Does Medicare cover 100% of cataract surgery?


Editorial team Published on

āŒ No, Medicare does not cover 100% of cataract surgery.

Original Medicare (Part B) covers 80% of the Medicare-approved amount for medically necessary cataract surgery after you meet your annual Part B deductible. You are responsible for the remaining 20% coinsurance, plus the deductible and any non-covered upgrades.

šŸ“Š Cost Breakdown for Standard Surgery

  • šŸ—“ļø Part B Deductible: You pay this annual amount first out of pocket.
  • šŸ“ˆ Medicare Share (80%): Paid by Part B for approved facility and doctor fees.
  • šŸ“‰ Your Coinsurance (20%): Your out-of-pocket share for the procedure and anesthesia.
  • šŸ—’ļø Glasses/Contacts: One standard pair of prescription glasses or contact lenses is covered after surgery.

āš ļø What is NOT Covered (Hidden Costs)

  • Premium Lenses: Multifocal or toric intraocular lenses (IOLs) meant to correct astigmatism or reduce glasses dependence entirely.
  • Laser-Assisted Surgery: Extra fees if you choose laser-assisted methods over traditional manual surgery.
  • Upgraded Eyewear: Designer frames or routine annual eye exams unrelated to the surgery.
  • Supplemental gaps: Unless you have a Medigap (supplemental) policy or a Medicare Advantage plan to pick up that 20% coinsurance, you pay it directly.