Prevent Blindness Applauds Legislation to Expand Medicare Vision Benefits; Encourages Low Vision Aids Path to Coverage

As part of a major effort to enact key health care priorities of the Biden Administration’s “Build Back Better” Act, Congress is currently considering legislation to expand Medicare to provide coverage for vision, dental, and hearing services. Under the Medicare vision benefit, beneficiaries would receive coverage for eyeglasses every 2 years or an annual supply of contact lenses, and routine eye exams to beneficiaries starting as soon as 2022. Previously, coverage for vision services in traditional Medicare has been disallowed since 2009 under the so-called “lens exclusion” that prohibits coverage for anything that could be used to enhance visual function through use of a lens.

Prevent Blindness applauds Congress for recognizing a critical gap in health care coverage for America’s seniors and working toward solutions to increase access to beneficiaries with unaddressed vision problems. Over 99% of Medicare beneficiaries had vision problems such as needing eyeglasses, having trouble seeing, having a diagnosis of legal blindness, needing assistance with a visual aid device, or having had cataracts, glaucoma, diabetes-related retinopathy, or age-related macular degeneration. Increased access to vision and eye care can help aging patients not only retain their sight and quality of life but avoid the serious health risks that come with diminished vision, including: injury or death from falls, costly chronic conditions, diminished mental and emotional health due to loss of independence or ability to engage in personal hobbies or exercise, and social isolation and loneliness.

Additionally, Prevent Blindness shares concerns with the ITEM Coalition that the legislation under consideration in the House does not allow for the eventual coverage of low vision aids and assistive devices, and would encourage removal of the “lens exclusion” as currently applied. Prevent Blindness has advocated for inclusion of the Medicare Vision Act of 2021, introduced by Reps. Kim Schrier (WA-08), Tom O’Halleran (AZ-01), Suzan DelBene (WA-01), and Elissa Slotkin (MI-08), in the Build Back Better Act. Improving coverage of these critical devices will help Medicare beneficiaries more fully participate in their medical care, achieve better health outcomes, live more independently, work, care for their loved ones, engage in civic functions, and perform everyday activities.

Currently, the House Ways and Means Committee is set to markup legislation this week with the House Energy and Commerce Committee holding hearings and markup on the bill next week. The Senate has yet to determine its own hearing schedule, but is expected to hold hearings and markup in key committees later this month. Prevent Blindness Government Affairs will provide updates as this fast-moving legislation moves through Congressional consideration.