Medicare Coverage and Cataract Surgery
Cataracts are a common part of aging — in fact, more than half of Americans over 80 either have cataracts or have had them removed. Left untreated, cataracts can interfere with daily life and may even cause blindness. The good news? Cataract surgery is safe, simple, and usually painless.
But what about the cost? The short answer: Yes, Medicare covers cataract surgery if it’s medically necessary. Here’s how coverage works and what you can expect.
Which Parts of Medicare Cover Cataract Surgery?
Most cataract surgeries are outpatient procedures, so they’re usually covered under Medicare Part B (Original Medicare) or Medicare Advantage (Part C).
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Part B (Original Medicare): Covers 80% of surgery costs after you meet your deductible. You’ll pay the remaining 20% unless you have a Medicare Supplement (Medigap) plan.
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Part C (Medicare Advantage): Coverage varies by plan, but most include cataract surgery. Staying in-network keeps costs lower.
Beyond the Surgery?
Coverage extends well beyond the procedure itself. Medicare helps pay for:
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Pre-surgery eye exams
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Medications
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Facility and provider fees
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Up to a year of follow-up care
Glasses and contacts: Medicare will pay for one pair of Medicare-approved glasses or contacts after cataract surgery. Some Advantage plans also offer allowances for additional eyewear.
What Lenses Are Covered?
Medicare covers standard monofocal intraocular lenses (IOLs), which provide a single focus point (often distance).
Premium lenses are NOT covered.
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Multifocal lenses (cover near, mid, and far vision in one)
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Toric lenses (for astigmatism)
If you choose these, you’ll pay the full cost.
Who Will Perform Your Surgery?
If Original Medicare is your primary you may use ANY medical provider that accepts Medicare.
If you have a Medicare Advantage Plan, your plan may have different rules. Some services may only be covered in certain settings or for patients with certain conditions.
Medicare Advantage plans are through private companies. This means things such as copays, coinsurance and networks vary from plan to plan. Your Medicare Advantage plan may also limit available providers to those within its network.
✅ Bottom line: Medicare does cover cataract surgery, standard lenses, and related care. Your actual costs depend on your Medicare plan, your provider, and whether you choose standard or premium lens options.
