If you’re new to Medicare or considering making changes to your plan in the future, you may be wondering about specific coverage areas. For instance, can Medicare help with eye health, namely cataract surgery?
Medicare — the federal health insurance program for people age 65 and older, as well as certain people with disabilities younger than 65 — can help you get this common corrective surgery and post-surgery vision care.
Here’s what to know about cataract surgery and how much it’s likely to cost with Medicare.
[READ: Does Medicare Cover Eye Exams, Glasses and Vision Care?]
When is Cataract Surgery Medically Necessary?
are common among older adults and closely associated with aging. They develop when proteins in your eye break down and cause a clouding of the natural lens. This lens bends and refracts light rays that come into the eye, so when it gets cloudy, it’s like looking through a foggy window.
“Most people will develop some degree of cataract by the time they reach age 55,” explains Valerie Sheety-Pilon, senior vice president of clinical and medical affairs with VSP Vision, a vision care health insurance company headquartered in Rancho Cordova, California.
But cataracts are problematic because they can impact your safety as your vision decreases, and they can eventually lead to blindness.
The good news is that surgery is generally considered to be a very safe and highly effective treatment option.
[READ: How to Prepare Seniors for Surgery: Anesthesia Risks and More]
Does Medicare Cover Cataract Surgery?
Yes, Medicare covers the most common type of cataract surgery, which involves the removal of the natural, clouded lens and replaces it with a clear artificial lens. Called an intraocular lens, or IOL, this plastic device works just like your natural lens did when it was clear.
More specifically, original Medicare — which includes Part A and Part B — generally covers the diagnosis and treatment of cataracts, including laser surgery.
However, Medicare only covers cataract surgery when it has been deemed “medically necessary.” This means the cataracts are causing significant vision impairment and interfering with your day-to-day life.
For example, if corrective lenses don’t improve your vision and cataracts begin interfering with your ability to complete daily tasks, such as reading, driving or engaging in hobbies, your ophthalmologist will likely recommend surgery as a medical necessity.
[READ: Cataract Surgery: What It Is and How Much It Costs]
Types of lenses covered by Medicare
Your doctor can use a few different types of lenses during cataract surgery, such as a standard monofocal or premium multifocal lens. Medicare, however, usually only covers standard cataract surgeries that involve the implantation of a standard, monofocal intraocular lens.
“Other forms of cataract surgery typically aren’t covered,” notes Bob Rees, chief sales officer with eHealth Inc., a health insurance broker and online resource provider headquartered in Austin.
Medicare also doesn’t cover advanced technology lenses or surgeries that are deemed elective, such as those to correct nearsightedness or astigmatism.
| Lens Type | Medicare Coverage | Average Cost to the Patient |
| Standard monofocal | Covered by Medicare Part B at 80% and many Medicare Advantage plans | $251 to $471 per eye depending on various factors, such as where the procedure is performed, according to Medicare.gov |
| Premium multifocal | Not covered by Medicare Part B | Upward of $4,000 per eye, according to some estimates, and the patient is responsible for the full cost of this procedure |
What Out-of-Pocket Costs Will You Pay After Cataract Surgery?
Eyeglasses coverage after cataract surgery
After the surgery, Medicare Part B will cover the cost of one pair of corrective glasses or contacts up to an allowed amount. That allowed amount is not a fixed dollar figure, but rather 80% of the Medicare-approved amount. You will be responsible for covering the remaining 20% coinsurance cost on those glasses or contacts.
You may also have additional out-of-pocket costs.
“For glasses, the coverage only extends to basic frames and lenses, so you may also pay more if you get fancier ones,” Rees explains.
What’s more, he notes, you have to get said lenses from the right provider.
“(Original) Medicare will only pay for your post-cataract surgery glasses or contact lenses from a supplier enrolled in Medicare. It’s not enough for them to bill Medicare for you; they must be a Medicare-enrolled supplier,” Rees says.
What to know about potential surgery complications and costs
“Cataract surgery is one of the most common, safe and effective surgeries performed in the U.S.,” Sheety-Pilon notes.
However, as with any type of surgery, there are some risks associated with cataract surgery, including:
— Swelling, bleeding and infections
— Vision loss or blurred vision
— Pain
— Retinal detachment
— Chronic inflammation
— Seeing halos, glare and dark shadows following surgery
Some patients can also develop what’s called a “secondary cataract” after surgery. This is common and happens when residual tissue forms a film over your new implant, making your vision cloudy again, Sheety-Pilon explains.
The treatment for secondary cataracts includes a minimally invasive eye procedure, called a YAG laser capsulotomy. In this “quick and painless in-office procedure, your eye doctor will use a laser to make an opening in the cloudy part of the lens, and most people will notice their vision improve almost immediately,” Sheety-Pilon notes.
