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]
• Vision USA [9]

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 counntry who specialize in vision rehabilitation. In most areas, Medicare covers low vision evaluations [10], which are different from regular eye examinations [11].

At the present time, Medicare, Medicaid and most private insurance plans do not provide coverage or reimbursement for some specialized vision rehabilitation services [12] (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.

There is, however, a Medicare Low Vision Rehabilitation Demonstration Project that is currently in progress, sponsored by the Centers for Medicare & Medicaid Services (CMS).

Medicare is conducting a five-year demonstration project to investigate the expansion of benefits for individuals with moderate to severe vision loss. Through this project, Medicare will assess the impact of providing reimbursement for up to nine hours of vision rehabilitation services in appropriate settings (including the home) by qualified vision rehabilitation professionals under general supervision by a physician. The demonstration is taking place in the following areas: Atlanta, Georgia; Kansas; New Hampshire; New York City (all five boroughs); North Carolina; and Washington State.

To be eligible, patients must meet the following criteria:

• Be enrolled in Medicare Part B fee-for-service and not be a member of a Medicare Advantage Plan;
• Have a diagnosis of moderate to severe vision impairment, including blindness that cannot be corrected by conventional means;
• Reside in one of the six demonstration areas;
• Be able to derive benefit from the rehabilitation.

For more details about the demonstration project, go to the CMS Low Vision Rehabilitation Demonstration [13] web page. Enter "vision" into the keyword search box, and select the "refresh list" button. Scroll down to "Medicare Low Vision Rehabilitation Demonstration." If you have questions, contact the Low Vision Rehabilitation Demonstration Project Officer at visiondemo@cms.hhs.gov [14]

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 [15] 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 [16] (IRS) web site. You may want to begin with their publication Tax Guide for Seniors [17].

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 [18]: The IRS web site provides complete instructions.