Have you noticed your vision has started to become cloudy or foggy? Do you see halos around lights at night? Or do colors look dimmer than they used to? If so, you might be one of the 20% of seniors with cataracts. June is cataract awareness month, a time to remember the importance of good vision as you age and understand how cataracts affect your eyesight.
If you do have cataracts, take comfort in knowing that surgery to remove them is common, successful, and covered by Medicare. The amount of coverage, however, depends on your supplemental plan and the kind of replacement lens you choose.
Medicare coverage for cataract surgery
Cataract surgery is an outpatient procedure where your doctor removes the cataract — your eye’s lens that has become cloudy — and places an artificial intraocular lens in your eye. The surgery is covered under Medicare Part B if it is deemed medically necessary by your doctor.
Your cataract surgery out-of-pocket costs for 2026 include your Part B deductible ($283), if you haven’t met your deductible yet. You’ll also pay 20% of the Medicare-approved amount for the surgeon and care facility where you have the procedure completed. Cataract surgery costs range from about $1,500 to $4,000 per eye.
Note: Your cost will vary depending on where you have surgery. According to Medicare.gov, the average beneficiary’s cost for an ambulatory surgery center (after Medicare pays 80%) is $343; the average expense at a hospital outpatient department is $563.
The Medigap Plan G advantage
Your Medigap Plan G coverage serves as your safety net, paying your 20% coinsurance after the Part B deductible is met. This coverage could add up to big savings, especially if you have cataracts in both eyes, which is relatively common. Here’s what a breakdown of costs for cataract surgery with Medigap Plan G might look like.
- If you owed $563 per eye, your total cost would be $1,126.
- You pay your $283 deductible.
- Medigap Plan G covers the remaining $843 that you would have owed.
- After Medicare pays its portion, your cataract surgery cost with Medigap Plan G is $0 (after the deductible).
Premium upgrades: Laser, toric lenses, and multifocal lenses
Medicare will pay the same rate for your cataract surgery regardless of the enhancements you choose. For instance, you can have standard surgery or laser surgery. Medicare covers both, but only pays for the standard procedure; you pay for the technology upgrade, which can be $1,000 to $2,500 per eye.
The same goes for special lenses. Medicare-covered cataract lenses are the standard option during surgery. You would pay extra fees for premium lenses – each offering different additional benefits.
- Monofocal lenses – The standard, providing clear vision at one distance, typically far. You often need reading glasses with these lenses after surgery.
- Multifocal lenses – Medicare doesn’t pay for multifocal lenses, which give you clear vision both near and far. These lenses can cost more than $2,000 above the cost of traditional lenses per eye.
- Toric lenses – These are for people with astigmatism (an irregular curve in the cornea or lens). These lenses can add more than $1,300 per eye over standard lenses.
Multifocal lens and toric lens options cost more but reduce the chances of having to wear glasses or contacts after surgery. These lenses are a good choice for people who are physically active or who switch from close-up to far-away tasks frequently during the day and don’t want the hassle of contacts or glasses.
Part B post-surgery benefit
Medicare typically doesn’t pay for eyeglasses, but there is an exception after cataract surgery. Your Medicare Part B plan will pay for one pair of standard eyeglasses or contact lenses after each surgery where a new lens is implanted.
Cataract surgery checklist
Before having cataract surgery, there are a few things to remember to ensure you receive appropriate, affordable care.
- Confirm medical necessity. Medicare will cover your costs if your vision meets guidelines for impairment, meaning it hinders daily activities and can’t be corrected well enough with glasses. Talk to your ophthalmologist to confirm medical necessity.
- Decide on your lens. Discuss the pros, cons, and costs of different lenses with your doctor to see which best fits your lifestyle and vision needs.
- Verify Medigap status. Check with your insurance plan provider to ensure your plan covers the 20% cost share for the surgery.
Poor vision shouldn’t keep you from performing daily activities, participating in sports, or enjoying travel. If it’s time for cataract surgery, talk with your doctor about the kind that will best suit your lifestyle — and enjoy peace of mind knowing your Medigap plan will help you pay for it.
