Does Health Insurance Cover Cataract Surgery?

Cataract surgery is a common procedure that is performed to remove cloudy lenses from the eyes. The surgery is typically performed on an outpatient basis the patient is usually able to resume normal activities within a few days. While cataract surgery is a safe effective treatment for this common eye condition many patients are concerned about the cost of the procedure. One of the most common questions that patients ask is whether health insurance covers cataract surgery.

What is Cataract Surgery?

Cataract surgery is a surgical procedure in which an eye surgeon removes the cloudy lens from the eye replaces it with an artificial lens. The procedure is typically performed under local anesthesia takes about an hour to complete. After the surgery the patient will be monitored for a few hours then released to go home.

Does Health Insurance Cover Cataract Surgery?

Most health insurance plans cover cataract surgery because it is considered a medically necessary procedure. However the amount of coverage the out-of-pocket costs can vary depending on the insurance plan. Some insurance plans require a copayment while others cover the entire cost of the procedure. It is important to check with your insurance carrier to determine the specific details of your coverage.

What about Medicare?

Medicare is a federal health insurance program that covers the cost of cataract surgery for eligible individuals. Medicare Part B covers 80% of the Medicare-approved cost of cataract surgery the patient is responsible for the remaining 20%. However some Medicare beneficiaries may have a Medigap policy that covers the remaining 20% of the cost.

What if I don’t have insurance?

If you do not have health insurance cataract surgery can be very expensive. The cost of the procedure can vary depending on the location the surgeon other factors. However there are some options for individuals who do not have insurance. Some eye clinics offer discounted rates for patients who pay cash some surgeons offer financing options to help patients afford the surgery.

Conclusion

Cataract surgery is a common effective treatment for the cloudy lenses in the eyes. While the cost of the procedure can be a concern for many patients most health insurance plans including Medicare cover the cost of cataract surgery. If you do not have insurance there are some options available to help you afford the procedure. If you are considering cataract surgery it is important to talk to your eye doctor your insurance carrier to determine your coverage out-of-pocket costs.