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does Medicare cover multifocal lenses for cataract surgery

Does Medicare Cover Multifocal Lenses For Cataract Surgery?

Original Medicare provides coverage for cataract treatment and cataract surgery. They also provide coverage for glasses or contact lenses after cataract surgery. However, the coverage has limitations. So what about multifocal lenses for cataract surgery?

If you need this type of lens, you probably want to know “does Medicare cover multifocal lenses for cataract surgery?” In this article, we answer that question in clear, plain English. You will also find the average costs of multifocal lenses and other helpful info about them.

Does Medicare Cover Multifocal Lenses For Cataract Surgery?

The short answer is no. In most cases, Medicare will not cover the cost of multifocal lenses for cataract surgery. That said, there may be some situations where you can get some costs of glasses covered. Below we’ll take a closer look at this to see what type of glasses/lenses you may be able to get coverage for after cataract surgery. 

Original Medicare

Original Medicare (Medicare Part A and Part B) does not provide coverage for multifocal lenses for cataract surgery. So that means you will have to pay 100 percent for your multifocal lenses for cataract surgery.

Original Medicare provides coverage for eyeglasses and contact lenses after cataract surgery. However, they only provide coverage for certain types of lenses for eyeglasses. Multifocal lenses are not one of them.

Original Medicare provides coverage for monofocal lenses for eyeglasses after cataract surgery. Coverage for eyeglasses with monofocal lenses after cataract surgery is provided by Medicare Part B.

Medicare Part B covers one pair of contact lenses or eyeglasses per lifetime for each eye that underwent cataract surgery. So that means if you underwent cataract surgery for one of your eyes, Medicare Part B would cover the costs of your contact lenses/eyeglasses. If you undergo cataract surgery for your other eye later in your life, Medicare Part B will provide coverage for one more pair of contact lenses/eyeglasses.

Once approved by Medicare Part B, they will pay for 80 percent of the costs of your contact lenses/eyeglasses. You will pay for the remaining 20 percent as copayment.

Part C Coverage for Multifocal Lenses for Cataract Surgery

Just like with Original Medicare, Medicare Advantage plans (Medicare Part C) also do not have to provide coverage for the multifocal lenses for cataract surgery. Medicare Advantage plans have to cover the same things that Original Medicare covers.

However, theses plan offer coverage for things Original Medicare does not, with vision benefits being a fairly common one. Each plan is different though in terms of what they will cover and what the costs for that coverage is. If you have a Part C plan, we recommend contacting your plan to see if you can get coverage for multifocal lenses.

How Much Do Multifocal Lenses Cost?

Multifocal lenses can be a little expensive. The costs usually range from $1,500 to $4,000 if you have to pay out of pocket.

What Are Multifocal Lenses?

While bifocal lenses have a clear separation between the near focus and far focus parts of the lens, multifocal lenses have a gradual shift between different focus planes.

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 Zilretta?

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