Medicare and Cataract Surgery (medical, plan, doctor, supplement)

[LookingatFL]

We have the chance to purchase vision insurance. I'm not sure it is worth it. My husband needs cataract surgery in January. The vision insurance claims that we would be paying a maximum $1,800 or $2,200 per eye, depending upon which lens he gets.

My neighbor said that Medicare paid for her cataract surgery and she paid $1,800 per eye (but could have chosen to pay the $2,200 per eye) and Medicare covered the difference.

Does Medicare pay for cataract surgery?

Does anyone know if Tricare For Life covers cataract surgery?

I'm trying to figure out if the vision insurance is worth it.

Thank you.

[in_newengland]

Originally Posted by LookingatFL

We have the chance to purchase vision insurance. I'm not sure it is worth it. My husband needs cataract surgery in January. The vision insurance claims that we would be paying a maximum $1,800 or $2,200 per eye, depending upon which lens he gets.

My neighbor said that Medicare paid for her cataract surgery and she paid $1,800 per eye (but could have chosen to pay the $2,200 per eye) and Medicare covered the difference.

Does Medicare pay for cataract surgery?

Does anyone know if Tricare For Life covers cataract surgery?

I'm trying to figure out if the vision insurance is worth it.

Thank you.

Medicare pays for cataract surgery. When I had it done two years ago, I think I only paid $200 per eye. My co-payments to the doctor were out of pocket though.

[moved]

I had cataract surgery two years ago, and Medicare paid for all of it, and it also pays for a pair of new eyeglasses after surgery. All I paid for were the office visit co-pays.

[biscuitmom]

I had cataract surgery earlier this year. Medicare paid and I had a $400 co-pay for each eye; that included the surgery and all office visits.

[arwenmark]

I had both eyes done about two years ago. small co pay. Now I have Macular degeneration and get shots in both eyes monthly Medicare pays 100% of that.

I don't think you need the vision insurance unless it covers glasses and such which Medicare usually does not.

[Travelassie]

Medicare pays for cataract surgery, including the monocular intraocular lens (such as for distance or closeup sight but not both) inserted into the eyes to replace the cataract (which is the original lens that's become thickened and miscolored, etc). Medicare also pays for one pair of glasses after the surgery.

There are also intraocular lenses for both distance and closeup vision, and to correct astigmatism, but Medicare does not cover the cost of those type of lenses-I'm guessing Medicare would pay towards them up to the amount it would pay for the monocular lens, but I'm not sure of that. The patient would otherwise bear the cost of these type of lenses.

The out of pocket expenses for cataract surgery for those on Medicare would depend on the type of Medicare plans (ie, Medicare Advantage plans, traditional Medicare with a supplemental insurance, or part B Medicare with no supplemental, so they pay out of pocket for the 20% not covered by Medicare) they have.

If they are subject to copays and payment of deductibles for covered services under these plans, they would have a copay for cataract surgery (such as the $200 INE mentioned). I have traditional Medicare with a secondary insurance which pays the 20% not covered by Medicare as well as the annual deductible, so I had no out of pocket expenses for my cataract surgery in 2013.

I have to mention, though, that there are several types of eyedrops prescribed by the eye surgeons to be used prior to and after the surgery. These would be covered under a patient's prescription drug plan, with copays applicable, and in my experience these can be pricey. The eyedrops include an antibiotic, a prednisone type drop and a nonsteroidal antiinflammatory drop, these are needed to prevent post-surgical infections, as well as inflammatory reactions to the "insult"of the surgery, and to the implanted lenses, so it's not a good idea to skip out on the drops.

[Travelassie]

Originally Posted by arwenmark

I had both eyes done about two years ago. small co pay. Now I have Macular degeneration and get shots in both eyes monthly Medicare pays 100% of that.

I don't think you need the vision insurance unless it covers glasses and such which Medicare usually does not.

I don't think vision insurance would even cover cataract or any other type of eye surgery (unless it's strictly for vision correction, such as Lasix) as these would be considered to correct or diagnose a medical condition and so be covered under medical insurance.

[LookingatFL]

Thank you, everyone.

[moved]

Yes, the eye drops are pricey, but I only paid $3.35 for each one. I have vision insurance through my medical insurance, and it only covers eye exams and eyeglasses.