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Does Original Medicare Cover Cataract Surgery?


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Yes, Medicare Part B generally covers surgery to remove cataracts. Cataract surgery involves replacing the affected eye lens with an artificial one, and Medicare Part B’s benefits usually cover the costs associated with this surgery.

Medicare Part B covers ophthalmologist and facility fees, provided that the amount has been approved by Medicare. You typically pay a 20% coinsurance fee for the surgery and anesthesia, if necessary, as well as your Part B deductible (if you haven’t met it yet). Medicare also covers the pre-surgery exam where you will meet to discuss your cataracts and any necessary post-surgery follow-up care.

Medicare Part B generally covers one pair of eyeglasses or contact lenses if needed after the surgery; again, you pay 20% of the Medicare-approved cost. The glasses or lenses must come from a Medicare-approved provider.

A Medicare Advantage plan also covers cataract surgery and related expenses as explained above, because these plans include all Medicare Part A and Part B benefits (except hospice care, which is still covered under Part A). Available from private insurance companies that contract with Medicare, Medicare Advantage plans often include additional benefits, such as prescription drug coverage.

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

 

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