Does Medicare cover cataract surgery and implants?
Answers
Yes, it does. Because cataract surgery is performed by a physician rather than an optometrist, Medicare Part B covers the surgery, including lens implants. And following that surgery, it can pay its share for one pair of eyeglasses. How much it pays for the glasses depends on whether you get new frames, and if so how much they cost. Medicare Part B will pay for both lenses and frames, but only basic frames. If you buy more expensive frames than the basic ones approved by Medicare, you'll have to pay out of pocket for the difference between the standard amount Medicare pays and the amount your frames actually cost.
For both the surgery and the glasses, you have to pay a coinsurance amount, which is 20 percent of the amount Medicare approves for the surgical procedure and for the glasses and frames. Before you choose new glasses after your surgery, make sure to let the doctor's or optometrist's office -- depending on which one you are ordering your glasses from -- know that you want the bill for your glasses sent to Medicare, and ask what frames they have that are fully covered by Medicare (not counting your 20 percent coinsurance amount).
As to the cataract article (Cataract expenses covered by Medicate), there is more information needed. My eye specialist has told me if the patient wants more than the standard, medicare paid for intraocular lense, the different is paid by the patient. To get an "accommodating" lense (such as Crystalens (made by Bauch and Lomb), there is a large out of pocket expense. However the patient will not need the use of eyeglasses, 90 percent of the time. The Crystalens accommodates the lenses so the patient can see close, near by, and distance subjects. They claim their lense acts like a the original, biological lense we were born with.
I have medicare and a supplemental healthcare plan. Imagine my surprise when I found out medicare does NOT approve the anesthetic used during cataract surgery. Since medicare doesn't cover, the supplemental won't pay a dime. My question for medicare would be, who in the world would have the lens of their eye sliced off without the eye being numb? I was wide awake for the procedure, no other anesthetic was given.
Just assisted my mom - one special implant (Toric)- one not. Out of pocket was about $2500 total for both eyes . One Rx of eye drops (there are 3 different eye drops for pre & post op) was $175 PER OUNCE - no generics available - she needed 2 complete sets (one for each eye). Toric lens costs $900 that Medicare paid zero on. Be prepared - " Medicare pays 100% of nothing" is the best advice we were given. Will spend over $500 for eye drops alone - not covered. Bring your wallet (Oh, btw, needed the money upfront before the surgeon would do the surgery!) Good news - she now has a better quality of life and (hopefully) no more glasses.
The best thing to do is make sure that your opthalmalogist gives you the amt of monies before you do anything.. Yes..it is going to cost you more for the non standard eye lenses, but that is your option not normal. Your vision will improve completely..but not to the tune that you don't use glasses. In any eye surgery the opthalmalogist that performs your surgery usually includes a package given to you with eye drops you will need. These are furnished to you by the surgeon that performs the surgery.. Insure that this is part of the surgery.. Many surgeons.. (eye surgeons) will issue you a kit for after surgery.. Bottom line.. get your total of monies out of pocket before you do anything.. or you will wind up paying or not having the procedure done.. With any insurance.. medicare or other,.. your cost for a standard cataract surgery will be 500-550 per eye.. unless you choose.. crystalens.. then you can expect to pay.. 1200+..and the best thing to do is ask your Dr. (surgeon) for sample eye drops.. all of them will give you samples.. why pay.. more?