Medicare will cover this procedure if it’s considered medically necessary. As with traditional cataract surgery, this type of surgery is covered at 80% under Medicare Part B, and you’ll be responsible for the remaining 20% of the cost.
Do Medicare Advantage Plans Cover Cataract Surgery?
Yes, Medicare Advantage plans cover cataract surgery. Some plans also offer additional vision services coverage.
For this reason, if eye health is a concern or you know you’re going to need cataract surgery soon, you may want to consider enrolling in a Medicare Advantage plan. There are many options on the market, and you’ll need to see what’s available in your area and compare those plans to find the right one for you.
“Medicare Advantage plans that offer routine eye exams annually provide the best eye health coverage,” says Terri Wilson, senior vice president of VSP Vision Care.
Routine eye exams are important for not only eye health, but they can also provide early detection of up to 270 other common diseases and conditions, such as diabetes, high blood pressure and even some cancers.
“A comprehensive eye exam allows your doctor to see the blood vessels in the back of your eye, unobstructed and in a noninvasive manner, which is the only place in the body where this is possible,” Wilson explains. “Often health problems may be detected in a routine eye exam before you notice or experience any symptoms.”
To get the most out of a vision plan with Medicare Advantage, check the fine print of the plan and make sure you’re using an in-network provider.
Medicare Part B Coverage vs. Medicare Advantage Coverage
Both original Medicare Part B and Medicare Advantage plans cover cataract surgeries that are deemed medically necessary. Here’s how the two types of insurance plans compare and what to expect for your out-of-pocket costs for cataract surgery using a standard IOL in 2026.
Do I Need Medicare Supplement (Medigap) to Cover Cataract Surgery?
| Cost consideration | Medicare Part B | Medicare Advantage |
| Premium | $202.90 per month | Varies by plan but averages $14 per month |
| Deductible | $283 | Varies by plan, may be as low as $0 |
| Coinsurance | Patient is responsible for 20% of the cost of the surgery | Varies by plan and services rendered |
| Out-of-pocket limit | No maximum | $9,250 is the maximum allowable for in-network services and $13,900 for combined in- and out-of-network services, but individual plans can set lower limits; average cap ranges between $4,900 and $5,900 |
| Average out-of-pocket cost for cataract surgery | $340 to $600 depending on the complexity of the surgery and where it is performed | Varies by plan but generally similar to patients with original Medicare |
| Cost for YAG laser capsulotomy | $115 to $170 depending on where the surgery is performed | Varies by plan but generally similar to patients with original Medicare |
| Routine eye exams | Not covered | Varies by plan but often covered |
You do not need supplemental insurance to cover cataract surgery. For those who are enrolled in original Medicare, however, Medigap plans can help you cover any out-of-pocket costs.
Cataract Surgery Costs and Lenses
Cataract surgery is usually conducted as an outpatient procedure. Medicare Part B covers the cost of the surgery once you’ve met your deductible.
In 2026, the annual deductible for all Medicare Part B enrollees is $283. If you have original Medicare, you’re responsible for 20% of the cost of surgery, after you’ve met the deductible.
If you have a Medigap plan, you may be able to get additional coverage for that 20%, which in some cases covers your full cost. Medigap plans are offered by individual insurance companies, not the federal government, so the costs and coverage options vary widely.
If you have Medicare Advantage, you’re also likely to have a cost-sharing requirement, depending on your plan’s specific details.
According to Medicare.gov’s Cost Lookup tool, the average total cost of cataract surgery varies depending on where it’s completed. Here are a few of the common procedure types and their average costs, depending on whether it’s completed in an ambulatory surgical center or hospital outpatient center. If the code of your particular procedure isn’t listed here, check the cost lookup tool.
| Procedure | Procedure code | Average patient cost in an ambulatory surgical center | Average patient cost in a hospital outpatient center |
| Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure) | 66983 | $251 | $471 |
| Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure) | 66984 | $343 | $563 |
| Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure) | 66825 | $397 | $617 |
| Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal | 66985 | $382 | $602 |
| Discussion of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (e.g., YAG laser) (1 or more stages) | 66821 | $115 | $167 |
These estimates include doctor and facilities fees only. Additional steps or services may increase the total cost.
