Does Medicare Cover Cataract Surgery?

  

If you know that you need to have cataract surgery, one of the things that you may be thinking about is how you’ll afford the procedure. After all, if you have Medicare, you’d assume that it covers the procedure in full, but that’s not always the case.

Keep reading to learn if Medicare will cover cataract surgery in Orlando!

What Medicare covers during cataract surgery

Older woman thinking on couch

If you have Medicare and need to have cataract surgery, it’s important to know exactly what your Medicare plan will cover, especially before you have cataract surgery! Here is what Medicare covers during cataract surgery:

  • The removal of your cataract
  • A basic lens implant
  • One pair of prescription eyeglasses or one set of contact lenses after cataract surgery

Specifically, Medicare Part B is the part that will cover your cataract surgery, since it is your medical insurance. This only covers medically necessary healthcare services.

Medicare Form Stock photo

If it’s been determined that cataract surgery is medically necessary, your benefits under Part B include any presurgical appointments and outpatient services after surgery. You’ll pay your Part B deductible for these appointments and services.

After paying your deductible, you’ll receive your coverage from Medicare but this will not include any copayments. You’ll still need to pay for these.

If you have Medicare Advantage, you’ll get the benefits of both parts A and B. Make sure to check with your healthcare provider before your procedure to see if you’ll receive any extra coverage.

If you’re being technical, then yes, Medicare covers cataract surgery, since it covers the physical removal of the cataract. But what many people don’t realize is that there’s more to cataract surgery than removing the cataract.

Why you need to have cataract surgery

Cataract before and after

To put it simply, cataract surgery involves removing the eye’s natural lens. Before you have cataracts, the lens is clear and easy to see through.

But over time, usually as a result of aging, the lens becomes cloudy and harder to see through. When this happens, proteins in the lens start to build up and clump together in the middle of the lens.

This leads to vision impairment, blurry vision, and other frustrating symptoms of cataracts. This is why patients need their cataracts removed during cataract surgery. The only way to remove the cataract is to remove the entire lens from the eye.

Medicare covers a basic lens implant, but what is that?

The other component of cataract surgery is the removal of the natural lens and replacing it with an artificial lens. The artificial lens, known as an intraocular lens (IOL) is one of the most crucial parts of cataract surgery.

If you want to have clear vision again after cataract surgery (and you do), then an IOL is a must! Without it, you wouldn’t be able to see well and would continue being visually impaired.

Now, here’s where things can get a little tricky to understand. Medicare will only cover a basic lens implant. This is a monofocal lens.

Monofocal lenses are intraocular lenses that only have a fixed focus for one distance. This will work to allow you to see for near vision, intermediate vision, or distance vision.

With this lens, you can only see at this distance. To see at other distances, you will have to wear glasses to compensate.

Monofocal IOLs are perfectly adequate, but it’s also important to know that there are other IOL options out there. The problem? These other IOLs are what’s known as “premium lens options” meaning that Medicare will not cover their cost.

Are premium lenses worth the extra cost?

There’s no right or wrong answer here. If you don’t mind wearing glasses to see after cataract surgery, then you may have no issue with choosing a monofocal lens as your IOL.

If you want visual freedom and a life that lets you rely less on wearing glasses, a premium lens may be worth it for that reason.

What are my options when it comes to premium lens implants?

IOLs Documentary

If you want to consider all your options, it’s important to know what’s available to you. Herschel LASIK and Cataract Institute in Orlando offers the following premium intraocular lens options:

Toric IOLs

Toric IOLs are unique because they are the only IOL that’s specifically designed for patients with astigmatism. Astigmatism occurs when the cornea is irregularly curved.

When this happens, your vision will be distorted and blurry. It’s also common to have other refractive errors like nearsightedness and farsightedness when you have astigmatism.

Toric IOLs correct astigmatism and provide patients with clear vision after cataract surgery.

Multifocal IOLs

If the concept of needing glasses to see at more than one distance wasn’t appealing, multifocal IOLs may sound better. These IOLs restore a full range of vision in both eyes.

This includes near vision, intermediate vision, and distance vision. Multifocal IOLs work because they contain rings with different magnifications which enable a wider range of clear vision.

These rings help the brain pick the right focus automatically. This is something that patients never have to think about since it happens automatically.

There is some adjustment that may be necessary, but most patients get used to their multifocal IOLs quickly.

Aspheric IOLs

Another kind of premium lens to consider is an aspheric IOL. With aspheric IOLs, this lens is the closest to the shape of the natural lens.

Although it seems like the eye is spherical and round, it’s actual aspheric. With an aspheric IOL, patients experience a much clearer vision because the lens is much closer to the shape of the natural lens.

Aspheric IOLs also produce fewer higher-order aberrations, which can make it difficult to drive at night or be in low light situations. With an aspheric IOL, these higher-order aberrations are completely eliminated.

If you do decide to go with a premium lens implant, know that this is something that Medicare will not cover. You will need to pay for these costs out of pocket.

For many patients, the cost is worth it to finally experience visual freedom for what’s often the first time in their lives.

Have questions about cataracts or not sure if you may need cataract surgery? Schedule a cataract screening at Herschel LASIK and Cataract Institute in Orlando, FL!

Now has never been a better time if you’re ready to say goodbye to cataracts and hello to clear vision!

Those who know choose Herschel LASIK and Cataract Institute

Beautiful office. Amazing and caring staff. Getting my surgery done Saturday and the Doctor and the staff helped choose the right option for me and I didn't feel pushed to commit. One of the only few who commits the patient to a dry eye treatment as per my research. Post-surgery I hope to keep my 5 star rating because I have nothing bad to say!

Yogi Nayyar (Google), February 2020

I recently did my LASIK procedure about 1 week ago and was completely blown away from beginning to end with the SERVICE received from the entire staff at Herschel LASIK. The office is beautifully decorated and the staff was always professional, personable, knowledgeable and friendly. I particularly enjoyed the way that everything was explained clearly before, during and after my procedure and questions were always encouraged and answered. My experience was the best encounter to date with a physician. Excellent doctor + excellent support staff +excellent service = excellent experience and a happy customer. Thank you so much Dr. Herschel, Doris and Francesca.

Vernicia Sturrup (Google), September 2019

Great service, sometimes a bit of a wait, but I take a full lobby as a sign of a well recommended doctor. Staff is friendly & quick to answerphones & squeeze me in when I got an eye problem. Would definitely recommend them to anyone wanting to get LASIK. Doctor even personally called to check on me the night after my procedure.

Stephanie G. (Yelp), January 2020

I got my LASIK procedure done here. I was apprehensive, mostly because anything to do with my eyes kind of freaked me out.
I went under a free consultation. The nurses/assistants were very nice and they answered any questions I had. Then I met Dr. Herschel and he was very nice and understanding. He explained all that would happen, how everything works, how long recovery will be, everything.
So, I agreed and start the process. I love the fact you always meet with Dr. Herschel at every appointment.
I now have 20/20 vision.
I'd highly recommend going to him for all of your vision needs.

Kelsea K. (Yelp), November 2019

Great surgeon and great staff. Do your research, Dr. Herschel is more than just a LASIK surgeon. He is certified and specializes in all areas of eye surgery so have peace of mind that you are getting one of the best. They use current technology and machines. More so, if your eyes aren’t ready for surgery he has no problem delaying 1-2 weeks until they are 100% good-to-go. He will not risk your health for the sake of money.

Dave T. (Yelp)
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