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Does Medicare Cover Cataract Surgery?

Cataract surgery is a medical concern for lots of seniors who rely on Medicare coverage. Luckily, this is a procedure that is usually included in your coverage. As long as it is deemed medically necessary by your provider and the procedure is performed within your network (if applicable). 

Which Plans Cover It?

Original Medicare and Medicare Advantage plans both cover necessary cataract surgery. The main difference between these two types of plans in this scenario is whether your coverage requires you to use specific providers within a network or area. Basic Medicare benefits also cover one pair of glasses or set of contacts following your surgery. Any upgrades past the basic needs will be an additional cost to you (tinting, progressive lenses, deluxe frames, etc.), but Medicare will pay for these basic post-operation needs as well. 

Medicare Supplement plans aren’t necessary to receive this care, but can greatly help with the costs. Depending on your Medigap plan the benefits could be applied in your deductible, copay, or coinsurance. 

Potential Out-of-Pocket Costs

Without any supplemental coverage your out-of-pocket costs are going to be higher. Having to stay in a facility as an inpatient for any time during or after your procedure could make your expenses higher, along with some follow-up care you might need. Any vision-related costs that could come after cataract surgery are not included in your Original Medicare or Medicare Advantage plans, so if you are concerned about those possibilities, investing in additional coverage might be a better option for you or your loved one. 

Prescription medications or eye drops are a common part of the recovery for this surgery, so having Medicare Part D or other prescription coverage will lower those costs as well. 

Have More Questions? Give Us a Call

You should have the security of knowing what you are guaranteed under your Medicare coverage. This can be complicated and misleading at times, so let the experts guide you through any questions you may have. Here at My HealthCare Direct, we can help you get the most from your plan and make the best decisions for your needs. Get started today by calling us at (888) 959-1028!