Does Medicare Cover Laser Cataract Surgery?

May 7, 2019 — by William Goldstein
Tags: Cataract Surgery

Steps of cataract surgeryLaser cataract surgery restores vision by removing a natural lens that has been clouded over by a cataract and replacing it with an intraocular lens, or IOL. Laser cataract surgery is a blade-free technique that further minimizes the already low risks of traditional cataract surgery.

Although cataracts can affect a person of any age, they are far more common among seniors. Because the majority of these patients are covered by Medicare insurance, it is common for them to wonder if Medicare covers laser cataract surgery. Detroit, MI eye surgeon William S. Goldstein and our staff help patients understand their insurance benefits so they know if they should expect any out-of-pocket costs for their procedure.

Medicare Coverage

Cataract surgery is a vision-saving procedure. It provides patients with an artificial lens that restores clear vision so that patients can complete basic daily tasks. Since cataract surgery is generally not an elective procedure, the cost of treatment is covered by Medicare insurance as long as a doctor deems it medically necessary.

Although Medicare does cover cataract surgery, there may still be some out-of-pocket expenses for our Detroit patients. Medicare will only cover the cost of procedures or techniques that are necessary. If a patient elects to receive upgraded techniques or products, additional costs related to those services will need to be covered by the patient.

Is Laser Surgery an Upgrade?

Laser surgery does offer benefits that are not provided by traditional cataract surgery.

According to the Centers for Medicare and Medicaid Services, Medicare coverage is the same whether a patient undergoes traditional cataract surgery or laser cataract surgery. In either case, Medicare will cover the cost of cataract removal and the placement of a conventional IOL.

The cost of laser-assisted treatment will incur an additional fee, which the patient will need to cover out-of-pocket. If patient are searching for the most affordable treatment option, they may prefer to undergo traditional cataract surgery.

Potential Out-of-Pocket Charges

Other expenses that are not covered by Medicare insurance are those related to the cost and placement of premium IOLs. Premium IOLs address different types of vision impairment to provide patients with a wider range of vision after cataract surgery.

Depending on a patient’s needs, premium IOLs can address nearsightedness, farsightedness, astigmatism, or presbyopia. Patients can also choose a multifocal lens that improves vision at multiple distances.

Medicare beneficiaries will have to cover the cost of premium IOLs. For those looking for the most affordable option, Medicare will cover the cost of a basic, monofocal IOL. This provides good vision at one distance, but patients will require glasses to see objects at all ranges.

Aside from the costs of premium services or products, Medicare beneficiaries will be responsible for all usual out-of-pocket expenses. This includes covering any applicable deductibles, copayments, and coinsurance. While patients should expect to cover some portion of the cataract surgery procedure, the majority of expenses will likely be covered by Medicare.

Learn More

If you have more questions about your Medicare coverage, or would like to learn more about cataract surgery, the staff at William A. Goldstein’s laser eye care center would be happy to help. Contact us at your earliest convenience to receive more information, or call our Detroit office at (586) 323-2020.