Yes. Medicare covers the diagnosis and treatment of cataracts, including cataract surgery, even though it doesn’t coverroutine vision care.
People develop cataracts for a variety of reasons;aging is the most commonfactor.
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Most cataracts aren’t visibly noticeable but they gradually become more dense, making the eye lens more opaque. Over time this can cause blindness. Cataract surgery is needed when your visual function becomes impaired and can’t be corrected with glasses or contact lenses.
Medicare covers medically necessary cataract surgery, which includes removing the cataract and implanting a basic intraocular lens (IOL), a small, lightweight, clear disk that replaces the focusing power of the eye’s natural crystalline lens. Ophthalmologists perform cataract surgery using traditional surgical techniques or lasers.
Medicare Part Bshould cover the outpatient procedure. Once you pay theannual Part B deductible, which is $240 in 2024, you’re responsible for the Part B coinsurance portion, which is 20 percent of the cost for covered services. If you buy aMedicare supplement policy, also known as Medigap, you’ll have full or partial coverage for the 20 percent Part B coinsurance.
Does Medicare cover glasses after cataract surgery?
Yes. Even though Medicareusually doesn’t coverglasses or contact lenses, it has one exception: Medicare Part B will pay for one set of corrective glasses or contacts after having cataract surgery to implant an IOL.
In this case, you’ll pay 20 percent of the Medicare-approved amount for the glasses or contacts. Medicare limits its coverage to standard eyeglass frames — you’ll have to foot the added cost if you want upgraded frames — and it requires that you purchase the glasses or contacts from aMedicare-approved supplier.
Does Medicare cover any other cataract-related costs?
Not really. Medicare covers medically necessary cataract surgery with IOLs. Medicare won’t cover advanced technology lenses or elective surgery primarily to correct vision from nearsightedness or astigmatism, called “refractive lens exchanges.”
Talk with your doctor about your options and costs before your surgery.
Keep in mind
If you opt for coverage from aprivate Medicare Advantage plan, rather than original Medicare, you’ll also have coverage for cataract surgery. However, you may have to pay different deductibles or copayments and use an in-network provider. Ask your plan about its coverage details before you schedule surgery.
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