Diabetic retinal eye exams

A diabetic eye exam is part of a comprehensive (or routine) eye exam performed by an eye care professional to check for signs of diabetic retinopathy. This condition can affect people with type 1 or type 2 diabetes and can cause serious complications, including vision loss or blindness.¹ Thankfully, a diabetic retinal eye exam is a generally simple, painless procedure that can help you prevent diabetic retinopathy or detect signs early.²

Before the exam, an eye care professional will dilate your pupils with eye drops. Once your pupils widen about 20 minutes later, the eye care professional will check your visual acuity (sharpness), depth perception and eye movement. They will also examine the back of the eye for signs of diabetic retinopathy. Since diabetes can increase your risk for glaucoma, some exams may include glaucoma testing.³

The retinal exam itself generally takes about 10 minutes. If you schedule the exam in-office with an eye care professional, you may get results immediately.⁴

Humana works with trusted vendors to provide at-home diabetic retinal exams. If you’re eligible for an at-home diabetic retinal exam, you may be contacted by one of the following Humana-approved vendors:

• HealPros
• Sprinter Health
• EasyHealth
• Signify
• Matrix

Humana Medicare Advantage plan members may have the opportunity for an at-home diabetic eye exam. Before the exam, a Humana-approved vendor will contact you to schedule your appointment. Next, an eye care specialist will give you a retinal exam from the comfort of your home. Unlike a traditional exam done at an ophthalmologist or optometrist’s office, an in-home screening does not require dilating drops and does not impair your vision. Our vendors utilize compact, lightweight fundus cameras that allow their technicians to take high-quality images transmitted to an ophthalmologist for review seamlessly.

Once an ophthalmologist has reviewed the images, your results will be mailed to you and your primary care physician (PCP). Humana will also update your records with your exam results.

Medicare members who have not completed their diabetic retinal exam within the past year are generally eligible for at-home exams, with some exceptions. Contact your provider to see if you qualify.

If you have been contacted about an at-home diabetic retinal exam and have questions about your appointment, reach out to the vendor that contacted you. If you would like to schedule the exam on your own, simply decline the request. That information will be recorded in our system, and the vendor won’t contact you again.

Humana Medicare Advantage medical plans cover eye exams for diabetic retinopathy once each year if you have diabetes. You don’t need a vision plan to receive coverage since the exam is considered preventive medical care. However, the exam must be done by an eye care professional who’s legally allowed to do the test in your state. Check the Evidence of Coverage for your plan for more details.

If Go365^® is included with your plan, you can submit proof of your exam through Go365.com. Please make sure to submit your proof within 90 days of the exam to receive your Go365 reward for completing the activity. Please note, that you are only eligible for reward reimbursement once per calendar year.