The surgeon’s fee can increase these totals significantly, and it’s really important to make sure your surgeon is in network with your Medicare plan. Generally speaking, cataract surgeries run about $3,000 to $5,000 in total, depending on:
— The complexity of the case
— The doctor’s fee schedule
— Whether any other doctors are involved in the care
— The location where the surgery is being performed
How Premium IOLs Impact Costs
If you’re considering whether to upgrade to a specialty lens, such as multifocal or Toric intraocular lenses, you may be wondering how much extra you’ll have to pay for that higher-level device. Here’s what to know about how various types of lenses increase costs compared to standard lenses.
| Type of premium lens | What makes them premium? | Best for | Downsides | How much extra do they cost on average? |
| Multifocal | Like bifocal glasses, these devices provide multiple focal zones that allow you to see at varying distances without glasses. | Patients who don’t want to wear glasses after surgery | Some users are bothered by glare or halos around lights at night, which means they’re probably not right for people who drive a lot at night or need super clear vision for certain tasks. | $1,500 to $4,000 more per eye |
| Extended depth of focus IOLs | These lenses are similar to multifocal lenses in that they allow you to see at various distances, but it’s a continuous range rather than specific focal points, typically causing fewer visual disturbances than traditional multifocal IOLs. | Patients who don’t want to wear glasses after surgery | Some patients experience limited near-vision sharpness, contrast sensitivity and visual disturbances such as halos or glare. | $2,000 to $4,000 per eye |
| Toric IOLs | In addition to removing the cataract, these IOLs correct for astigmatism, a common vision issue. | Patients with astigmatism | Some patients’ astigmatism isn’t fully resolved, and the lens can sometimes rotate out of place, leading to blurred vision and additional procedures to correct it. You’ll also still need reading glasses for near-vision tasks. | $900 to $1,500 per eye |
| Accommodating IOLs | These lenses help your eye muscle adjust focus to see more clearly up close. | Patients who don’t want to rely on reading glasses to see fine details up close | These lenses often work well in the beginning but lose how well they work over time and can become tilted or clouded, which require an additional procedure to correct. | $3,000 to $5,000 per eye |
| Light-adjustable lenses | These light-sensitive lenses are fully customizable so your doctor can fine-tune the lens to correct nearsightedness, farsightedness or astigmatism. | Patients who want a fully customizable solution to address multiple vision issues | This most expensive option also requires several post-surgical office visits to set the final prescription, and you’ll have to follow strict rules regarding ultraviolet light exposure during that period. | More than $4,000 per eye |
Ask Questions to Understand Your Financial Responsibilities
The key here is to make sure you understand ahead of time what your financial responsibility will be when scheduling your surgery. You can do that by asking your doctor several questions before you set up your surgical appointment, including:
— Do you accept Medicare, or are you in-network with my Medicare Advantage plan?
— Where will the procedure be performed?
— Will the procedure be completed as inpatient surgery (overnight hospital admission) or outpatient surgery (same-day hospital discharge or in a medical office)?
— Will I need any prescription medications before or after the procedure, and are these covered by my prescription plan?
— What is the Medicare code for the procedure? (Use that to look up the cost of that procedure in your plan documents.)
— Can you give me a cost estimate for the surgery?
You should also contact your insurance company prior to surgery to ask several questions including:
— Is the provider in-network?
— Is the facility where the procedure will take place in network?
— What is my cost-sharing percentage for this surgery?
— Can you give me a cost estimate for my portion of the surgery after benefits?
These considerations are particularly important for individuals with a Medicare Advantage plan, as those networks are typically smaller than what’s usually found with original Medicare plans.
You should also check with your prescription plan to ensure that any prescriptions you’ll need afterwards will be covered. If they aren’t, how much will you have to pay out of pocket to get those prescriptions?
Resources for Affording Vision Care
If the vision care you need isn’t covered by your Medicare plan, check with the following organizations and programs to see if they can help you afford eye health care:
— Medicaid. If you’re eligible for Medicaid, a state-based health insurance program, you may be able to get cataract surgery free of charge. There are strict qualifications requirements for Medicaid, and as with Medicare, the surgery must be deemed medically necessary.
— Operation Sight. This cataract surgery program from the charitable arm of the American Society of Cataract and Refractive Surgery, the ASCRS Foundation, was launched in 2014 to help financially vulnerable, uninsured individuals who can’t afford or access eye health care.
— Mission Cataract USA. Based in Fresno, California, and launched in 1991, this charity offers free cataract surgery to people of all ages who have no means to pay.
— EyeCare America. This public service program of the American Academy of Ophthalmology offers free, comprehensive eye exams and eye care to eligible adults by matching uninsured and underinsured people aged 18 and over with volunteer providers.
— Lions Clubs International. This volunteer service organization has chapters all across the country, and many sponsor programs to help you get eye care and eyeglasses for free or reduced cost. They also run the SightFirst charity, which is fighting preventable blindness and assisting those with vision impairments around the world.
Bottom Line: Get the Vision Care You Need
Vision health is a key component of overall health and wellness, and you don’t need to accept clouded vision as part of getting older. Talk with your doctor about what you can do to address cataracts, and check your Medicare plan details for more information.
If you need help understanding or navigating your Medicare benefits, visit Medicare.gov or reach out to the Centers for Medicare & Medicaid Services call center at 1-800-Medicare.
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Does Medicare Cover Cataract Surgery in 2026? A Complete Guide originally appeared on usnews.com
Update 05/27/26: This story was published at an earlier date and has been updated with new information.
