Does Medicare Cover Cataract Surgery?
Key Takeaways
- Typically, Medicare Part B covers cataract surgery and corrective lenses after your surgery.
- Medicare does not cover all the costs of your cataract surgery but will cover a portion after your Part B deductible.
- Inpatient services, while rare, will typically be covered by Medicare Part A.
A cataract is the clouding of the eye’s natural lens. According to the National Eye Institute, more than half of Americans age 80 or older either have cataracts or have had cataract surgery, which successfully improves eyesight in nine out of 10 cases.
Cataract surgery, if medically necessary, is covered by Medicare Part B or a Medicare Advantage plan. Medicare covers related costs and one corrective lens device (a pair of eyeglasses or contacts) after surgery.
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Does Medicare Cover Cataract Surgery?
Medicare Part B, which is medical insurance, covers outpatient cataract surgery. Part B will pay for corrective lenses if you receive an intraocular lens to replace your eye’s natural lens (which is usually the case). If you need inpatient treatment as a result of surgery, you will use Medicare Part A, which is hospital insurance.
If you have switched to Medicare Advantage (Part C), your plan will at least match Original Medicare’s coverage and may offer additional benefits.
How Much Does Medicare Pay for Cataract Surgery?
Medicare Part B pays 80 percent of the cost of cataract surgery after you meet your annual deductible. You are responsible for paying the remaining 20 percent in coinsurance.
If you have Original Medicare for Part A and Part B coverage, adding a Medicare Supplement plan can help you with out-of-pocket costs like coinsurance.
In the rare instances where the surgery is considered inpatient and qualifies for Part A coverage, Part A will cover the hospital bill after you pay your deductible for the benefit period.
Does Medicare Pay for Laser Cataract Surgery?
If you require cataract surgery, Medicare will cover the procedure. Medicare will pay the same amount for the surgery whether your Medicare-approved doctor uses a laser or not. If there is a cost difference between the two procedures, you will be responsible for additional costs because Medicare won’t pay more for a more expensive procedure.
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Sources
- At a glance: Cataracts. NEI.NIH.gov.