Many seniors ask, “Does Medicare cover cataract removal?”—and the good news is, in most cases, the answer is yes.
This is true whether you’re on a Medicare Advantage Plan, a Medigap (Medicare supplement plan), the Med-Share 65+ health sharing plan, or simply enrolled in Original Medicare by itself. Each of these plans helps pay for cataract removal.
However, each plan is structured differently. Your out-of-pocket costs will vary depending on your plan.
What To Know About Cataract Removal Surgery
- Cataracts affect more than 24 million Americans aged 40 and older. — Source: American Academy of Ophthalmology (AAO)
- Half of all Americans have cataracts by age 75. — Source: National Eye Institute (NEI)
- Cataracts are the leading cause of blindness worldwide and the primary cause of vision loss in the U.S.
— Source: World Health Organization (WHO), CDC - More than 3.7 million cataract surgeries are performed annually in the United States.
— Source: American Society of Cataract and Refractive Surgery (ASCRS) - Medicare Part B covers 80% of the approved cost of cataract surgery, including standard IOL and one pair of glasses or contact lenses post-surgery.
— Source: Medicare.gov - In a Medicare outpatient setting, the average total cost of cataract surgery is around $3,500 per eye.
- With Original Medicare alone, a beneficiary may pay roughly $700 (20%) out-of-pocket, after the Part B deductible ($240 in 2025).
— Source: Healthline, CMS claims data - Laser cataract surgery or premium lenses can increase costs by $1,000 to $3,000+ per eye. Medicare does not cover this additional cost.
— Source: American Academy of Ophthalmology
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What are Cataracts?
Cataracts are a common eye condition in older adults that cause cloudiness in the eye’s lens, leading to blurry vision, light sensitivity, and trouble seeing at night.
Cataract removal surgery is the only effective treatment. It involves taking out the cloudy lens and replacing it with an artificial intraocular lens (IOL).
Does Medicare Cover Cataract Removal?
Medicare Part B covers cataract removal if it is medically necessary.
This includes the surgical removal of the cataract and the insertion of a standard intraocular lens. However, Medicare does not cover advanced lenses like multifocal or toric lenses used to correct vision beyond the basic medical need.
After the procedure, Medicare also covers one pair of prescription eyeglasses with standard frames or one set of contact lenses if an IOL was implanted. Routine vision care, including annual eye exams or eyewear not related to cataract removal, is not covered.
Types of Cataract Surgery
There are two main types of cataract removal procedures: manual and laser-assisted.
Laser-assisted cataract removal uses advanced technology to make precise cuts and correct astigmatism.
However, laser-assisted surgery is generally more expensive. The additional cost is not generally covered under Original Medicare.
Manual vs. Laser Cataract Removal Under Original Medicare
The type of cataract removal you receive affects your Medicare coverage.
Manual cataract surgery uses traditional surgical tools and is covered under Medicare Part B. If you don’t have any additional plan in place, you’ll pay the Medicare Part B deductible ($240 as of 2025), if you haven’t already covered it with other medical spending.
Original Medicare will then cover 80% of the cost for both the physician and the facility if it’s done in an outpatient center, which is the normal practice. You or your private plan will be responsible for the other 20%.
The same 20% coinsurance applies if the surgery is done in a doctor’s office. You may also have additional charges for anesthesia, facility use, and follow-up appointments, depending on your location and provider.
With laser-assisted surgery, Medicare only pays up to the amount it would for manual surgery. So you must cover any additional fees for the laser portion, which can range from $1,000 to $3,000 per eye. These additional costs are not reimbursed by Medicare. However, some Medicare Advantage plans may help pick them up.
Drug Costs After Cataract Removal
After cataract removal, you’ll likely be prescribed eye drops to prevent infection and control inflammation.
These medications are generally low-cost, but if you have Medicare Part D, your plan may help cover them. If costs are an issue for you, ask your doctor for generic versions or for free samples to reduce your out-of-pocket costs.
If you’re a MediGap Advisors client, you can also use your AdvantageRx discount card, a valuable member benefit that can help you get discounts on hundreds of medications, lab costs, and other medical services.
Medicare Advantage and Cataract Removal Coverage
Medicare Advantage (Part C) plans must cover everything Original Medicare covers, including cataract removal.
However, each plan has its own rules for copays, provider networks, and prior authorization.
Some Medicare Advantage plans may include extra benefits, like vision care or glasses beyond what Medicare Part B offers. They also come with a maximum out-of-pocket limit (MOOP), which can help protect you from high medical expenses if you need additional care.
Medicare Advantage plans generally have very low monthly costs. Some even have a zero premium. However, they also require you to get non-emergency care (including cataract surgery) from authorized, in-network providers. They also have higher out-of-pocket costs compared to Medicare supplement insurance plans in the event you need care.
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How Medigap Plans Help Pay for Cataract Removal
Medicare Supplement (Medigap) plans work with Original Medicare to help cover out-of-pocket costs.
Your out-of-pocket costs for cataract surgery with a Medigap plan will depend on the type of plan you have. However, the most popular plan is currently Plan G, which covers all your out-of-pocket costs for the physician and facility except for the $240% deductible as of 2025.
This is the most comprehensive Medigap plan currently available to new subscribers.
Unlike Medicare Advantage, Medigap plans don’t have networks. That means you can choose any provider who accepts Medicare. You aren’t limited to your plan’s network.
This gives you much more flexibility when scheduling cataract removal and may help reduce surprise bills.
Note: Medigap plans don’t include prescription drug coverage. However, you can supplement your Medigap plan with a Medicare Part D Plan for prescription drug coverage.
Medi-Share 65+ and Cataract Removal
Medi-Share 65+ is a popular non-insurance, health sharing alternative to Medigap.
Under Medi-Share 65+, cataract removal costs are shareable if they’re covered under Original Medicare. This plan has an annual member responsibility amount (MRA) of $500 per year per household. So your total plan members’ expenditure for the year must exceed this threshold for Medi-Share 65+ to share your cataract costs.
However, there’s no coinsurance for Medi-Share 65+ members. Once you meet that annual member responsibility amount, the plan will generally pay for 100% of all costs approved but not paid under Medicare Parts A or B over that $500 MRA for the year.
Medi-Share 65+ generally follows Medicare standards. But they have a few rules of their own, such as a six-month waiting period for pre-existing conditions, unless you enrolled during your initial eligibility window when you turned 65.
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Conclusion
So, does Medicare cover cataract removal?
Yes—Original Medicare covers standard cataract removal and lens replacement when medically necessary. However, you’re still responsible for some out-of-pocket costs unless you have Medigap or a strong Medicare Advantage plan.
For personalized help understanding your options, contact a Medi-Gap Advisors Personal Benefits Manager. We can help you enroll in the right plan and make sure your cataract removal is both medically effective and financially manageable.
For Further Reading:
Christine Corsini is one of your Personal Benefits Managers at MediGap Advisors. She loves working for Medigap Advisors especially helping clients choose the right Medicare plan.