Does Medicare cover the cost of cataract surgery?
Cataract surgery cost in New Smyrna Beach is a question that never enter ones mind until the little floating objects start to appear regularly or maybe it’s the increased sensitivity to light. What ever the symptoms, many people put off the surgery because they fear it will cost to much.
Medicare generally does not pay for vision care, but it will cover certain medically necessary services, such as cataract surgery. If you have Original Medicare, these services are covered under Part B, which covers outpatient services. Medicare Advantage Plans services as Original Medicare, but may have different costs and conditions. If you have a Medicare Advantage Plan, contact a plan representative to learn about how the plan covers cataract surgery.
Specifically, Medicare covers:
The removal of the cataract
Basic lens implants
One set of prescription eyeglasses or one set of contact lenses after the surgery
Medicare covers cataract surgery that involves intraocular lens implants, which are small clear disks that help your eyes focus. Although Medicare covers basic lens implants, it does not cover more advanced implants. If your provider recommends more advanced lens implants, you may have to pay some or all of the cost. It is important to talk with your health care provider before the surgery to understand which costs you will be responsible for, and which costs will be paid by Original Medicare or your Medicare Advantage Plan.
After the surgery, Medicare will also cover one pair of glasses or contact lenses. This is an exception to Medicare coverage rules, which normally exclude eyeglasses from coverage. If you have Original Medicare, You pay 20% of the Medicare-approved amount for corrective lenses after each cataract surgery with an intraocular lens, and the Part B Deductible applies. You pay any additional costs for upgraded frames and may not cover additional lens treatments or enhancements. Medicare will only pay for contact lenses or eyeglasses from a supplier enrolled in Medicare, no matter if you or your supplier submits the claim.
Some beneficiaries may have trouble getting Original Medicare or their Medicare Advantage Plan to cover their glasses or contact lenses following cataract surgery. If your glasses or contact lenses are denied coverage, you can appeal the decision. You can request that the glasses or contact lenses be covered, or request reimbursement if you already paid out of pocket for your prescription. You and your health care provider can both write appeal letters to the plan. Be sure to state that because you met the Medicare requirements for cataract surgery, your prescription glasses or contact lenses must be covered.