Will Medicare Cover My Cataracts?





Medicare reimburses for some “medically-necessary” services needed for cataract treatment. Restrictions do apply on what the program covers.

Will Be Reimbursed

“Medically-necessary” is an essential term to understand here. If you suspect you have cataracts, get an eye exam. Your eye doctor will then submit the results of the exam as “medically-necessary.” This is all dependent on whether you have cataracts. If you DO have cataracts, Medicare will pay for the exam. If you DO NOT have cataracts, you will have to pay for the exam out of your pocket. Regular eye exams are not reimbursed by Medicare.

Cataract Surgery

Nowadays cataract surgery, in most cases, is an outpatient procedure. You’re wheeled into the surgery room in the morning and you are completely finished in an hour or two. This means Medicare Part B, because it is an outpatient procedure, will reimburse 80% of the surgery cost. Keep in mind, the 80% is AFTER you have paid your deductible for the year.

Is Anything Else Covered After The Surgery?

Yes. You will probably need glasses, especially if you wore glasses before the surgery. Medicare will reimburse 80%, of the preapproved amount, for one pair of glasses or contacts. This reimbursement only applies after cataract surgery. Normally eye glasses and contacts are NOT covered by Medicare.

Remember: Medicare Providers Only



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