Does Medicare Cover Cataract Surgery & Eye Exams?
Want to know more about Medicare vision and what’s covered (and what’s not)? Let me guess. You’re probably wondering:
- Does Medicare cover cataract surgery?
- Does Medicare cover eye exams?
- Does Medicare cover vision?
Good news — We’re going to answer all these questions about Medicare vision coverage, surgeries and more.
Does Medicare Cover Cataract Surgery?
Does Medicare cover eye surgery? Medicare will cover your cataract surgery as long as it is done using traditional surgical techniques or using lasers. There are some basic requirements to qualify for cataract surgery.
The Medicare requirements for cataract surgery are:
- Your doctor must say that your cataract surgery is Medically necessary.
- The doctor that is treating you must accept a Medicare plan as payment.
Does medicare pay for cataract surgery?
The quick answer is yes.
Your cataract surgery will be paid by Medicare, as long as your physician has determined that it’s a medically necessary surgery for you to live a healthy life.
How much does medicare pay for cataract surgery?
Cataract surgery can cost anywhere from around $3,600 to $6,000 per eye. Remember that Medicare pays 80% of the medical expenses that are surgery related. You will be responsible for the remaining 20% of these costs unless you have a Medicare Supplement.
Your Medicare plan pays for the following services:
- preoperative exam
- cataract removal
- lens implantation
- postoperative exam
- postoperative prescription eyeglasses (1 pair)
Let’s review:
Your Medicare Part A provides coverage for your inpatient hospital stays. You will not require an overnight stay after your cataract surgery (typically). Now if you were to require a stay at the hospital (for example, if you had complications) Part A would provide coverage for these additional accommodation costs.
Medicare Part B provides coverage for preventative and medically necessary procedures. Cataract surgery is covered as well as certain post surgical costs.
medicare vision coverage
Since Medicare may pay for your cataract surgery, you may be also be wondering, “does Medicare pay for eye exams?”
There is no Medicare eye exam coverage. In other words, Medicare will not cover your eye exams (also referred to as eye refractions) for contact lenses or eyeglasses. You will pay 100% for your eye exams
does medicare cover glasses?
Does Medicare cover eyeglasses? Typically, Medicare will not provide coverage for your prescription eyeglasses. The only exception is for the one pair of glasses or contact lenses that you get once you complete your cataract surgery.
Frequently Asked Questions
💡 Your next step: Medicare covers cataract surgery at 80% — you pay the 20% Coinsurance. Medigap Plan G picks up that cost, making your procedure effectively free out of pocket.
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Written by Michael Quinn
Licensed Broker, REMEDIGAP Founder
Fact Checked by Joann Quinn
Chief Compliance Officer
As a licensed insurance broker, REMEDIGAP upholds the principles of integrity in our editorial standards and ensures transparency in how we receive compensation from our insurance partners.