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Does Medicare Cover Cataract Surgery?
Medicare covers cataract surgery, but there may be coverage restrictions or coinsurance.
Elizabeth Aldrich is a writer at NerdWallet specializing in Medicare and other insurance topics including health, life, auto and homeowners insurance. She has been a financial journalist for 10 years, and her work has appeared in Forbes, Business Insider, CBS News, Bankrate, USA Today, CFP Board and Yahoo Finance. Prior to NerdWallet, she was a banking editor with expertise in Federal Reserve policy and produced studies that were cited by First Financial Bank and researchers at University of Chicago Law School and USC Gould School of Law. Elizabeth holds degrees in economics and philosophy from the University of Oregon. She is based in Portland, Oregon.
Holly Carey is a managing editor at NerdWallet. She leads the Health Insurance team and supports other insurance topics including life, auto and homeowners. She joined NerdWallet in 2021 as an editor focused on expanding content to additional topics within personal finance. Previously, Holly wrote and edited content and developed digital media strategies as a public affairs officer for the U.S. Navy. She is based in Virginia Beach, Virginia.
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Medicare covers medically necessary cataract surgery. But you're still responsible for the Part B deductible and a 20% coinsurance. And coverage limits apply to premium technology and upgraded lenses.
Cataract surgery involves the removal of the cataract and the placement of an artificial lens. Medicare also includes one pair of eyeglasses or one set of contact lenses post-surgery.
Does Original Medicare cover cataract surgery?
With Original Medicare, Medicare Part B covers 80% of the cost of cataract surgery after the Part B deductible is met. The surgery must be performed using traditional surgical techniques or lasers. If hospitalization is required — and that’s unusual — Medicare Part A (hospital insurance) pays.
The role of Medicare Supplement Insurance
Medicare Supplement Insurance(or Medigap) can lower your out-of-pocket costs for cataract surgery. Medigap plans cover part or all of the Part B coinsurance.
Medicare Advantage is an alternative to traditional Medicare offered by private health insurers. It covers the same benefits as Medicare Part A and Part B.
UnitedHealthcare
4.11
CMS Star Rating
Average Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed.
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed.
Humana
3.79
CMS Star Rating
Average Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed.
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed.
Medicare Advantage covers everything that Original Medicare covers (with a few exceptions), and it does cover cataract surgery. As with many other medical services, a Medicare Advantage plan may offer lower out-of-pocket costs for cataract surgery. But Medicare Advantage may also limit available providers to those within its network. Copays, coinsurance and deductibles vary by plan, so contact yours for details.
How much does cataract surgery cost with Medicare?
After your Part B deductible is met, cataract surgery costs around $346 to $560 per eye with Medicare. Here’s the average cost breakdown for cataract surgery on one eye under Medicare’s 2026 payment structure:
Expense type
Hospital outpatient facility
Stand-alone surgery center
Facility fee
$2,280
$1,214
Doctor fee
$521
$521
Total charge
$2,801
$1,735
Medicare pays
$2,241
$1,388
Your coinsurance
$560
$346
With or without Medicare, the cost of cataract surgery depends on where it's done. You can save over $200 per eye by choosing a stand-alone surgical center instead of a hospital.
Other costs may apply. Patients with complex cases might need more than one doctor, for example. To avoid a surprise bill, ask your health care provider about costs before the procedure.
Questions to ask:
Do you accept reimbursement from Original Medicare or my Medicare Advantage plan?
What is the doctor fee for the procedure?
Will the procedure be performed in a stand-alone surgery center or a hospital outpatient facility?
What other costs should I expect after surgery?
Does Medicare cover other costs that come with cataract surgery?
Original Medicare doesn’t cover eyeglasses or contact lenses in most circumstances. But if you need them after cataract surgery, Medicare Part B pays for one pair of eyeglasses with basic frames or one set of contact lenses
The coinsurance for corrective lenses after each cataract surgery is 20% after you meet the Part B deductible. You’ll pay more for more expensive frames. Your supplier of corrective lenses must be enrolled in Medicare.
Medicare Advantage plans may come with some vision coverage that includes eyeglasses. And Medigap plans will cover part or all of your Part B coinsurance.
Medicare covers traditional and laser cataract surgery, but doesn’t pay for New Technology Intraocular Lenses, or NTIOLs. For example, some toric lenses, designed to correct astigmatism, may not be fully covered. Discuss with your eye doctor whether it makes sense to pay more for NTIOLs.
Are there alternatives to cataract surgery?
In the early stages, some patients may be able to improve their cloudy vision without surgery. Here are some things that can help:
Using brighter lights.
Anti-glare sunglasses.
Magnifying lenses for close activities.
Updated prescription lenses.
But when recommended by doctors, surgery is a safe and effective long-term solution.
Can cataracts be prevented?
Medical experts believe that some strategies may help prevent cataracts or slow the progression
Curb alcohol. Drinking to excess can raise the risk of cataracts.
Get regular eye exams. Detecting cataracts early can help people take preventive or other steps sooner.
Take care of overall health. People with other health problems, like diabetes, should follow their doctor’s orders for self care.
Eat healthy foods. Getting a variety of vitamins and nutrients from a regular diet can help keep eyes healthy.
Wear sunglasses. Choose shades that block ultraviolet B, or UVB, light, which may speed cataract development.
Frequently Asked Questions
Is cataract surgery fully covered by Medicare? Is cataract surgery fully covered by Medicare?
If cataract surgery is medically necessary, Medicare Part B covers 80% of the cost after you meet the Part B deductible. The surgery must be performed using traditional surgical techniques or lasers. If you have Medigap, your plan may cover certain out-of-pocket costs, such as your Medicare Part B coinsurance.
Medicare Advantage covers medically necessary cataract surgery and may offer lower out-of-pocket costs, but you’re generally limited to in-network providers. Copays, coinsurance and deductibles vary by plan.
What type of lens does Medicare cover for cataract surgery? What type of lens does Medicare cover for cataract surgery?
Medicare covers cataract surgery that involves an intraocular lens. Newer lenses that correct for conditions such as astigmatism, nearsightedness or presbyopia aren't covered by Medicare.
How bad do cataracts have to be to qualify for surgery? How bad do cataracts have to be to qualify for surgery?
Generally, Medicare will cover surgery for cataracts when your vision has declined to below 20/40, which in many states is the legal minimum vision required to drive.
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Medigap plan types the company generally offers (availability may vary by location). Options include Plans A, B, C, D, F, G, K, L, M and N.
NAIC complaint rate
How often the company’s members file complaints about their policies as compared to the industry average, according to data from the National Association of Insurance Commissioners (NAIC). NerdWallet conducts its data analysis and reaches conclusions independently and without the endorsement of the NAIC.
Premium discounts available
Based on the number and size of a company’s available discounts on monthly premiums, in comparison to other insurance companies.
We will match you with Medicare companies and offers based on the information you provide us. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.
We will match you with Medicare companies and offers based on the information you provide us. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.
We will match you with Medicare companies and offers based on the information you provide us. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.
We will match you with Medicare companies and offers based on the information you provide us. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.