Introduction
Cataracts are a common condition in adults over the age of 40, and it is estimated that more than half of Americans aged 80 or older have a cataract or have had cataract surgery. Cataracts occur when the lens of the eye becomes cloudy or opaque, which can cause blurry vision and difficulty seeing at night. When left untreated, cataracts can lead to blindness, so surgery is often necessary to restore vision. But the question remains: does Medicare cover cataract surgery?
Overview of Medicare Coverage for Cataract Surgery
Most types of cataract surgery are covered by Medicare Part B, which covers medically necessary procedures and services. Medicare will pay for both the surgery and the intraocular lenses (IOLs) used during the procedure. However, there are some restrictions on what type of IOLs are covered and whether you must pay an additional fee for them. Medicare will also cover pre-surgery exams and post-surgery follow-up visits.
In general, Medicare will pay 80 percent of the cost of cataract surgery, but you may need to pay the remaining 20 percent out of pocket. This amount can vary depending on your specific plan and any additional fees associated with the procedure. It is important to note that if you choose to have a laser cataract surgery, Medicare may not cover all of the costs associated with this procedure.
Out-of-Pocket Costs Associated with Cataract Surgery
In addition to the 20 percent that Medicare does not cover, there are other out-of-pocket costs associated with cataract surgery. These include co-payments, deductibles, and other fees that may be charged by the surgeon or facility. Co-payments are a set fee that you will have to pay at each visit, while deductibles are a set amount that you must pay each year before Medicare will start paying for the procedure. Other fees may include charges for the use of specialized equipment or for medications.
It is also important to consider the cost of post-surgery care, such as glasses or contact lenses. Medicare does not cover these costs, so they must be paid out of pocket. Additionally, Medicare does not cover routine eye exams, so you will need to pay for these as well.
How to Find a Qualified Cataract Surgeon Under Medicare
When looking for a qualified cataract surgeon under Medicare, it is important to research doctors and facilities in your area. Ask friends and family for recommendations and look online for reviews. You should also contact your local Medicare office for information about which surgeons and facilities are covered by Medicare. They may also have additional resources that can help you find a qualified surgeon.
Once you have narrowed down your list of potential surgeons, ask for references from past patients. Talk to these patients about their experience and ask any questions you have about the surgeon’s expertise and skill. Also, make sure to check that the surgeon is certified by the American Board of Ophthalmology.
Conclusion
Cataract surgery is a necessary treatment for many individuals who suffer from cataracts and can help restore vision and improve quality of life. Medicare provides coverage for most types of cataract surgery, including pre-surgery exams and post-surgery follow-up visits. However, there are certain out-of-pocket costs associated with the procedure, such as co-payments, deductibles, and other fees. It is important to research doctors and facilities in your area to ensure that you are getting the best care possible.
In conclusion, Medicare does cover much of the cost of cataract surgery, but it is important to understand the out-of-pocket costs associated with the procedure. Doing your research and talking to your doctor can help you make the best decision for your health and budget.
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