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Can Medicare Cover Cataract Surgery and Prevention?

Medicare Bob
Discover who is at risk for cataracts, strategies to help prevent them and whether Medicare can cover cataract surgery.
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Cataract — a clouding of the eye lens — is very common in older people. In fact, the risk of developing cataracts increases with age.

Cataracts are most prevalent in white Americans, according to recent studies. Research from the National Eye Institute shows that by age 75, half of white Americans will have developed cataracts.

While research has shown cataract surgery can cost as much as $2700 for one eye, Medicare can help cover some of that cost and may help pay for corrective lenses post-surgery. We’ll explain how and offer a few healthy lifestyle changes you can make to help minimize risk factors and prevent cataracts.

Risk Factors & Preventing Cataracts

Factors that can increase your risk for cataracts include:

  • Aging

  • Having diabetes

  • Excessive exposure to sunlight

  • Smoking

  • High blood pressure

  • Eye injury

  • Prolonged use of corticosteroids

  • Drinking excessively

When it comes to your health, you have the power to make changes today that could help prevent cataracts later in life. Doctors recommend the following strategies that may help prevent cataracts:

  • Have regular eye exams

  • Quit smoking

  • Manage your diabetes and other medical conditions (like blood pressure)

  • Reduce alcohol use

  • Reduce exposure to sunlight by wearing sunglasses to protect your eyes from ultraviolet B (UVB) rays

  • Choose to eat healthy foods, including lots of fruits and vegetables

What Can Medicare Cover?

While Medicare doesn’t typically cover the cost of routine eye care, it can cover medically necessary services — like cataract surgery. Medicare Part B outpatient insurance can cover up to 80% of the surgery expenses, including one pair of conventional monofocal intraocular lenses (standard eyeglasses or contacts) after the surgery.

Conventional monofocal intraocular lenses provide corrections for distance vision, like what you need when you drive.

If your cataract surgery requires you to stay in a hospital, Medicare Part A can help cover the service.

Overall, when it comes to cataract surgery, Medicare can cover:

  • Exams before surgery

  • Removal of the cataract

  • Implantation of an artificial intraocular lens

  • Exams after surgery

  • One pair of lenses after surgery

If you experience cloudy or blurred vision, find a provider for an eye exam by searching “ophthalmology” on Medicare.gov. Call Senior Healthcare Direct at 1-833-463-3262, TTY 711, for more help from a licensed agent.


LEGAL DISCLAIMER: The above is meant to be strictly educational and not intended to provide medical advice or solicit the sales of an insurance product or service of any kind.

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