Medicare for the BlindJanuary 2, 2020
In a world full of technology, it is easy to assume we all have equal access to Medicare information. But for those who are blind or have visual impairment, this isn’t always the case. In 2016, three blind Medicare beneficiaries changed the path for blind seniors and Medicare eligibles.
National Federation of the Blind vs. Centers for Medicare and Medicaid Services (CMS)
What happened in 2016 to change Medicare for the blind? Three blind beneficiaries decided to challenge how Medicare information is provided to those who are blind or have low vision.
This dispute brought attention to those who are Medicare-eligible and blind and highlighted that they are not provided with equal access to Medicare information. They explained that there was a lack of materials available to someone who was blind or had vision loss.
The Case Results in New Medicare Benefits for the Blind
Two years later, NFB and CMS reached an agreement that requires CMS to provide health care materials for blind or visually impaired beneficiaries in formats such as Braille, large print, and audio. CMS is also now required to extend any time restraints for beneficiaries who have difficulty accessing time-sensitive information.
CMS has responded quickly and implemented critical procedural policies, including training employees in compliance with Section 504 of the Rehabilitation Act of 1973. They are also testing the accessibility of materials on Medicare.gov, providing e-books, and establishing Customer Accessibility Resource Staff.
Medicare and Disability for Blindness
Blind beneficiaries may qualify for benefits from the Social Security Administration (SSA) paid through Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI). These monthly payments can be used to help ensure you have what you need.
The SSA is the organization that administers Medicare benefits for most enrollees. Eligible retired railroad employees get Medicare benefits through the Railroad Retirement Board.
Legally Blind Meaning for Medicare
The Social Security Administration defines blindness as, “vision [that] can’t be corrected to better than 20/200 in your better eye or if your visual field is 20 degrees or less in your better eye for a period that lasted or is expected to last at least 12 months.”
Medicare Benefits for the Blind
In general, any disease or medical issue that affects your vision will likely qualify for coverage Medicare Part B. Treatments, as well as yearly preventive visits and diagnostic exams, could be covered for conditions like macular degeneration or glaucoma.
Medicare may also cover routine eye exams for certain high-risk groups, such as diabetics who are more likely to develop conditions that impair their visual acuity.
Unfortunately, Medicare does not classify eyeglasses or contact lenses as “durable medical equipment” and will not pay for them in most cases. Some exceptions include Part B beneficiaries who have had cataract surgery or have a congenital absence.
Medicare Coverage for Service Animals
Medical coverage at the state and federal level do not cover service animals. The average service animal costs between $15,000-$30,000 to adopt. So if you’re on a restricted income, this might be too costly. What can you do if you need a service animal and can’t afford one?
There are numerous nonprofit organizations that raise, train, and offer service animals for reduced costs. Some organizations provide a service animal free of charge if you qualify.
Additionally, while Medicare benefits won’t pay for the obtaining, feeding, or care for the animal, disability benefits may be able to help cover this additional cost. Other necessities, such as support canes, may also be covered by these disability benefits.
The Americans with Disabilities Act (ADA) does not consider “emotional support animals, or companion animals” to be service animals. In order for your service animal qualify, it must be a dog, and help you “perform specific tasks” directly related to your disability. For example, many service animals are guide dogs that help blind owners get from point A to point B.
Qualifying for Medicaid & Medicare Benefits for the Blind
Medicaid is a state and federal program that provides medical benefits to people who meet certain income eligibility requirements. Medicare is public health insurance available to most people 65 and older, and most people who have ALS, ESRD, or who have received SSDI for at least 25 months.
People who qualify for both Medicare and Medicaid may be eligible for a type of Medicare Advantage plan called a Dual Special Needs Plan (DSNP). Medicare Advantage plans are private insurance policies that can offer many benefits that Original Medicare cannot such as meal delivery, non-emergency medical transportation, and coverage for hearing aids.
If you have a DSNP, you also qualify for a Special Enrollment Period (SEP) that allows you to make changes when other people cannot. Most people have to wait until the Annual Enrollment Period (AEP), which is from October 15 – December 7.
Your DSNP SEP allows you to make one change per quarter from January to September. You can still make changes to your coverage from October to December, however, but you can only make a change during AEP. The changes you make during this period will take effect on January 1 the following year.
Do you have the right Medicare coverage?
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This post was originally published on August 23, 2018, by Kelsey Davis. The latest update was on December 9, 2020, by Addison McNatt.