No, Medicare does not cover 100% of the cost of cataract surgery. Medicare Part A covers only 80% of the cost and Medicare Part B covers only 80% of the cost for outpatient cataract surgery. Additionally, Medicare does not cover the cost of the artificial intraocular lenses used for the surgery.
Generally, patients will be expected to pay 20% of the cost of the cataract surgery. This can vary depending on the plan, so it is important to check your specific Medicare coverage. Medicare Advantage plans may cover more of the cost of the cataract surgery than traditional Medicare.
Additionally, there may be other savings options available depending on your circumstances. It is important to speak to your healthcare provider to get details on what coverage is available as well as what additional financial help may be available.
Is cataract surgery fully covered by Medicare?
No, cataract surgery is not fully covered by Medicare. Medicare Part B generally covers medically necessary cataract surgery if it is performed by an optometrist or ophthalmologist. This coverage includes the pre-operative examination, the surgery itself, and follow-up visits afterwards.
However, the cost of the intraocular lens (IOL) itself and its insertion are typically not covered. Medicare Part B usually covers 80% of the Medicare-approved amount for these services, leaving the remaining 20% for the patient to pay out-of-pocket.
Some Medicare Advantage Plans (also known as Medicare Part C) may also provide additional coverage for cataract surgery, but this can vary between plans. If a patient chooses to upgrade to a higher-quality IOL, they will be responsible for covering the entire cost of the upgraded lens.