Does Medicare Cover Cataract Surgery?
Fair Square Medicare

Does Medicare Cover Cataract Surgery?

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By Daniel Petkevich

Dec 22, 2022

See how you might save on this procedure

Your vision might deteriorate as you age, but that does not mean you have to live with a cloud over your life. Medicare might not offer coverage for vision expenses like eyewear, but Medicare will cover medically-necessary surgery for cataracts. Read more to find out how Medicare can cover your surgery.

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Overview of Cataract Surgery

Cataract surgery is a common eye procedure that can help restore vision. During the surgery, your eye doctor will remove the cloudy lens from your eye and replace it with an artificial lens or implant. Cataract surgery is considered medically necessary to treat cataracts, which are cloudy areas in the lens of the eye that can cause vision loss.

What is a Cataract and How Is It Treated with Surgery?

A cataract is an eye condition caused by a clouding of the lens. Cataracts can cause blurry vision, difficulty seeing at night, and sensitivity to light. Surgery is the most common way to treat cataracts, as it can address the root cause of the problem and restore clarity to your vision.

Does Medicare Cover Cataract Surgery?

Yes, Medicare covers cataract surgery as part of its coverage for medically necessary eye care services. To determine whether you qualify for Medicare coverage of cataract surgery, your eye doctor will need to assess the severity and progression of your condition. Your eye doctor may also order tests to determine if surgery is the best option for you.

If you qualify for Medicare coverage of cataract surgery, your eye doctor and insurance provider will be able to provide more detailed information about what services are covered as part of your plan. Medicare Part A will cover the hospital costs for your surgery, including the surgical team, the operating room, and any other necessary hospital services. Medicare Part B will cover the costs of the surgeon, the anesthesiologist, and any other medical services related to the surgery. You might still be responsible for some out-of-pocket costs, like the deductibles and up to 20% of the Medicare-approved amount. The best way to lower your out-of-pocket expenses is with Medicare Supplement Plan G.

What Are the Costs Involved With Cataract Surgery?

The costs of cataract surgery vary depending on the type of lens you choose and other factors. Generally, Medicare covers the majority of your cataract surgery costs; however, you may still be responsible for copays, coinsurance, or deductibles. It's important to discuss any potential out-of-pocket expenses with your optometrist before the procedure.

Tips for Choosing an Eye Care Provider for Your Cataract Surgery

When selecting an optometrist for your cataract surgery, consider the following tips:

  • Ask friends and family about their experiences with eye care providers in your area.

  • Check online reviews to get an idea of the quality of care offered by different eye doctors.

  • Research the qualifications and certifications of any potential providers.

  • Make sure the eye doctor is certified by Medicare.

Questions to Ask Before Deciding on Cataract Surgery

Before opting for cataract surgery, it's important to discuss the potential risks and benefits with your eye doctor. Here are a few questions to ask:

  • What kind of vision will I have after the procedure?

  • How long is the recovery time?

  • Are there any complications associated with this type of surgery?

  • Are there any out-of-pocket costs I should be aware of?

Conclusion

Cataract surgery is a safe and effective way to improve your vision. Medicare covers most of the costs associated with this procedure, making it more accessible for seniors. Before deciding to have cataract surgery, talk to your eye doctor about the potential risks and benefits of the procedure, as well as any out-of-pocket expenses you may be responsible for. This content is for informational purposes only. If you have any further questions about Medicare coverage, please contact Fair Square Medicare. We are always here to help!

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