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How Can Medicare Help People With Low Vision or Vision Impairment? In a Provider Education Article (Transmittal AB-02-078) dated May 29, 2002 from the Department of Health and Human Services, the door appears to have been opened for, "medically necessary rehabilitation services" that may benefit people with vision impairment. The bottom line to the physician and provider community is, "Medicare beneficiaries who are blind or visually impaired are eligible for physican-prescribed rehabilitation services from approved health-care professionals on the same basis as beneficiaries with other medical conditions that result in reduced physical functioning." "A Medicare beneficiary with vision loss may be eligible for rehabilitation services designed to improve finctioning, by therapy, to improve performance of activities of daily living, including self-care and home management skills. Evaluation of the patient's level of functioning in activities of daily living is critical and should be performed by an occupational or physical therapist." (NOTE: Therapy assistants cannot perform such evaluations.) "Vision impairment ranging from low vision to total blindness may result from primary eye diagnosis, such as macular degeneration, retinitis pigmentosa or glaucoma, or as a condition secondary to another primary diagnosis such as diabetes mellitus or AIDS." Rehabilitation services must follow a written treatment plan from a Medicare physician implemented by approved Medicare providers. Theraputic services that are covered may include Mobility, Activities of daily living and other rehabilitation goals that are medically necessary. "The patient must have a potential for restoration or improvement of lost functions, and must be expected to improve significantly within a reasonable and generally predictable amount of time. Most rehabilitation is short-term and intensive." Maintainence therapy is not covered. However, "instruction in the use of adaptive equipment" may be covered. Ask your health-care professional. Will Medicare Pay For Magnification Equipment? Many of our customers have asked whether Medicare will pay for low vision equipment like the CCTV equipment Bossert Specialties carries. Although we are not experts on the Medicare system we have learned from various sources that Medicare has traditionally denied claims for re-imbursement for low vision CCTV equipment. Despite the fact that there are no rules preventing them from paying, they deny claims as a matter of routine. However, we have also been told that persistent action through the appeals process may prompt Medicare re-imbursement. There are no guarantees. |