Truth :
Did you know that under Original Medicare Part B, you may have coverage for cataract surgery that implants conventional intraocular lenses (if deemed medically necessary by your provider)? Cataract surgery removes a cloudy natural lens from your eye and, in most cases, replaces it with a clear artificial lens. Medicare Part B may also cover for you one pair of eyeglasses with standard frames (or one set of contact lenses) after each cataract surgery that implants an intraocular lens.
Something worth noting is that premium upgrades will not be covered, such as advanced technology lenses, laser assisted surgery. Covered services are subject to your Medicare Part B deductible, then picked up at 80% by Medicare, and if you have a Medicare supplement, the remaining 20% should be picked up as well.
Tip/Trick:
Prior to scheduling for surgery, make sure your provider accepts the Medicare Assignment, and thoroughly discuss with the provider their recommendations and find out if any electives such as upgrades to the lens or an above standard operation is going to be performed. I’ve had a client who opted in for the laser and upgraded lens, that is responsible for thousands more out of pocket due to not being covered under original Medicare.
If you are charged up front prior to the appointment, double check to understand what they are charging you. It could be something the office knows Medicare will not cover (like upgrades). Remember that you should never pay at the time of visit or prior. If Original Medicare is your primary insurance, Medicare needs to be billed first. Post-op if you receive a prescription for standard eyeglass lenses and frames or contact lenses, make sure you order through a Medicare approved supplier. As always, if you have additional questions, please reach out to our office at The Health Insurance Store! (724) 603-3403.