Covered Service" because glasses are viewed as a routine convenience, not a medical treatment.
The Out-of-Pocket Fee
To provide you with an updated prescription for your eyeglasses during a medical visit, there is a nominal $35 out-of-pocket fee for the refraction. If you have a separate Vision Plan (like VSP or EyeMed), we can often coordinate benefits to cover this specific fee.
Comprehensive Care
Managing Age-Related Conditions
We utilize state-of-the-art diagnostic imaging to detect and manage sight-threatening diseases covered by your Medicare plan.
Glaucoma Management
Regular eye pressure checks, visual field testing, and OCT nerve scans allow us to protect your optic nerve from irreversible damage caused by Glaucoma.
Learn MoreMacular Degeneration
We utilize advanced OCT scanning and rigorous monitoring for age-related macular changes (AMD) to preserve your central reading and driving vision.
Learn MoreDiabetic Retinopathy
Annual dilated retinal evaluations are covered by Medicare to prevent silent, progressive vision loss resulting from elevated blood sugar levels.
Learn MoreCataract Surgery Co-Management
Navigating cataract surgery is easy with Dr. Fouladian as your medical advocate.
1
Diagnosis & Monitoring
We monitor the progression of your cataracts during your Medicare visits until they begin to compromise your daily safety, night driving, and overall quality of life.
2
Surgical Referral & Lens Selection
When it's time for intervention, we refer you to elite Los Angeles surgeons. Dr. Fouladian will help you decide between standard covered lenses or premium upgrades (like Toric or Multifocal lenses). Note: Your surgical evaluation and the standard procedure itself are covered under your Medicare benefits.
3
Post-Op Healing
Following the surgery, you return to our familiar, convenient clinic for all post-operative care. We monitor your healing, eye pressure, and inflammation to ensure a perfect, comfortable outcome.
Ready to Use Your Benefits?
Contact us today to schedule your comprehensive Medicare eye exam. We will verify your coverage and answer any billing questions you may have.
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