Cataract surgery

Medicare Coverage Information

Overview

Medicare Part B covers medically necessary cataract surgery, including standard lens implantation and related pre-surgical and post-surgical care. Patients are responsible for a portion of the surgical costs, typically 20% after meeting their annual deductible.

  • Medicare Part B covers cataract surgery when deemed medically necessary
  • Covers standard intraocular lens implantation during surgery
  • Includes pre-surgical exams and post-surgical follow-up care
  • Outpatient surgical procedures are typically covered
  • Patients are responsible for 20% of approved Medicare costs
  • Medicare Part B beneficiaries
  • Patients with documented medical need for cataract removal
  • Individuals 65 and older
  • Some disabled individuals under 65 may also qualify
  • Patients pay 20% of Medicare-approved costs after meeting Part B deductible
  • Typical out-of-pocket costs range from $500-$1,500 depending on specific procedure
  • Additional costs may apply for advanced lens options beyond standard implants
  • Must be performed by Medicare-approved healthcare providers
  • Surgery must be medically necessary, not purely cosmetic
  • Advanced lens technologies may require additional out-of-pocket expenses
  • Frequency of coverage limited to medically required procedures
  • Consult with an ophthalmologist to determine medical necessity
  • Verify coverage details with your specific Medicare plan
  • Get pre-authorization for surgical procedure
  • Call 1-800-MEDICARE for specific coverage questions
Last updated: 6/15/2025

Quick Information

Provider
Medicare
Last Updated
6/15/2025
Topics
Medicarecataract surgeryeye surgeryMedicare Part Bvision coverage

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Medicare Coverage for Cataract Surgery: What You Need to Know