Does Medicare Cover Cataract Surgery?

Mon, Dec 21, 2020 7:23 PM Medicare Medicare Supplement

The costs related to cataract surgery are covered by Medicare Part B. This includes if, as a result of surgery, you require corrective lenses such as contact lenses or glasses.

Before cataract surgery, let's get into the necessary details you want to hear. Like, how much am I going to pay? But first, what is a Cataract? And second, why would you need surgery for cataracts?

What is a Cataract?

The National Health Institute says:

• To begin with, in older people, cataracts are a very common eye condition.

"When you are young, there's a clear lens in your eye. The proteins in the lens of your eye start to break down about age 40 and clump together. This clump produces a cloudy area or a cataract on your lens. The cataract becomes more serious over time and clouds more of the lens."

• Cataracts are a cloudy region that impacts vision in the lens of the eye.

• Cataract risk rises not only with age, but with long-term exposure to sunlight, diabetes, and smoking, according to the Center for Medicare and Medicaid Services. Drinking too much, or having a family history of cataracts, in addition to taking certain drugs.

• Surprisingly, more than half of Americans over the age of 80 have undergone or had surgery to suppress cataracts (and have only lived with them).

What is cataract surgery?

The removal of your cloudy eye lens, and then replacement of your original lens with a new, artificial lens, is cataract surgery. It is performed in a hospital or an ambulatory surgical center in an outpatient environment. This ensures, without an overnight hospital stay, you are in and out.

Why would you have cataract surgery?

The cataracts of certain individuals do not bother them enough to do anything about them. If you want to stave off the process, you can try

• minimize the glare of your sunglasses or glasses,

• or the amount of light in your living areas is only growing.

• to get stronger glasses,

• or a lens or magnifying device,

If it gets to the point where you have trouble seeing, however, you might need surgery. People who have cataracts, according to the National Health Institute, may notice:

• Seeing Dulled Colors

• Reading difficulties

• Bad Vision of Night

• Seeing Double Double

• Vision Fuzzy

• Hazy/Halo Vision

With age, some people only get cataracts naturally. While some will grow them after other eye operations, problems with eye injuries, or glaucoma.

How much does Medicare cost for cataract surgery?

There is a 'Procedure Price Lookup' page on the CMS Medicare.gov website where you can see the estimated costs of medical procedures.

Remember, this isn't the exact cost of what you're going to pay. This is just an estimation, but it can be very useful. Your real expenses will rely on what your doctor charges, any hospital fees, where you live, and any other variable medical costs associated with your treatment if you have additional insurance.

How to look up your Medicare.gov cost estimate

If you want to know the approximate cost of cataract surgery, you can visit their website. Then, type in "Complex cataract removal with lens insertion"  

At the end of 2020, when we looked up this process, the average cost was:

• Ambulatory Surgical Centers Total cost of $1,7777

1. Patient Costs $355 to pay

2. Pays for Medicare $1,4222

• Full Cost of $2,7866 for Hospital Outpatient Surgery

1. Patient Pays $5577 dollars

2. Medicare Pays $2,229

• It gives an estimation of what will be paid for by Original Medicare.

• But, in the form of a Medicare Supplement (Medigap) Plan or a Medicare Advantage Plan, you most likely have extra insurance.

Are Medicare Cataract Surgery Eyeglasses Covered?

The only time that Medicare covers eyeglasses or contact lenses is if you need them for corrective purposes after cataract surgery, according to Medicare.gov. You will also be responsible for 20 percent of the expense in this situation.

Furthermore, Medicare Part B would refer to the corrective lenses, so Medicare Part B Deductible would also apply. When you have supplemental coverage, this is (for example, Medigap or Medicare Advantage).

Does Medicare cover total eyeglasses or contacts?

Usually, outside of cataract surgery, Original Medicare will not cover contact lenses or eyeglasses. Nevertheless, there are Medicare Advantage plans that have a glass or contact bonus included. The sum varies from one initiative to another and from one year to the next. There are corrective lens criteria outside of, or in addition to, cataract surgery.

Conclusions

Medicare Part B includes cataract surgery. The first thing to do is to speak with your medical practitioners if you are considering cataract surgery.

Then, consult the expense details or staff of your insurance company. Tell them what your financial obligation is for the expenses that do not cover Initial Medicare Part B (the 20 percent coinsurance).

You could be liable for all, any, or none of the co-insurance payments, depending on what form of coverage you have.

 

 

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