Does Medicare cover glasses after cataract surgery?

What glasses does Medicare cover after cataract surgery?

Medicare Part B covers one pair of eyeglasses with standard frames, or one set of contact lenses, after each cataract surgery that implants an intraocular lens. Medicare.gov lists one pair of conventional eyeglasses or contact lenses provided after a covered cataract surgery among the prosthetic devices Part B covers. Otherwise, Medicare doesn't usually cover eyeglasses or contact lenses.

CMS's Medicare Benefit Policy Manual sets the same limit: one pair of conventional eyeglasses or conventional contact lenses furnished after each cataract surgery with insertion of an intraocular lens is covered.

What do I pay for glasses after cataract surgery?

After you meet the Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount for corrective lenses after each covered cataract surgery with an intraocular lens. You pay any additional costs for upgraded frames. The specific amount you owe also depends on other insurance you may have, how much your doctor charges, whether your doctor accepts assignment, the type of facility and where you get the item.

Where do I have to get my glasses for Medicare to pay?

From a supplier that participates in Medicare. Medicare will only pay for contact lenses or eyeglasses from a supplier that participates in Medicare, whether you or your provider submits the claim.

What doesn't Medicare cover for glasses after cataract surgery?

Medicare doesn't pay the extra cost of upgraded frames, and CMS's Medicare Benefit Policy Manual says replacement of the conventional eyeglasses or contact lenses covered after cataract surgery with an intraocular lens isn't covered. CMS's rules for prosthetic cataract lenses also say:

• Medicare doesn't cover cataract sunglasses obtained in addition to the regular (untinted) prosthetic lenses.
• Lenses with ultraviolet absorbing or reflecting properties may be covered instead of regular (untinted) lenses, if they're medically reasonable and necessary for you.

What if my cataract surgery didn't implant a lens?

CMS's Medicare Benefit Policy Manual says permanent prosthetic lenses are covered when they're required by a person lacking the natural (organic) lens of the eye because of surgical removal or congenital absence. Prosthetic lenses obtained on or after the date you become entitled to Part B may be covered even if the lens of your eye was removed before that date. See Medicare coverage for cataract surgery.

Does Medicare Advantage or Medigap cover more for glasses?

Some Medicare Advantage Plans (Part C) offer extra benefits that Original Medicare doesn't cover, like vision, so contact the plan for more information. Medicare Advantage plans must cover all medically necessary services that Original Medicare covers, and rules and costs vary by plan. A Medigap (Medicare Supplement Insurance) policy helps cover your share of costs, like coinsurance and deductibles, for services Original Medicare covers, and Medicare.gov notes that Medigap plans generally don't cover vision care or glasses. See Medicare and glasses.