Does Medicare Pay for Cataract Surgery?

By age 80, more than half of all Americans either have a cataract or have had cataract surgery, according to the National Eye Institute. This surgery is one of the most common procedures performed in the United States, and if you're a candidate, you may wonder if Medicare pays for cataract surgery.

Medicare covers many medically necessary surgical procedures, and cataract surgery is considered one of them.

Don't Wait to Get Your Covered Cataract Surgery

If you’ve been diagnosed with cataracts in both eyes and advised to have surgery, it will usually be done on each eye separately. Your eye surgeon will typically wait four weeks between surgeries.

Even if you think you can wait for surgery, ophthalmologists recommend you do the surgery sooner rather than later. That’s because as you age, lenses actually harden, so replacing them becomes more difficult for your doctor.

Medicare not only pays for cataract surgery, but also for a set of prescription eyeglasses or contact lenses following your surgery. You will be responsible for additional charges for upgrading your frames from “basic” frames.

Determine Your Cataract Surgery Costs

As with any surgery or procedure, you may not know exactly what everything is going to cost until you meet with your health care team and they determine what you need. You can do some advance planning and estimate your costs by determining whether:

• You’ll be inpatient or outpatient, since inpatient costs more
• Your other insurance might pay, including Medicare Advantage and Medicare Supplement Plans (Medigap)
• You’ve met your deductibles for Part A, your hospital insurance, and Part B, your medical insurance, or Medicare Advantage, which includes both. If not, you’ll pay those before Medicare pays for cataract surgery and you may still have to pay copayments.

There's plenty of helpful information at our Medicare page to help you decide which plans and options are best for you.

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Anthem Blue Cross Life and Health Insurance Company is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross Life and Health Insurance Company depends on contract renewal. Anthem Blue Cross Life and Health Insurance Company (Anthem) has contracted with the Centers for Medicare & Medicaid Services (CMS) to offer the Medicare Prescription Drug Plans (PDPs) noted above or herein. Anthem is the state-licensed, risk-bearing entity offering these plans. Anthem has retained the services of its related companies and authorized agents/brokers/producers to provide administrative services and/or to make the PDPs available in this region. Anthem Blue Cross Life and Health Insurance Company is an independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

Anthem Blue Cross is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross depends on contract renewal. Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

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