Does Medicare advantage cover cataract surgery?
Over half of people over the age of 80 either have cataracts or have had cataract surgery, but the price of cataract surgery can be overwhelming. Does Medicare Advantage cover cataract surgery? It will cover basic cataract surgery, lens implants, and a pair of eyeglasses or contact lenses. Read more below to learn about your coverage options and out-of-pocket expenses.
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Leslie Kasperowicz
Farmers CSR for 4 Years
Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...
Farmers CSR for 4 Years
UPDATED: May 16, 2023
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UPDATED: May 16, 2023
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- Medicare Advantage will cover at least basic cataract surgery and lens implants along with a pair of eyeglasses or contact lenses.
- The estimated total cost of cataract surgery performed in a surgical center is $1,777.
- Your estimated out-of-pocket expenses are estimated to be between $355 and $557, but these costs could vary.
Cataracts and cataract surgery are extremely common (over half of people over 80 either have cataracts or have had cataract surgery). The thought of having to pay for cataract surgery out-of-pocket can be overwhelming.
So, does Medicare Advantage cover cataract surgery? What will your out-of-pocket expenses be after Medicare covers their share? We’ll answer these questions below.
Affordable health insurance could be right around the corner. Use our free tool above to compare health insurance quotes today.
Does Medicare Advantage cover cataract surgery?
So, does Medicare cover cataract surgery? Which parts of Medicare cover cataract surgery?
Medicare Part B covers cataract surgery as long as the surgery is completed using either traditional methods or lasers. Since Medicare Advantage plans have to be the same or better than original Medicare, these plans will cover the cataract surgery as well.
Medicare covers what is called an intraocular lens implant, which is a small disk that is implanted after the removal of cataracts to help with focusing your vision. However, Medicare will only cover the basic implant rather than the advanced ones.
Does Medicare Advantage cover eyeglasses and contact lenses?
After your cataract surgery, Medicare will cover one pair of eyeglasses or contact lenses. If you choose eyeglasses, you will have specific frames you can choose from. If you choose to upgrade to different frames, your out-of-pocket expenses will increase.
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How much does cataract surgery cost with Medicare?
How can you know what your costs will be before cataract surgery? What other factors may affect how much you pay?
After your premiums and health care deductible, Medicaid will generally charge a 20 percent coinsurance. This means you will have to pay 20 percent of cataract surgery costs out-of-pocket.
What is the cost with Medicare? According to Medicare.gov, an estimated total cost of cataract surgery performed in a surgical center is $1,777. Medicare would pay $1,422, while you would need to pay $355. In a hospital, the estimated total cost is $2,786. Medicare would pay $2,229, and you would pay $557.
The cost of your surgery may vary due to multiple factors, including your Medicare plan, the specifics regarding your surgical needs, the facility and healthcare provider, and potential complications (either during surgery or due to other disorders).
How much does cataract surgery cost with Medicare?
How can you know what your costs will be before cataract surgery? What other factors may affect how much you pay?
After your premiums and health care deductible, Medicaid will generally charge a 20 percent coinsurance. This means you will have to pay 20 percent of cataract surgery costs out-of-pocket.
What is the cost with Medicare? According to Medicare.gov, an estimated total cost of cataract surgery performed in a surgical center is $1,777. Medicare would pay $1,422, while you would need to pay $355. In a hospital, the estimated total cost is $2,786. Medicare would pay $2,229, and you would pay $557.
The cost of your surgery may vary due to multiple factors, including your Medicare plan, the specifics regarding your surgical needs, the facility and healthcare provider, and potential complications (either during surgery or due to other disorders).
Conclusion
If you have a Medicare Advantage plan, your insurance provider will cover a basic cataract surgery with lens implants and one pair of eyeglasses or contact lenses.
After your premiums and deductible, you will need to pay a 20 percent coinsurance. The estimated cost for this out-of-pocket expense ranges from $355 to $557, depending on your Medicare plan, your surgical needs, the facility and doctor, and any potential complications. A Medigap plan may help cover some of these expenses.
You should contact your Medicare Advantage policyholder to get details about their cataract surgery and other vision coverage options.
If you need help getting health insurance rates, use our free quote comparison tool below simply by entering your ZIP code to start comparing today.
Frequently Asked Questions
Does Medicare advantage cover cataract surgery?
Yes, Medicare Advantage plans generally cover cataract surgery.
What factors affect the cost of cataract surgery?
Various circumstances will determine how much you pay for cataract surgery, which is usually performed on one eye at a time. The specific procedure employed by your surgeon, the length of the surgery and any underlying medical conditions can impact your cost.
Does Medicare cover other costs that come with cataract surgery?
Original Medicare doesn’t cover eyeglasses or contact lenses in most circumstances. But if you require them after surgery, Medicare Part B pays for one pair of eyeglasses with basic frames or one set of contact lenses. The copay for corrective lenses after each surgery is 20% after you meet the Part B deductible. You’ll pay more for fancier frames. Your supplier of corrective lenses must be enrolled in Medicare.
What is Laser cataract surgery?
Laser cataract surgery has the same function as standard cataract surgeries, but this procedure uses advanced femtosecond lasers (which is an infrared laser with the ability to pulse more quickly and accurately) instead of hand-held tools to make incisions in the eye lens.
When should I see a doctor?
Cataracts aren’t always noticeable in their early stages, which is why it’s best to schedule regular visits with your eye doctor for early detection. But, if you do experience any of the following symptoms, it’s time to visit your doctor.
Does Medicare Advantage cover cataract surgery for both eyes?
Yes, Medicare Advantage plans typically cover cataract surgery for both eyes if it is deemed medically necessary.
Will Medicare Advantage cover the cost of anesthesia during cataract surgery?
Yes, Medicare Advantage plans generally cover the cost of anesthesia during cataract surgery.
Are you looking for free insurance quotes?
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Leslie Kasperowicz
Farmers CSR for 4 Years
Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...
Farmers CSR for 4 Years
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.