Fair Square Medicare Wordmark

Is Vitrectomy Surgery Covered by Medicare?

elderly woman with glasses having difficulty reading her phone stock image
By Daniel Petkevich
Dec 2, 2022

The answer may depend on your choice of plan

Medicare offers coverage for treatments and procedures they deem to be medically necessary. Vitrectomy surgery is no exception. But some Medicare Advantage plans might deny coverage and require you to pay out-of-pocket for the surgery. Which plans will help you spend less? Let's find out.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

What is Vitrectomy Surgery?

Vitrectomy surgery is a type of eye surgery that removes the vitreous humor, or gel-like substance, from inside the eye. This procedure is often done to treat conditions such as retinal detachment and

macular degeneration

.

What are the benefits of Vitrectomy surgery?

Vitrectomy surgery can help improve vision by removing scar tissue, repairing retinal tears, or restoring normal blood flow to the eye. It can also reduce pain and discomfort associated with these problems.

Medicare Coverage for Vitrectomy Surgery

Medicare Part B typically covers 80% of the cost of vitrectomy surgery , including doctor visits and lab tests related to the procedure. However, you may be responsible for a portion of the remaining cost. Medicare also requires that your doctor provide documentation stating why the surgery was medically necessary for it to be covered.

What is the cost of vitrectomy surgery?

The cost of vitrectomy surgery depends on the type of procedure you have and your insurance coverage. Generally speaking, it can range anywhere from $1,000 to $7,000 per eye. Be sure to check with your doctor and insurance provider for more specific information about your situation.

How to qualify for Medicare coverage of vitrectomy surgery?

In order to qualify for Medicare coverage of vitrectomy surgery, your doctor must certify that the procedure is medically necessary. Your doctor will need to provide documentation and obtain prior authorization from your insurance provider before the procedure can be scheduled. Additionally, you'll also have to meet any other requirements set by your insurer.
There have been some instances of Medicare Advantage plans denying this procedure, in which case, you might have to pay for the cost of surgery out-of-pocket. That is why we typically recommend Medicare Supplement Plan G to our clients for the most comprehensive coverage.

Does Medicare cover vitrectomy chairs?

After vitrectomy surgery, many people find it more comfortable to rest in a face-down position. Medicare does not cover specialized chairs designed for this type of procedure, as they are not deemed medically necessary.

Alternatives to vitrectomy surgery

In some cases, vitrectomy surgery can be avoided through less invasive treatments such as laser therapy or injection of medications. Talk to your doctor about the potential alternatives that may be available to you before deciding if a vitrectomy is the best course of action for your eye condition.

Takeaway

Vitrectomy surgery is a safe and effective way to treat certain eye conditions. In most cases, Medicare Part B will cover 80% of the costs associated with vitrectomy surgery as long as it is deemed medically necessary by your doctor. However, some Medicare Advantage plans may not cover this procedure, and you may end up having to pay out-of-pocket for the cost of the surgery. Before pursuing this surgery, talk with your doctor to see if it's right for you. This content is for informational purposes only. Fair Square Medicare is here for all your Medicare-related questions.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

Doctor demonstrating upper cervical spine anatomy stock photo
Does Medicare Cover Cervical Disc Replacement?
Jan 20, 2023
Vitamin in a syringe stock photo
Does Your Medicare Plan Cover B12 Shots?
Aug 15, 2022
Dames Point Bridge in Jacksonville, Florida stock image
13 Best Ways for Seniors to Stay Active in Jacksonville
Mar 3, 2023
Cover image
Does Medicare Cover Shock Wave Therapy for Plantar Fasciitis?
Nov 30, 2022
Cover image
The Fair Square Bulletin: February 2024
Feb 15, 2024
Hands of doctor or nurse in medical gloves injecting a shot to a man patient stock photo
Does Medicare Pay for Allergy Shots?
Nov 29, 2022
Senior woman fretting in front of her laptop stock photo
How Medicare Costs Can Pile Up
Oct 11, 2022
Cover image
Will Medicare Cover it?
Oct 3, 2023
senior african american man feeling pain in his knees from arthritis while on a couch stock photo
How Much Does Xeljanz Cost with Medicare?
Jan 25, 2023
woman working from home with a headset on stock image
How Do Medicare Agents Get Paid?
Apr 12, 2023
Leg bones and knees, 3d rendering. stock photo
Does Medicare Cover Boniva?
Nov 29, 2022
Illustrated referential images of a hospital bill, coins, cash in a wallet, a calculator, and a magnifying glass
What Are Medicare Part B Excess Charges?
Jan 6, 2023
Doctor physician consulting with male patients in hospital exam room stock photo
Is PAE Covered by Medicare?
Nov 23, 2022
A women's restroom sign that has been modified to show the stick figure woman needing to use the toilet
Does Medicare Cover Bladder Sling Surgery?
Jan 11, 2023
Medsupp Thumbnail
Plan G vs. Plan N
Jan 28, 2022
Cover image
What To Do If Your Medicare Advantage Plan Is Discontinued
Feb 26, 2024
What is the ICEP?
What is the Medicare ICEP?
Apr 7, 2023
Orthopaedist at work treating a bunion, stock photo
Does Medicare Pay for Bunion Surgery?
Nov 29, 2022

