Medicare Coverage for Cataract Surgery

By David Gross on March 29, 2019


CataractCataracts refer to a buildup of proteins on the clear lens of the eye. This creates a cloudy formation that interferes with a person’s vision. Cataracts can affect people of all ages, but they are most common among senior citizens.

In their early stages, the extent of vision impairment caused by cataracts can be managed with prescription lenses. However, as cataracts progress, cataract surgery is the only effective treatment for vision loss. During cataract surgery, the clouded lens is removed and replaced with an intraocular lens, or IOL. The IOL acts like a permanent contact lens to improve vision.

Cataract surgery is highly effective, but it does come at a price. Since most cataract surgery patients are seniors living on fixed incomes, the cost of surgery may be a concern.

The eye care team at Deen-Gross Eye Centers can discuss cataract surgery and Medicare coverage with our Merrillville, IN patients, so that they know what type of expenses to expect for this vision restoring procedure.

Will Medicare Cover Cataract Surgery?

By the time patients are ready to undergo cataract surgery, it is nearly always considered a medically necessary surgical procedure because vision is significantly impaired. As long as an eye doctor deems that the surgery is medically necessary, Medicare will provide coverage for the procedure.

The thing that patients need to keep in mind is that Medicare will only cover costs of cataract surgery and treatment that are considered a necessary part of ophthalmological care.

Will There Be Out-of-Pocket Expenses?

If a patient elects to receive any premium products, or undergo any advanced techniques, they can expect out-of-pocket expenses for their cataract surgery. Examples of services that would incur out-of-pocket expenses include premium IOL lenses, laser cataract surgery, or an additional incision to correct astigmatism.

Our doctors will go over every surgical option with patients prior to proceeding with cataract surgery. We will discuss the benefits of premium services and products, but will always be up front about which options will not be covered by Medicare.

Because of the many benefits that are provided by premium IOLs and laser surgery, many patients opt to go with these surgical options despite the out-of-pocket cost. However, every treatment is customized to the patient’s unique needs, so if these options are not financially appropriate for the patient, then cataracts can be treated through traditional cataract surgery.

Alternate Payment Options

If patients do wish to receive premium cataract surgery options and do not have cash to pay for out-of-pocket expenses, there are other payment options to consider. We can talk to patients about payment plans, including medical credit cards, that can make it easier to afford any cataract surgery expenses not covered by Medicare.

Learn More

If you need cataract surgery and have questions about what the procedure will cost, our team at Deen-Gross Eye Centers in Merrillville is happy to help. Contact us online at your earliest convenience or call (219) 769-8989 to learn more about Medicare coverage for cataract surgery.

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