Does Medicare Cover Macular Degeneration?

Yes, Original Medicare covers diagnostic tests and treatments, including some injected drug treatments, for Medicare beneficiaries diagnosed with age-related Macular Degeneration.

Macular degeneration is a condition that affects the retina, the part of the eye responsible for sending visual information to the brain. As the name suggests, macular degeneration affects the macula, the part of the retina responsible for sharp, central vision.

What Does Medicare Cover for Macular Degeneration?

Medicare covers a range of vision care services and treatments for macular degeneration, including eye exams, diagnostic tests, and treatment options. Here’s a quick overview of what you can expect:

Eye exams: Medicare Part B (Medical Insurance) covers eye exams to diagnose and treat macular degeneration, other eye diseases, and vision problems.

Diagnostic tests: Medicare covers several diagnostic tests to help diagnose macular degeneration, such as optical coherence tomography (OCT), fundus photography, and fluorescein angiography.

Treatment options: Medicare covers several vision services and treatment options for macular degeneration, including injections, laser treatments, and photodynamic therapy (PDT).

What You'll Pay For Macular Degeneration Treatment

As with most healthcare services, you’ll typically pay some of the costs of macular degeneration treatment. Here’s what you can expect to pay:

  • Outpatient Services: Treatments for Macular Degeneration, like eye exams, diagnostic tests, and treatment options, are covered under Medicare Part B, and your out-of-pocket costs will include your annual Part B deductible and your Part B coinsurance of 20%.
  • Hospital Outpatient Setting: If you receive treatment in a hospital outpatient setting, you will be responsible for paying an outpatient facility copayment in addition to your Part B deductible and coinsurance.

Which Injections for Macular Degeneration Does Medicare Cover?

Medicare covers a range of injections for macular degeneration, including anti-VEGF (vascular endothelial growth factor) injections, steroids, and antibiotics.

Anti-VEGF injections help reduce the abnormal blood vessels in the eye associated with wet macular degeneration. Steroid and antibiotic injections can treat inflammation caused by dry macular degeneration.

Bottom Line

Macular degeneration is a serious eye condition that can impact your quality of life and cause vision loss. Fortunately, Medicare covers a range of services and treatments to help diagnose and manage this condition.

If you’re diagnosed with macular degeneration, talk to your healthcare provider about the best treatment. Together, you can work to minimize the impact of macular degeneration on your vision and your life.

Sources: Medicare.govMedicalNewsTodayHelpAdvisor


  • Does Medicare pay for eye shots for Macular Degeneration?

    Yes, Medicare covers injections for macular degeneration, including anti-VEGF, steroid, and antibiotic injections.

  • What is dry Macular Degeneration?

    Dry macular degeneration: Dry AMD is caused by aging and deterioration of the light-sensitive cells in the macula. This affects your central vision, making it difficult to see objects that are straight ahead. Symptoms can include blurred or distorted vision, difficulty adapting to different brightness levels, and difficulty recognizing faces and colors.

  • What is Wet Macular Degeneration?

    Wet macular degeneration: Wet AMD is caused by the growth of abnormal blood vessels in the eye. These leak fluid and cause scarring, resulting in distortion or loss of central vision. Symptoms can include blurry or distorted vision, difficulty adapting to different levels of brightness, and difficulty recognizing faces and colors.

Mark Prip

Since 2003, Mark Prip has been leading  Policy Guide, Inc., providing knowledgeable information about Medicare, life insurance, and dental coverage to clients in over forty states. With his unparalleled hands-on experience aiding countless Medicare beneficiaries in selecting an appropriate health plan, he is a prime example amongst other competitors for expertise and assistance. Mark has held his Florida Health & Life Insurance License (E051889) since 2003. View his license profile on the Florida Department of Insurance website.