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Original Medicare does not regularly provide coverage for vision and dental services and care. However, it does cover some vision services and treatments if they are medically necessary to treat a medical condition. So what about eye surgeries?
Well, a common question many people have is, “does Medicare cover eye surgery?” In this article, we answer that question in clear, plain English. You will also find the average costs of eye surgeries and other helpful info.
Does Medicare Cover Eye Surgery?
The short answer is yes; Medicare will cover the cost of eye surgeries. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your eye surgeries. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for eye surgeries. Even though Original Medicare does not provide coverage for routine vision services, they provide coverage for eye surgery if it is medically necessary. If you have a chronic eye condition such as a cataract or glaucoma, Medicare will provide coverage for any surgery needed as treatment.
If you have eye surgery in an inpatient setting, Medicare Part A will provide coverage for the expenses. On the other hand, if you have eye surgery in an outpatient setting, coverage will fall under Medicare Part B.
After undergoing cataract surgery, Medicare Part B will also provide coverage for the purchase of a pair of eyeglasses or contact lenses. Medicare Part B will provide another pair of eyeglasses or contact lenses if you undergo cataract surgery for your other eye later in your life.
Original Medicare, however, does not provide coverage for all types of eye surgery. Original Medicare does not provide coverage for LASIK eye surgery as it is considered as an elective procedure. LASIK is not considered as medically necessary as it is only for correcting vision and not to prevent vision loss or treat a chronic eye condition.
Part C Coverage for Eye Surgery
Medicare Advantage plans (Medicare Part C) also provide coverage for eye surgery. They cover everything Original Medicare covers, as well as offer some additional benefits. However, exactly what it covers and what your out-of-pocket costs are will vary depending on the specifics of your plan.
Since Medicare Part C provides coverage for routine vision care, they also provide coverage for some surgeries that Original Medicare does not cover. This includes LASIK eye surgery.
How Much Does Eye Surgery Cost?
The exact cost of eye surgery will depend exactly on what type of surgery you will be having. Cataract surgery usually costs around $1,000 in an inpatient setting and closer to $2,000 in an outpatient setting.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to 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 diabetic supplies?