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I’ve used glasses for nearly my entire life, but recently I’ve found my vision deteriorating. My vision is blurry, hazy, and less colorful. I am also having more trouble reading.
I’ve done some research online, and I think I may have developed cataracts. I’m wondering, does Medicare cover cataract surgery in Florida?
Worried about my vision,
Sharon from Fort Lauderdale, Florida
We’re happy that you’ve reached out to us with your question.
Cataracts are very common. In fact, 50% of people 80 or older have cataracts or cataract surgery.
Because most cataracts are age-related, it’s most likely because of expected changes in your eyes. In some cases, they can also develop after an eye injury or glaucoma, but you didn’t mention those. As you may have researched, the only treatment for cataracts is surgery.
You may have cataracts if your vision is blurry, hazy and colors are less vibrant. However, the only way to know is if you see your eye doctor to check. Your ophthalmologist will perform a simple and painless dilated eye exam to check for cataracts and other eye problems.
While your symptoms might be mild at first, as cataracts grow – and they do – they can cause more severe changes to your vision. These changes could include:
Of most importance. If you don’t have your eyes checked and have cataracts or another eye problem, you are at risk of vision loss. So, we’re really happy you’re being proactive and asking questions.
“Original Medicare may cover 80% of a traditional cataract surgery. Alternatively, a Medicare Advantage plan often provides comprehensive vision coverage, plus cataract surgery without out-of-pocket coinsurance costs.“
Medicare pays 80% of the cost of traditional cataract surgery, which would be covered by Medicare Part B. You must pay 20% of the procedure plus the Part B deductible and medications. However, more advanced treatments, like laser and New Technology Intraocular Lenses (NTIOLS), may require that you cover a more significant percentage or even all of the cost.
Original Medicare may not cover multifocal or toric lenses, but it will cover mono-focal lenses. You should check with your ophthalmologist and doctor to discover which type of procedure they recommend.
Suppose you’re worried about the out-of-pocket costs for your vision exam and potential cataract surgery. In that case, you should research and enroll in either a Medicare Supplement (Medigap) or Medicare Advantage plan in Florida.
A Medigap plan can help you cover the out-of-pocket expenses for the 20% cost of the cataract surgery, while Medicare covers 80%.
Suppose you’re looking for a Medicare plan that will cover the entire cost of the cataract surgery, plus coverage for the vision care appointments to discover what’s ailing your eyes. In that case, a Medicare Advantage plan might be best for you.
A Medicare Advantage plan is available at a $0 monthly premium and often comes with vision, dental, hearing, and other extra benefits that you can’t get with Original Medicare or a Medigap plan. Depending on if you have vision coverage, this might be the most cost-effective option.
I hope this information helps you discover your next steps. You’ll definitely want to see an eye doctor. And if you’d like your exam and eyeglasses covered, we can help you choose a Medicare Advantage plan with those benefits. If vision coverage isn’t essential, we can help you select a plan that accepts Medicare at your preferred cataract surgery center.
At Connie Health, we help you throughout your Medicare journey. If you have additional coverage questions, contact a local licensed Connie Health agent at (623) 223-8884 (TTY: 711) for help.
Read more by William Revuelta
I am a Spanish-speaking Florida Life and Health Insurance Licensed Agent and have been helping people with Medicare since 2009. I’m an avid sports fan and enjoy watching international soccer matches and college football. When not with my family, I listen to podcasts ranging from history to sports talk.