Are you wondering if Medicare covers cataract surgery? 🤔 You’re not alone! Many people are unsure about Medicare coverage for this standard eye procedure.
The good news is that Medicare Part B does cover cataract surgery that is considered “medically necessary.”
👍 This means that if your cataract is causing blurred vision or other problems with your vision, Medicare will help pay for the surgery.
In this post, I all take a closer look at Medicare coverage for cataract surgery. I all answer all of your questions, so you can be confident that you’re getting the care you need.❓
I all also discuss other costs associated with cataract surgery, such as the cost of eyeglasses or contact lenses after surgery. 💰
So if you’re considering Lasik, 📖 read on! 👇
What is Cataract Surgery
Cataract surgery is a minimally invasive procedure usually performed on an outpatient basis.
The surgeon makes a small incision in the eye and uses a laser or ultrasound to break up the cloudy lens. The lens is then removed and replaced with a clear artificial lens.
Cataract surgery is a very successful procedure. Most people who have cataract surgery experience significant improvement in their vision.
Related Post: Do Eyes Look Different After Cataract Surgery
What Types of Cataract Surgery Does Medicare Cover
Cataract surgery is a procedure to remove the cloudy lens in the eye and replace it with a clear artificial lens. The surgery is usually done on an outpatient basis and takes about 30 minutes.
There are three main types of cataract surgery:
- Phacoemulsification: This is the most common type of cataract surgery. A small incision is made in the eye, and the cloudy lens is broken up with ultrasound and then suctioned out.
- Femtosecond laser-assisted cataract surgery (FLACS): This type of surgery uses a laser to make the incision and break up the cloudy lens.
- Extracapsular cataract extraction (ECCE): This is an older type of cataract surgery that involves making a larger incision in the eye.
Does Medicare Cover Cataract Surgery
Yes, Medicare Part B covers cataract surgery considered “medically necessary.” Medically necessary means that the surgery is needed to improve your vision or to prevent further loss of vision.
Medicare does not cover cataract surgery for cosmetic reasons, such as improving your appearance.
What is Considered Medically Necessary
Medicare considers cataract surgery to be medically necessary if it meets the following criteria:
- The cataract is causing blurred vision or other problems with your vision.
- The cataract is interfering with your daily activities, such as driving, reading, or watching TV.
- The cataract is not likely to improve on its own.
How Much Does Medicare Cover for Cataract Surgery
Medicare Part B covers 80% of the Medicare-approved amount for cataract surgery. You are responsible for the remaining 20%, which is called the coinsurance.
In addition to the coinsurance, you may also have to pay for other out-of-pocket costs, such as the surgeon’s fees, the facility fees, and the cost of any medications.
What Out-of-Pocket Costs Can I Expect for Cataract Surgery
The out-of-pocket costs for cataract surgery can vary depending on a number of factors, including the type of surgery you have, the surgeon’s fees, and the facility fees.
However, you can expect to pay the following out-of-pocket costs for cataract surgery:
- Coinsurance: 20% of the Medicare-approved amount
- Surgeon’s fees: $1,000 – $3,000
- Facility fees: $500 – $1,000
- Medications: $100 – $200
Medicare Advantage and Cataract Surgery
If you have a Medicare Advantage plan, you may have different coverage for cataract surgery than if you had Original Medicare.
Some Medicare Advantage plans have higher coinsurance or other out-of-pocket costs for cataract surgery. Others may not cover cataract surgery at all.
It is important to check with your Medicare Advantage plan to find out what your coverage is for cataract surgery.
Medigap and Cataract Surgery
If you have a Medigap policy, it can help to pay for the out-of-pocket costs of cataract surgery. Most Medigap policies cover the coinsurance and other out-of-pocket costs for cataract surgery.
However, some policies may have a waiting period before they start covering cataract surgery. It is important to check with your Medigap policy to find out what your coverage is for cataract surgery.
Related Post: Does Cataract Surgery Hurt
Other Costs Associated with Cataract Surgery
In addition to the cost of the surgery itself, there may be other costs associated with cataract surgery. These costs can include:
- The cost of pre-surgery testing, such as an eye exam and blood tests.
- The cost of anesthesia.
- The cost of medications, such as pain medication and antibiotics.
- The cost of eyeglasses or contact lenses after surgery.
- The cost of transportation to and from the surgery.
🙋♀️I hope this article has helped you understand Medicare coverage for cataract surgery. 😊 If you have any other questions, 👍 please talk to your doctor or insurance company. 🤗
Thank you for reading! 🙏 I hope this information was helpful to you. 😊 If you have any other questions, please don’t hesitate to ask. 🤗
I wish you the best of luck with your cataract surgery! 👓
Visit our Website at surgery-costs.com for Additional Details.
Does Medicare Cover Cataract Surgery – FAQs
Yes, Medicare covers cataract surgery that is medically necessary. This means that surgery is needed to improve your vision and relieve your symptoms.
Medicare covers the removal of the cataract and the implantation of a basic intraocular lens (IOL). The IOL is a clear lens that replaces the cloudy lens in your eye.
Cataract surgery is usually covered under Medicare Part.
Medicare Part B benefits cover 80% of the Medicare-approved amount for cataract surgery.
The Part B coinsurance for cataract surgery is 20% of the cost for covered services.
No, Medicare does not cover advanced technology lenses or elective surgery primarily to correct vision from nearsightedness or astigmatism, called “refractive lens exchanges”.
Yes, Medicare covers cataract surgery if it’s done using traditional surgical techniques or using lasers.
Yes, if you opt for coverage from a private Medicare Advantage plan, rather than original Medicare, you’ll also have coverage for cataract surgery.
The cost of cataract surgery with Medicare Advantage is covered by your benefits.
No, you don’t need a referral for cataract surgery with Medicare.
If you buy a Medicare supplement policy, also known as Medigap, you’ll have full or partial coverage for the 20% Part B coinsurance.