What is EyeCare America?
- An Academy national public service program that provides medical eye care to underserved seniors and those at increased risk for glaucoma, through volunteer ophthalmologists.
- Since 1985, EyeCare America has helped nearly 2 million people.
What are ECA volunteer program options?
- Seniors Program: Provide a medical eye exam to eligible seniors (65+) and care at no out-of-pocket cost for up to one year for any condition diagnosed at the initial visit for the doctor’s services (see Responsibilities).
- Glaucoma Program: Provide a glaucoma exam, and if deemed necessary, initiate treatment. This is a one-time exam for those who may not know their glaucoma risk. (see Responsibilities).
- Retina Re-referral Program: Provide retina care to eligible Seniors Program patients who need to be re-referred to a retina subspecialist volunteer. (see Responsibilities)
How does EyeCare America work?
- Program eligibility questions are answered online.
- The computer matches eligible patients to the nearest volunteer ophthalmologist by ZIP code on a rotating basis.
- Doctors and patients receive referral letters explaining program details.
- Bill each patient according to program requirements following the exam. (see Responsibilities.)
- Return the patient outcome form to EyeCare America (form provided in referral letter).
How do EyeCare America patients qualify?
All EyeCare America patients must be U.S. citizens or legal residents and NOT belong to an HMO.
To be eligible for the Seniors Program, patients:
- Must be age 65 or older
- Not have been seen by an ophthalmologist in the last three years.
To be eligible for the Glaucoma program, patients:
- Must not have had an eye exam in the last 12 months.
- Must be at increased glaucoma risk (determined by age, race, family history).
Are all EyeCare America patients uninsured?
- No; 88% of seniors referred have Medicare or other insurance and 46% of glaucoma eligible patients are insured.
- EyeCare America does not ask financial questions. The program is designed to provide access to medical eye care for seniors and those at increased glaucoma risk.
How many patients will I see?
- The average number of patients seen per year is 0-4 (depending on the area and need).
- The annual patient-seen limit is 15 per program (some exceptions are made).
Resources and medication assistance programs are available at aao.org/eyecareamerica.org. Staff: 877-887-6327 (M-F, 8:00 a.m. to Noon PT); or eyecareamerica@aao.org
Responsibilities
Seniors Program Volunteer Responsibilities
- Provide a dilated medical eye exam and up to one year of care at no out-of-pocket-cost for any condition diagnosed in the initial exam.
- Return the patient’s outcome form to EyeCare America.
Billing: Seniors and Retina Program Care
- Bill Medicare and/or the patient’s supplemental insurance, waiving any co-payments and unmet deductibles for the care provided, per EyeCare America's waiver. *
- Any other insurance that legally requires a co-payment must not be billed.
- Uninsured seniors are provided the exam and follow-up care at no charge. Volunteers may encourage uninsured seniors to enroll in Medicare Part B.
Service Fees Not Included
- Additional services that are not under the volunteer’s control, such as: Hospital, surgical facility, anesthesiologist fees and medications are the patient’s responsibility (or their insurance).
- EyeCare America does NOT include or cover the cost of eye glasses. If refraction is provided to the patient, the patient must be informed and agree to the cost prior to the exam.
- Care beyond one year is NOT provided under ECA services. The doctor may refer the patient to other local resources and/or discuss other options.
Glaucoma Program Volunteer Responsibilities
- Provide one glaucoma exam. Initiate treatment if deemed necessary.
- If follow-up care is needed, volunteers refer the patient to local available services.
- Return the patient’s outcome form to EyeCare America.
Billing: Glaucoma Program
- Eligible patients self-report their insurance status, which is indicated on the outcome form on the backside of the volunteer referral letter.
- Insured patients are billed and responsible for co-payments and unmet deductibles
(NO co-pays waived).
- Uninsured patients are provided the glaucoma exam at no charge.
Glaucoma Exam Includes (based on Medicare’s Glaucoma Detection Benefit):
- Visual acuity test,
- Slit-lamp exam,
- Applanation tonometry, and
- Dilated exam of the optic disk by direct or biomicroscopic method (unless contraindicated).
A Visual field test is NOT part of the program (if provided, patient should NOT be billed).
Retina Re-referral Program
- Provide care to eligible seniors who need to be re-referred to a subspecialty volunteer.
- Follow the Seniors Program responsibilities.
* Waiver: Health & Human Services OIG Advisory Opinion 99-7 permits only ECA volunteers to waive Medicare
co-payments and unmet deductibles for ECA patients.