Does Medicare Cover Cataract Surgery?
Yes, Medicare covers cataract surgery. If you have Medicare Part B, standard cataract surgery is considered a medically necessary outpatient procedure. After meeting your Part B deductible, you will be responsible for 20% of the Medicare-approved amount.
What Medicare Part B Covers
- The surgical procedure to remove the cataract
- One pair of standard eyeglasses OR one set of contact lenses after surgery (this is the only instance where Medicare covers glasses)
- Pre-operative and post-operative visits related to the surgery
- Anesthesia administered during the procedure
What Medicare Does NOT Cover for Cataract Surgery
- Premium intraocular lenses (IOLs) that correct astigmatism or presbyopia — you will need to pay the upgrade cost out of pocket
- Laser cataract surgery if chosen solely for lifestyle preferences (the standard technique is covered; any laser premium is your responsibility)
- Routine eye exams before or after surgery that are unrelated to the cataract
Medicare Advantage (Part C) plans are required to cover everything that Original Medicare covers, ensuring that cataract surgery is always included. Some plans may also offer additional lens upgrade allowances—be sure to check your plan’s Summary of Benefits.
How Much Will You Pay?
| Part B deductible | $240 in 2024 (this amount must be paid first) |
| Coinsurance | 20% of Medicare-approved amount after the deductible |
| With Medigap | A Medigap (supplement) plan often covers your 20% coinsurance |
Frequently Asked Questions
Does Medicare cover both eyes?
Yes. Medicare covers cataract surgery for each eye, typically as separate procedures scheduled weeks apart.
Is there a waiting period?
No waiting period applies as long as your doctor certifies that the procedure is medically necessary.
What if I want premium lenses?
Medicare will pay its standard approved amount for a basic monofocal lens. If you choose to upgrade to a premium toric or multifocal IOL, you will need to pay the difference. It’s advisable to ask your surgeon for a cost estimate before scheduling your procedure.
Yes, Medicare covers cataract surgery. If you have Medicare Part B, standard cataract surgery is considered a medically necessary outpatient procedure. After meeting your Part B deductible, you will be responsible for 20% of the Medicare-approved amount.
What Medicare Part B Covers
- The surgical procedure to remove the cataract
- One pair of standard eyeglasses OR one set of contact lenses after surgery (this is the only instance where Medicare covers glasses)
- Pre-operative and post-operative visits related to the surgery
- Anesthesia administered during the procedure
What Medicare Does NOT Cover for Cataract Surgery
- Premium intraocular lenses (IOLs) that correct astigmatism or presbyopia — you will need to pay the upgrade cost out of pocket
- Laser cataract surgery if chosen solely for lifestyle preferences (the standard technique is covered; any laser premium is your responsibility)
- Routine eye exams before or after surgery that are unrelated to the cataract
Medicare Advantage (Part C) plans are required to cover everything that Original Medicare covers, ensuring that cataract surgery is always included. Some plans may also offer additional lens upgrade allowances—be sure to check your plan’s Summary of Benefits.
How Much Will You Pay?
| Part B deductible | $240 in 2024 (this amount must be paid first) |
| Coinsurance | 20% of Medicare-approved amount after the deductible |
| With Medigap | A Medigap (supplement) plan often covers your 20% coinsurance |
Frequently Asked Questions
Does Medicare cover both eyes?
Yes. Medicare covers cataract surgery for each eye, typically as separate procedures scheduled weeks apart.
Is there a waiting period?
No waiting period applies as long as your doctor certifies that the procedure is medically necessary.
What if I want premium lenses?
Medicare will pay its standard approved amount for a basic monofocal lens. If you choose to upgrade to a premium toric or multifocal IOL, you will need to pay the difference. It’s advisable to ask your surgeon for a cost estimate before scheduling your procedure.
