Does Medicare Cover Cataract Surgery?
Are you enrolling in Medicare soon? Do you already have Medicare coverage and are wondering if you can get cataract surgery? You’ll be happy to learn that Medicare Part B does cover cataract surgery that implants an intraocular lens.1 As for follow up vision care, there are specific times that Medicare Part B may help pay for corrective lenses, too. Read on to learn more about what you can expect.
Medicare Part B: Glasses and Contacts
If you get cataract surgery that implants an intraocular lens, Medicare Part B will cover you for one pair of glasses or contacts following the surgery. If you want more coverage for vision benefits, you can enroll in Medicare Advantage. Or, you can apply for a separate vision insurance plan.
As you consider what’s right for your needs, keep in mind that you may pay an extra premium for vision insurance or Medicare Advantage. This is in addition to the premium you pay for Medicare Part B.
Medicare Part B and Eye Exams
Routine vision exams aren’t covered under Medicare Part B unless you’re a high-risk individual.2 But these exams are important in detecting eye issues at an early stage, so you can take the right steps to help correct them. If you’re interested in this benefit, there are a couple of ways to apply for vision insurance.
One option is to purchase a separate vision insurance plan. If you’re looking for this type of coverage, you can usually find a plan that works for your needs and your budget. That being said, there are two main types of vision plans:3
Discount Vision Plans: With this plan, you’ll typically pay into the program and in return receive discounted prices for the vision care that you need.
Vision Benefits Packages: This plan provides coverage for your vision needs up to a certain amount. You can decide what amount you need your insurance to cover, and the types of vision care you need that coverage for.
Or, you can check if your current insurance provider offers vision “riders”, which is an added-on benefit to a current insurance plan.
Medicare Advantage and vision benefits
If you want to get additional vision benefits, another way is with a Medicare Advantage plan. Medicare Advantage plans vary by insurance company. Not all plans include vision benefits, so remember to ask when you’re deciding which plan you want.
As for costs, there are Medicare Advantage plans that offer a $0 premium. Ask your Medicare Advantage insurance provider about monthly costs when choosing the plan that’s right for you.
Can you enroll in Medicare with vision loss?
You can enroll in most Medicare plans with pre-existing conditions, such as vision loss. With all Medicare plans, you have “guaranteed issue rights.” This means that pre-existing conditions won’t affect your Medicare enrollment if you’re eligible for Medicare and enroll during your initial enrollment period (IEP).4 However, if you specifically need vision benefits, a separate vision insurance policy may be the best choice for you.
As mentioned, it’s best to enroll in Medicare during your initial enrollment period (or apply during open enrollment period for Medicare Supplement Insurance). The only Medicare plan that might be affected by pre-existing conditions are Medicare Supplement insurance plans.5 If you have a pre-existing condition and enroll in Medicare Supplement outside of your initial enrollment period, a few things can happen:
- Your application could be underwritten. This means the insurance company make look into more details about your life, like health history and current habits
- Your application could be denied by the Medicare Supplement insurance provider
- The Medicare Supplement insurance provider may postpone your coverage for the first 6 months of your policy due to a pre-existing condition
Learn more about Medicare
There are Medicare options that can help cover some of your vision needs.6 So you can rest assured knowing you won’t miss out on seeing your grandkids’ sports games or reading your favorite books!
1,2,6 Medicare.gov. Web page: Eye Glasses/Contacts. Retrieved on July 31, 2018, from website https://www.medicare.gov/coverage/eyeglasses-contact-lenses.html
3 All About Vision (April 2018). Web page: Choosing A Vision Insurance Or Vision Benefits Plan. Retrieved on January 14, 2019, from website https://www.allaboutvision.com/vision-insurance/choosing-vision-plan.htm
4,5 Medicare.gov. Web page: I have a pre-existing condition. Retrieved January 14, 2019, from website https://www.medicare.gov/node/32731