Paying for Vision Rehabilitation Services: Costs and Tax Information

The following information can help you learn more about paying for vision rehabilitation services, locating financial assistance, and learning about tax deductions and disability and Medicare benefits for which you might eligible. If you have health insurance, either privately or through your employer, it's recommended that you check with your insurance agent for details of your specific coverage.

How can I pay for vision rehabilitation services?

There are several payment options for vision rehabilitation services:

• In most cases, vision rehabilitation services are provided free of charge through tax dollars paid by you, your spouse, or your family members.
• Insurance plans sometimes cover portions of your eye and low vision examinations. Check with your provider to determine if you have coverage for these services.
• Many agencies offer services on a sliding fee scale and develop payment plans based on your circumstances and financial need.

For more information on Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits, you can visit the Centers for Medicare and Medicaid Services (CMS) [1] and Social Security Online [2].

The Social Security Administration also publishes "If You Are Blind or Have Low Vision — How We Can Help" [3], an online publication that discusses legal blindness, disability benefits, and special services for people who are blind.

The following charitable and fraternal organizations can also offer financial assistance to eligible persons:

• EyeCare America [4]
• Knights Templar Eye Foundation [5]
• Lions Clubs International [6]
• Mission Cataract USA [7]
• New Eyes for the Needy [8]
• Surgical Eye Expeditions (SEE) International [9]
• Vision USA [10]

Does Medicare provide funding for vision rehabilitation services?

Since 2002, Medicare has reimbursed for vision rehabilitation for beneficiaries who have visual impairments on the same basis as it reimburses for rehabilitation for any other physical impairment that compromises function in daily activities.

The only stipulation, clarified by Medicare in 2005, is that the provider of services be an occupational therapist (OT); there are OTs in many areas of the country who specialize in vision rehabilitation. In most areas, Medicare covers low vision evaluations [11], which are different from regular eye examinations [12].

At the present time, Medicare, Medicaid and most private insurance plans do not provide coverage or reimbursement for some specialized vision rehabilitation services [13] (such as Vision Rehabilitation Therapy or Orientation and Mobility) or for many adaptive daily living devices and products, such as adaptive kitchen equipment or writing devices.

The Centers for Medicare & Medicaid Services (CMS) sponsored the five-year Medicare Low Vision Rehabilitation Demonstration Project in order to investigate the expansion of Medicare benefits for individuals with moderate to severe vision loss.

The demonstration project has been completed, and the status of Medicare reimbursement for vision rehabilitation services remains uncertain.

Through this project, Medicare assessed the impact of providing reimbursement for a specified number of hours (up to 12) of vision rehabilitation services in appropriate settings (including the home) by qualified vision rehabilitation professionals under general supervision by a physician. The demonstration took place in the following areas: Georgia; Kansas; New Hampshire; New York City (all five boroughs); North Carolina; and Washington State.

For more information about the Medicare Low Vision Demonstration Project, go to Medicare Policy Issues Related to Low Vision Rehabilitation [14], by Robert W. Massof, Ph.D., from the Wilmer Eye Institute at Johns Hopkins University School of Medicine.

You can also read the Medicare Low Vision Demonstration Project Final Report [15], compiled by Brandeis University and released as three separate reports. The first is the Final Report on Provider Case Studies; the second is the Final Report on Beneficiary Case Studies; the third is the Final Report on Claims Analysis.

Do federal programs for older adults provide coverage for vision rehabilitation services?

The primary source of federal funds for vision rehabilitation services (such as Vision Rehabilitation Therapy and Orientation and Mobility) and adaptive devices for older adults is Title 7, Chapter 2 of the Rehabilitation Act (Independent Living Services for Older Individuals Who are Blind). Through this program, states provide the following services:

• Daily living and communication skills
• Independent travel
• Use of low vision devices
• Peer and family counseling
• Outreach to rural and undeserved adults

You can read more about Title 7, Chapter 2 programs and funding at the American Foundation for the Blind [16] web site.

Are there tax deductions, disability benefits, or discounts for people with vision loss?

All questions related to taxes, deductions, earned/unearned income, expenses related to guide dogs or other animals aiding persons with disabilities can be found at the Internal Revenue Service [17] (IRS) web site. You may want to begin with their publication Tax Guide for Seniors [18].

The IRS is making its tax forms accessible to people who are blind or have low vision. Read more information on "talking" IRS forms:

• IRS Accessible Tax Forms [19]: The IRS web site provides complete instructions.