Medicare coverage of cataract surgery

Limited Medicare coverage: vision and dental

Medicare generally does not cover routine vision care, but it will cover certain eye care services if you have a chronic eye condition, such as cataracts or glaucoma. A cataract is a cloudy area that forms on the lens of your eye, which can make your vision blurry and cause blindness over time. Cataract surgery repairs the function of the eye by removing the cataract and replacing your eye’s lens with a fabricated intraocular lens.  

Specifically, Medicare covers:

  • The removal of the cataract
  • Basic intraocular lens implants (small clear disks that help your eyes focus)
  • One set of prescription eyeglasses or one set of contact lenses after the surgery

Medicare covers cataract surgery that is performed using traditional surgical techniques or using lasers. Although Medicare covers basic intraocular 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.

If you have Original Medicare, cataract surgery is covered under Part B. Medicare Advantage Plans must cover the same services as Original Medicare, but they may have different costs and coverage rules. If you have a Medicare Advantage Plan, contact your plan to learn about how the plan covers cataract surgery.

Typically, Medicare does not cover eyeglasses or contact lenses. However, after cataract surgery Medicare will cover one standard pair of untinted prescription eyeglasses or one set of contact lenses. If it is medically necessary, Medicare may pay for customized eyeglasses or contact lenses.

If you have Original Medicare, you should get your glasses or contact lenses from a supplier who takes assignment. After you meet the Part B deductible, you will pay 20% of the Medicare-approved amount for corrective lenses. If you have a Medicare Advantage Plan, contact your plan to learn about its costs and coverage rules for your glasses or contact lenses.

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.