More of our articles

13 Best Ways for Seniors to Stay Active in Philadelphia

13 Best Ways for Seniors to Stay Active in Phoenix

14 Best Ways for Seniors to Stay Active in Seattle

14 Best Ways to Stay Active in Charlotte

2024 "Donut Hole" Updates

2024 Cost of Living Adjustment

Are Medicare Advantage Plans Bad?

Can I Change Medicare Advantage Plans Any Time? | Medicare Plans

Can I Have Two Primary Care Physicians?

Can Medicare Advantage Plans be Used Out of State?

Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?

Do I Need to Renew My Medicare?

Do You Need Books on Medicare?

Does Medicare Cover a Spinal Cord Stimulator?

Does Medicare Cover Abortion Services?

Does Medicare Cover Cala Trio?

Does Medicare Cover Cosmetic Surgery?

Does Medicare Cover COVID Tests?

Does Medicare Cover Driving Evaluations?

Does Medicare Cover Exercise Physiology?

Does Medicare Cover Geri Chairs?

Does Medicare Cover Home Heart Monitors?

Does Medicare Cover Ilumya?

Does Medicare Cover Inqovi?

Does Medicare Cover Inspire for Sleep Apnea?

Does Medicare Cover Iovera Treatment?

Does Medicare Cover Jakafi?

Does Medicare Cover Ketamine Infusion for Depression?

Does Medicare Cover Kidney Stone Removal?

Does Medicare Cover Kyphoplasty?

Does Medicare Cover Lipoma Removal?

Does Medicare Cover LVAD Surgery?

Does Medicare Cover Nexavar?

Does Medicare Cover Nuedexta?

Does Medicare Cover Ofev?

Does Medicare Cover Orthodontic Care?

Does Medicare Cover Physicals & Blood Work?

Does Medicare Cover Piqray?

Does Medicare Cover Qutenza?

Does Medicare Cover Robotic Surgery?

Does Medicare Cover RSV Vaccines?

Does Medicare Cover Service Animals?

Does Medicare Have Limitations on Hospital Stays?

Does Retiring at Age 62 Make Me Eligible for Medicare?

Does Your Plan Include A Free Gym Membership?

Explaining IRMAA on Medicare

Explaining the Different Enrollment Periods for Medicare

Fair Square Bulletin: We're Revolutionizing Medicare

How Are Medicare Star Ratings Determined?

How Can I Get a Replacement Medicare Card?

How Does Medicare Cover Colonoscopies?

How Much Does a Pacemaker Cost with Medicare?

How Much Does Medicare Cost?

How Much Does Trelegy Cost with Medicare?

How to Apply for Medicare?

Is Emsella Covered by Medicare?

Is the Shingles Vaccine Covered by Medicare?

Medicare 101

Medicare Deductibles Resetting in 2024

Medicare Savings Programs in Kansas

Medicare Supplement Plans for Low-Income Seniors

The Fair Square Bulletin: January 2024

The Fair Square Bulletin: The End of the COVID Emergency Declaration

Top 10 Physical Therapy Clinics in San Diego

Welcome to Fair Square's First Newsletter

What Happens to Unused Medicare Set-Aside Funds?

What is a Medicare Beneficiary Ombudsman?

What Is Medical Underwriting for Medigap?

What Is the Medicare Birthday Rule in Nevada?

What You Need to Know About Creditable Coverage

What's the Deal with Flex Cards?

When Can You Change Medicare Supplement Plans?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2024

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2024 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M