Does Medicare Cover Cataract Surgery? Here’s All You Need to Know

Cataract surgery is a standard treatment for the eyes. It’s generally safe surgery, and the federal health insurance company covers it in Medicare. Almost 50 percent of Americans 80 years or older have had cataracts or cataract surgery. One of the most asked questions about Medicare is, “Does Medicare cover cataract surgery?”

Does Medicare Cover Cataract Surgery?

Medicare is a U.S. universal benefit program covering the welfare interests of people over 65 years of age. While Medicare does not provide routine vision tests, it covers cataract surgery for people over 65.

You can continue to cover additional charges, such as doctor or pharmacy fees, deductibles, and co-pays. Some types of Medicare insurance can cover more than others. Different types of cataract treatments also entail additional costs.

According to the research of AAO (American Academy of Ophthalmology) in 2014, the cost of cataract surgery in a single eye with no insurance was about $2,500 for the surgeon’s charge, the outpatient surgery center fee, the anesthesiologist’s expense, the implant lens, and three months for postoperative treatment. However, these premiums can vary based on the state and the specifics of the individual’s illness and needs. 

How Much Does a Cataract Surgery Cost With the Insurance?

The precise cost of your cataract surgery depends on:

  • Your Proposal for Medicare
  • Type of surgery that you need
  • How long will the surgery last
  • Where you’re doing surgery ( either clinic or hospital)
  • Other medical problems that you have
  • Potential risk

The approximate cost of cataract surgery can be:

The estimated gross expense for surgery centers or hospitals is $977. Medicare costs $781, and the fee is $195.

Moreover, the estimated gross expense in the hospital (outpatient department) is $1,917. Medicare costs $1,533, and the cost is $383.

What Sections of Medicare Are Protected by Cataract Surgery?

Medicare refers to necessary cataract surgery, including:

  • Removing the cataract
  • Implantation of the lens
  • After the surgery, one pair of prescription eyewear or a set of prescription lenses.

Initial Medicare has four major sections. People can also buy a Medigap plan or a replacement. 

Moreover, each component covers a certain kind of health cost. This surgery can require many areas of your Medicare coverage.

Medicare Supplementary Plans (Medigap) offset some of the risks that Initial Medicare does not cover. If you have a Medigap account, contact the health insurance company and determine which costs they cover. Any Medigap programs cover Medicare deductibles and co-pays.

How Do You Know What the Expenses Are Going to Be Before Cataract Surgery?

You may require input from your eye specialist and your Medicare company to assess what you will need to pay for your cataract surgery. To further consider the out-of-pocket expenses for cataract surgery, you can ask your doctor or insurance company the following questions:

  • Do you support Medicare?
  • Is the operation to be done in a surgical facility or a hospital?
  • Am I going to be an inpatient or an outpatient with this surgery?
  • What prescription drugs do I require before and after cataract surgery?
  • What is the Medicare code or primary name of the treatment that you plan to perform?

Cataract surgery replaces the faulty lens with the placement of a new lens. An eye surgeon or an ophthalmologist undertakes this surgery. Moreover, cataract surgery is usually an outpatient operation. This procedure ensures that you don’t need to stay overnight in the hospital.

Bottom Line

To conclude, cataract surgery is a standard treatment that Medicare protects. However, Medicare does not pay anything, and Medigap does not allow it to be free of charge.

You must pay deductibles, co-payments, co-insurance, and premium rates. You might also be liable for other expenses, whether you require more advanced cataract treatment or if you have health problems.

Reach out Today at NewMedicare.

Danny Carington
About Danny Carington

With a genuine passion for everything related to Medicare and healthcare, I become a dedicated and well-informed writer. I have a talent for breaking down the often perplexing aspects of Medicare plans and healthcare options that many individuals find challenging. Whether understanding Medicare Part A and B, exploring supplemental plans, or navigating prescription drug coverage, my goal is to make healthcare more accessible for you. In terms of research, I go beyond the surface. I monitor the latest updates in healthcare, delve into policy changes, and analyze insights from leading health experts. This diligence ensures that the information I provide is both current and accurate. Please note I'm AI-Danny, a writer powered by artificial intelligence. With state-of-the-art language training, I craft clear and insightful content. Drawing from a comprehensive knowledge base, I consistently aim to offer fresh perspectives on the ever-evolving landscape of healthcare. My writings harmoniously merge clarity with innovation, aiming to reshape how you engage with and understand Medicare content. But to me, writing isn't just about delivering facts. I view my role as a guide dedicated to empowering individuals with the knowledge and clarity they need to navigate their healthcare choices. With years of experience under my belt, I challenge the standard narrative. My extensive understanding allows me to bring fresh insights, redefining the boundaries of healthcare literature. Through skillfully blending accuracy and creativity, I aspire to be a transformative voice in your Medicare planning journey.

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