Cataracts are a serious eye condition that can cause symptoms such as cloudy, distorted, or blurred vision. This condition often requires medical attention.
How can cataracts be treated?
Well, surgery is one of the most common ways to remove cataracts in an affected eye.
And if you need surgery, there are a lot of procedures required of you before and after your cataract surgery. One of them includes using specific eye drops.
This leads to a very common question those facing this procedure face, which is: “does Medicare cover eye drops for cataract surgery?”
In this article, we answer that question in clear, plain English. You will also find the average cost of eye drops for cataract surgery and other helpful info.
Does Medicare Cover Eye Drops for Cataract Surgery?
The short answer is yes; Medicare will cover the cost of eye drops for cataract surgery. But not 100% of the time.
As is often the case with Medicare, certain conditions must be met for Medicare to pay for your eye drops for cataract surgery. Below we look at what these are so you know what to expect.
Original Medicare Coverage of Eye Drops
Original Medicare (Medicare Part A and Part B) does provide coverage for eye drops in cataract surgery.
Medicare Part A Coverage of Eye Drops for Cataract Surgery
Coverage for cataract surgery is provided by Medicare Part A if it takes place in an inpatient setting.
Medicare Part B Coverage of Eye Drops in Cataract Surgery
On the other hand, coverage is provided by Medicare Part B if it takes place in an outpatient setting. Once approved, Medicare Part B covers 80 percent of cataract surgery costs. You will pay for the remaining 20 percent.
It may be helpful to know that Original Medicare also provides coverage for the cataract surgery itself too.
As is the case for your eye drops, the operation must also be first ordered by your healthcare provider for Original Medicare to receive coverage.
Part C Coverage for Eye Drops in Cataract Surgery
Medicare Advantage plans (Medicare Part C) also provide coverage for cataract surgery. They cover everything Original Medicare covers, as well as some additional benefits. However, what a plan covers and how much your out-of-pocket costs are will vary depending on the specifics of your plan.
Medicare Part C plans that include prescription drug plans will also provide coverage for medications your healthcare provider prescribes.
Part D Coverage for Eye Drops in Cataract Surgery
Medicare Part D plans cover medications you need after cataract surgery, including eye drops.
Medicare Part D is a prescription drug plan, and just like Medicare Part C, Medicare Part D plans are provided by private insurance companies.
How Much Do Eye Drops for Cataract Surgery Cost?
The cost of eye drops for cataract surgery varies greatly, with bottles costing from $15 to $100. This depends on the brand, the type of eye drops, and the length of time the eye drops are needed.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage. Always double-check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series, including: Does Medicare Cover Psychiatric Hospitalization?