Both Traditional and Laser-Assisted Cataract Surgery with the placement of a standard monofocal intraocular lens is covered by Original Medicare and by Medicare Advantage Plans. Medicare does not require physicians to obtain prior authorization for medically necessary cataract surgery.
Understanding Your Medicare Coverage
Cataract surgery done in an outpatient setting is covered by Part B of Medicare. If you only have Original Medicare, you will be responsible for your annual Part B deductible if you haven't already satisfied it, along with 20% co-insurance and potentially Part B excess charges if you use a non-participating provider. If you have a Medigap Supplement, depending on the plan you have, it may cover most if not all of those costs.
Most Medicare Advantage plans cover this surgery under an outpatient surgical copay which includes the physician's fees, anesthesiology, facility fees, etc. That copay could be $0 to $350 or more depending on your plan and whether you are using in-network or out-of-network providers (PPO Plans Only).
Your doctor may require certain testing to be done prior to surgery like an EKG and bloodwork – Medicare will cover these tests. Your share of the cost will be determined by the type of Medicare coverage you have.
Lens Options and Additional Costs
Remember Medicare will only cover a standard monofocal lens – if you are wanting a multifocal or Toric lens, you will be responsible for the difference in cost of those lenses which could be $500 to $4000 per lens. The advantage to a multifocal or Toric lens is that it may negate your need to wear glasses or contacts, whereas with a monofocal lens, you will most likely still have to wear glasses for distance or reading depending on the lens you choose.
The great news is that Medicare will cover a new pair of eyeglasses or contacts after cataract surgery since your prescription will most likely have changed, as long as you get them from a provider that contracts with Medicare.
It is likely that you will be prescribed some prescription medications to use before and after your cataract surgery – these medications should be covered under your Part D prescription drug coverage. Generic eye drops will typically save you quite a bit over brand-name eye drops so talk to your doctor about whether generic alternatives will be safe and effective for you.
As a side note, I had this surgery done in one of my eyes 10 years ago and I have a Toric lens implant. If you are concerned or scared about the process and you would like me to share my experience with you or if you would like to just reach out to us at info@americanretire.com. I am happy to help ease your fears.
If you have other Medicare or Retirement questions, reach out to us at 602-281-3898. We are here to make your retirement journey 123Easy!
By American Retirement Advisors
American Retirement Advisors helps retirees and pre-retirees navigate Medicare, estate planning, and retirement income — so you can enjoy the retirement you've earned.
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Easy Eddie's Take
The personal experience shared about cataract surgery really shows how common this procedure is among Medicare beneficiaries. Here's something most people are surprised to learn: cataract surgery is one of the most frequently performed procedures covered by Medicare Part B, with over 4 million surgeries done each year through the Centers for Medicare & Medicaid Services.
Let's talk timing for a moment. If you're planning cataract surgery for 2026, remember that Medicare's Annual Open Enrollment Period runs from October 15 through December 7, 2025. This is your chance to review whether your current Medicare Advantage plan or Medicare Supplement insurance gives you the best coverage for the eye surgeons you want to use. Some Medicare Advantage plans have preferred networks for outpatient surgery that could save you hundreds of dollars in copays.
One question that comes up all the time is whether Medicare covers both eyes if you need surgery on both. The good news is yes, Medicare Part B covers medically necessary cataract surgery for each eye separately, though most doctors prefer to wait several weeks between surgeries. And that's what makes planning ahead 123easy.