Vision Benefit

Preserving your best vision is an important part of taking good care of your overall health.

In addition to the vision-related benefits covered by Original Medicare, your Martin’s Point Generations Advantage plan offers extra benefits that go beyond Original Medicare.

Extra Benefits Beyond Original Medicare

• $0-Copay Annual Routine Vision Exam: You pay a $0 copay for one routine vision exam per year. This benefit includes a diabetic (dilated-pupil) eye exam for people with diabetes and glaucoma screening for those at high-risk for glaucoma. See your Evidence of Coverage for details.

• Eyewear Reimbursement: Your plan reimburses up to an annual amount for prescription lenses, frames, and contact lenses. Amount varies by plan.

• Benefit Maximum: A benefit maximum is a dollar limit on a service. The benefit maximum will depend on the plan elected:

How to Use Your Eyewear Reimbursement Benefit

STEP ONE:

Check your Summary of Benefits to see your plan’s annual reimbursement amount.

STEP TWO:

Purchase your qualifying items (prescription lenses, frames, and/or contact lenses) and make a copy of your itemized receipt and proof of payment.

STEP THREE:

Download the 2023 Eyewear Reimbursement Form for items or services purchased while enrolled in a Generations Advantage plan in 2023. (Reimbursement Forms must be submitted by March 31, 2024).

STEP FOUR:

Mail completed reimbursement forms with itemized receipts and proof of purchase to:

Martin’s Point Generations Advantage Claims Department
PO Box 11410
Portland, ME 04104-9863 

We’ll process your request and get a check out to you within 4-6 weeks.

Services and Items Covered by Original Medicare

• Medicare-Covered Eye Exam: Copay varies by plan $0-$45 for outpatient physician services for the diagnosis and treatment of diseases and injuries of the eye, including treatment for age-related macular degeneration.

• Medicare-Covered Eyewear after Cataract Surgery: 20% Coinsurance for one pair of eyeglasses or contact lenses after each cataract surgery that includes insertion of an intraocular lens. See your Evidence of Coverage for details.

The supplemental eyewear benefit covers eyewear/and repair of eyewear and contact lenses for the purpose of correcting/improving a member’s vision.

Member Reimbursement Request for Medical Services (PDF)

Note: Within a year of the date of service, reimbursement paperwork must be received. When submitting, kindly include the itemized proof of payment.

The following services are covered under the Supplemental Eyewear Benefit: