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En español | Yes. Even though Medicare doesn’t cover routine vision care, it covers diagnosis and treatment of certain chronic eye conditions, including cataracts and cataract surgery.
Cataracts happen because of a variety of causes, and aging is the most common factor. Most cataracts aren’t visibly noticeable.
Gradually, cataracts become denser, which means the eye's lens becomes more opaque. Over time this can cause blindness. Cataract surgery is performed when the 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). This is a small, lightweight, clear disk that replaces the focusing power of the eye’s natural crystalline lens. This procedure is performed using traditional surgical techniques or lasers.
Cataract surgery is usually an outpatient procedure, covered under Medicare Part B. Once you pay the annual Part B deductible, which is $233 in 2022, you’re responsible for the Part B coinsurance.
That means you’ll pay 20 percent of the cost for covered services yourself. If you buy a Medicare supplement policy, also known as Medigap, you’ll have full or partial coverage for the 20 percent Part B coinsurance.
Yes. Even though Medicare usually doesn’t cover eyeglasses 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. In covering prescription glasses or contacts following surgery, Medicare limits its coverage to standard eyeglass frames. You must foot the additional bill if you want upgraded frames. Medicare requires that you purchase the glasses or contacts from a Medicare approved supplier.
Not really. Medicare covers medically necessary cataract surgery with standard intraocular lenses. 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.
If you opt for coverage from a private 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 need to use an in-network provider. Ask your plan about its coverage details before you schedule surgery.
Updated September 29, 2022
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