Do you suffer from cataracts?

There are many Medicare Health Plan options to ensure you can pass through underwriting and provide coverage assistance for certain treatments, medications, etc.

What is a cataract? A cataract a clouding of the eye’s natural lens, which lies behind the iris and the pupil. Once cataracts form, the lens becomes increasingly opaque (or cloudy) as cataracts restrict with light getting through to your retina. You can have cataracts in one eye, or the disease can affect both of them. According to the American Academy of Ophthalmology, cataracts affect more than 24.4 million Americans age 40 and older, and by age 75, approximately half of all Americans have cataracts.

When you have cataracts, your awareness of your surroundings (i.e. colors, headlights from a vehicle, and sunlight) may change. Double vision can also occur in people with cataracts if cataracts cause a difference in the degree of opacity in one part of the lens over another. While none of these symptoms inevitably mean that you have cataracts, they are the symptoms commonly associated with cataracts.

There are a few different classifications of cataracts

  • Multiple cataracts which affect multiple parts of the eye.
  • Nuclear cataracts which occur in the central part of the eye.
  • Cortical cataracts affect the cortex, which is the surrounding part of the center of the eye.
  • Posterior subscapular cataracts occur in the back of the lens.

While there are no known way to naturally cure cataracts, doctors more times than none suggest surgery correct the issue. The surgery is a simple process and has become very common to Americans who suffer from cataracts. The surgery has proven to be extremely successful and prevents cataracts from returning once removed, while also having a quick recovery time.

Cataract surgery removes the lens and replaces them with an artificial lens, which cannot develop a new cataract. While most of the time, the vision can be back to 100%, there are some instances where your doctor will prescribe reading glasses.

Surgery to remove cataracts is covered by Original Medicare, but there are some specifics. Original Medicare only pays expenses that are directly related to cataracts. For example, if you had a non-Medicare-covered condition before developing cataracts, you may be able to treat that condition during the same surgery, taking care of both of the issues, but Original Medicare only covers the costs associated with cataracts and not the other. Original Medicare will ask the surgeon to bill you separately for the parts not related to cataracts.

Original Medicare Part B covers the surgery since the surgery is performed by an ophthalmologist and not an optometrist. Original Medicare will cover the fees from the ophthalmologist and the facility, but only the amounts that are approved by Original Medicare. You will be required to pay a 20% Original Medicare Part B coinsurance for the surgery, along with your Medicare deductible. When going in for surgery for cataracts, Medicare covers a pre-surgery exam to discuss the surgery, anesthesia and the follow-up care. You will also be required to pay your Medicare deductible for this as well.

While Medicare does not normally cover other vision services, cataracts are a special case. Original Medicare covers glasses, contacts and intraocular lenses that follow surgery to treat cataracts. Standard frames are covered under Medicare Part B, but for more expensive frames, you will have to pay the difference over the amount that is approved by Original Medicare. You can always ask your health care provider which frames will be covered. Always be sure to double check that your supplier is enrolled in Medicare and has a Medicare supplier number. If they are not enrolled and do not have a supplier number, Original Medicare will not pay the claim, leaving all the costs up to you.

If you have questions and need a review of your current plan, need to be enrolled in a plan that better fits your medical and financial needs to help with the treatment of cataracts, give us a call at 866-466-9118. By contacting that number, you will be connected with a licensed insurance agent.

Sources:

https://www.ehealthmedicare.com/about-medicare/cataracts/

https://www.medicare.gov/coverage/cataract-surgery.html