Whether you have just had cataract surgery or are considering getting a new pair of glasses, there are some important things to know. The amount of time you will have to wait after cataract surgery depends on the size of your cataract and how much you have to pay out of pocket. However, you can expect to receive one pair of eyeglasses or contact lenses free of charge through Medicare.
Medicare Will Cover One Pair of Eyeglasses or Contact Lenses
If you are new to Medicare or have been on it for years, you should know that Medicare will only cover one pair of eyeglasses or contact lenses after cataract surgery. Whether you qualify for vision coverage depends on the cataract surgery procedure you received and your deductible. If covered under Medicare Part B, you will be paid for standard frames and lenses for one pair of eyeglasses. If you are covered under Medicare Part D, you may be substituted for one pair of contact lenses after cataract surgery. In addition to standard prescription eyeglasses and contact lenses, Medicare covers specific surgical procedures to repair the eye and its function. These procedures include cataract surgery, laser treatment for cataracts, and eye exams. Medicare will not cover unrelated techniques or add-ons. For example, if you need a second pair of glasses after cataract surgery, you must pay the difference between Medicare-approved amounts and the supplier's charge. In addition, depending on your particular plan, you may require prior authorization from your provider before receiving vision services.
Getting New Glasses Depends on the Severity of Your Cataract
Getting new glasses after cataract surgery depends on the severity of the cataract. For example, a cataract in the center of your eye will likely impact your vision more than if it is situated on your eye's periphery. Fortunately, some advanced surgical techniques allow you to minimize the need for glasses after your surgery. A cataract is a clouding of the eye's natural lens that causes blurry and double vision. It can also cause an increased sensitivity to light, making it difficult to see at night and drive in the dark. The best way to determine if you have cataracts is to have an eye exam. The ophthalmologist will use a small device called an ophthalmoscope to check the health of your eyes, test the retina and
optic nerves, perform a tonometry test to measure fluid pressure in your eyes, and do an ocular microscopy to examine the lens of your eye. If you are eligible for Medicare Part B coverage, you can enroll in a Medicare Advantage plan that covers vision services. Some Medicare Advantage plans will cover a new pair of glasses every two years, while others may cover glasses more often. Most Medicare Advantage plans have an annual dollar limit on vision coverage, with the average yearly limit being $160 in 2021. If you have cataract surgery at a hospital, Medicare will pay up to $2,131. If you have cataract surgery at an ASC, Medicare will pay up to $1,284. Suppose you have cataract surgery with an intraocular lens (IOL). In that case, you may qualify for coverage if you are a high-risk individual such as someone who is African American, over 50, or has diabetes. Regardless of the type of cataract surgery, you may also be eligible for coverage if you have had glaucoma testing.
