Eye Care & Low Vision Resources
Our vision changes as we age. Some eye diseases that cause vision loss have no symptoms. That’s why it’s important to receive yearly eye exams to maintain your eye health. If more advanced care is needed, your eye doctor can refer you to a specialist.
How do I get this?
Medicare – Medicare provides limited coverage when it comes to eye care depending on your risks and medical conditions.
- “Welcome to Medicare” preventative visit:
- If you have a family history of vision problems (ie. cataracts, glaucoma, macular degeneration, etc.), be sure your doctor adds this information to your family history record at this initial “Welcome to Medicare” preventative visit. This allows for your doctor to order testing around these issues down the road and have it be covered by Medicare.
- Routine Eye Exams:
- A yearly exam for those with diabetes
- A yearly exam for those at high risk for glaucoma (which includes having diabetes, a family history of glaucoma, if you are 50-years+ and African American, or if you are 65-years+ and Hispanic/Latino)
- Diagnostic tests and treatments for some people who have macular degeneration
- Eyeglasses or Contact Lenses: Medicare may cover eyeglass lenses (frames not included) or contact lenses once a year for those who have had cataract surgery.
- Medical Procedures/Surgery: Medicare may cover surgeries that are medically-necessary including cataract surgery. Be sure to talk to your eye doctor about what is covered before scheduling surgery.
You may have eye care coverage through supplemental insurance or an Advantage Plan – these are purchased in addition to Original Medicare. To find out if you have this kind of coverage, call the customer service number on the back of your health insurance card. If you would like to purchase supplemental insurance or an Advantage Plan, call your local State Health Insurance Assistance Program (SHIP) office at 1-888-696-7213 (Colorado). You may only be able to purchase this at certain times of the year.
Private Pay ‐ Some people purchase private insurance. If you have vision insurance, call your insurance company to find out what services are covered. Your eye doctor’s office can also help explain your benefits. Call your local State Health Insurance Assistance Program (SHIP) office at 303-480-6835 (Denver-metro) or 1-888-696-7213 (Colorado) to find out more about private vision insurance.
Medicaid ‐ Depending on your income, you may qualify for Medicaid to pay for limited eye care.
- Eye exams are covered for “problem-focused” visits.
- Glasses are covered only after eye surgery
- Contact lenses are only covered if there’s a medical reason
- Other vision aids are covered with prior authorization
Contact your county Department of Human Services for eligibility guidelines and a Medicaid application or visit coloradopeak.secure.force.com/AC_Welcome to complete an application online.
If you are on Medicaid, visit www.colorado.gov/hcpf/find-doctor. Use the options on the left side to select “optometrist” or “ophthalmology,” and search by your location to get a list of providers in your area.
Veterans ‐ You may be eligible for services. Contact your county Veteran Service Office (VSO) for more information: https://vets.colorado.gov/county-veterans-service-offices. You can also call the Colorado Division of Veterans Affairs: 303-284-6077 (Denver location) or 800-827-1000 (Lakewood location).
Community ‐ For financial assistance options, call your Area Agency on Aging / Aging & Disability Resource Center: 1-844-265-2372 (statewide) or the Colorado Gerontological Society at 303-333-3482. If you do not have vision insurance and are not on Medicare, Prevent Blindness has a list of low cost options: www.preventblindness.org.
If you plan on applying for community financial assistance, do not start your vision care (get an exam or order your eyeglasses) until you submit an application and receive an answer as to whether or not you’re approved for assistance. Often, financial assistance will not cover care that has already been started, so it is important to plan ahead.
Colorado Center for the Blind offers an Independence Training Program (ITP) for people experiencing vision loss including: home management, cane travel, Braille, and computer and adaptive technology. They also offer support groups and in-home training for older adults. 303-778-1130; www.cocenter.org
Assistive Technology Partners provides a list of assistive technology funding resources, one-on-one assessments/consultations on how to use adaptive devices, and a device exchange program through the University of Colorado College of Engineering & Applied Science. 303-315-1280; Email at: firstname.lastname@example.org.
Audio Information Network of Colorado gives people with vision loss audio access to printed materials like newspapers, magazines, grocery ads and other local publications. English and Spanish are available. 303-786-7777 or 877-443-2001; http://aincolorado.org/
Talking Book Library provides recorded, Braille, and large-print books and magazines on loan. 303-727-9277 or 800-685-2136; www.cde.state.co.us/ctbl/
The American Academy of Opthalmology is also a great resource for eye health resources: www.aao.org/eye-health
Things to Consider:
Remember that you can always ask for an estimate for any eye care before you receive services. This way, you can seek a second opinion to compare costs before making a decision.
Who provides eye care and how they are licensed:
Optometrists are licensed with a doctor of optometry (OD) degree. They provide primary vision care which includes routine eye exams, vision tests, and fitting of glasses and contacts. An optometrist is not a medical doctor.
The National Board of Examiners in Optometry – Verify a Professional License: www.optometry.org
Ophthalmologists are medical doctors who have graduated from medical school and completed specialized training. They diagnose and treat eye diseases, perform eye surgery, and fit glasses and contacts.
American Board of Ophthalmology – Verify a Professional License: www.abop.org/verify-a-physician
Opticians are trained to design and fit glasses and contact lenses. They use prescriptions provided by ophthalmologists and optometrists. They do not perform vision tests, diagnose or treat eye diseases.
Need more assistance or want to talk with someone?
- Aging & Disability Resources for the Denver Metro Area: 303-480-6700
- Aging & Disability Resources for Colorado: 1-844-265-2372
- Colorado Gerontological Society: 303-333-3482
- Eldercare Locator (a national hotline for aging resources all over the US): 1-800-677-1116
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This guide is brought to you by the Denver Coordinated Workgroup. The Denver Coordinated Workgroup is made up of experts from the field of aging who are committed to creating and sharing information in order to guide people to the services they need to thrive as they grow older. Western Care Partners is proud to serve with this group of talented professionals.