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Original Medicare does not typically cover vision care, it does cover about 80% of the costs for cataract surgery when the surgery utilizes certain accepted traditional surgical techniques as well as newer laser methods.
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Medicare Advantage (Part C) plans are comprehensive benefits administered through private insurance companies that pay for all the same things that Original Medicare covers.
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Cataracts often develop due to an individual having diabetes or the normal aging process in which the proteins and different fibers that give structure to the eye’s lens begin to break down, causing the lens to become cloudy, less flexible, and thicker.
Cataracts often develop during the normal aging process of human eyes. Many people can benefit from the multiple surgical procedures developed to combat this degeneration, especially seniors. Medicare can help with the cost of cataract surgery, but it’s important for beneficiaries to understand the ways that their insurance interacts with vision care and cataract surgery procedures.
Original Medicare and Cataract Surgery
While Original Medicare does not typically cover vision care, it does cover some costs relating to cataract surgery under Part B when the cataract surgery is completed via outpatient services utilizing certain accepted and traditional surgical techniques the use of lasers. Medically necessary exams relating to the disease are covered along with post-operation corrective eyeglasses or contact lenses. Rarely, the surgery is conducted in a hospital setting and would be covered under Medicare Part A. Original Medicare will typically cover about 80% of the related expenses.
What is the Cost of Cataract Surgery?
If you do not have Medicare or other health or vision insurance coverage, the cost of cataract surgery can be exorbitant. Depending on where you live, cataract surgery can cost anywhere from about $3,500 to $7,000 per eye. If you need special intra-ocular lenses for astigmatism or want to have cataract laser surgery done, the cost can be even higher. With Medicare coverage the beneficiary will pay 20% of the costs after paying the deductible amount.
Is Cataract Surgery Covered Under a Medicare Advantage Plan?
Medicare Advantage Plans are provided by private insurance companies that contract with Medicare to provide Medicare Part A and B benefits. Medicare Advantage Plans typically include vision plans that do cover cataract surgery, but you will be required to pay for any deductibles and for the required 20% of coinsurance.
What Does a Medicare Supplement Plan (Medigap) Cover?
If you have Original Medicare, you will still have to pay out of pocket for a certain percentage of the cataract surgery costs. A Medicare Supplement plan also known as a Medigap Plan can typically pay for the required additional 20% coinsurance as well as other costs that are associated with your cataract surgery.
