Cataracts are a serious medical condition that causes low vision and can lead to blindness. Read on to find out how Medicare Part A and Medicare Part B coverage works for treatment and surgery related to this debilitating vision problem.
Though anyone can develop cataracts at any age, the National Eye Institute confirms that the risk of developing them increases as you grow older. Over half of the people in the United States will experience a cataract or require cataract surgery by the time they turn 80.
Other risks factors for developing cataracts include certain medical conditions, such as diabetes, as well as substance abuse or long exposure to sunlight. Aging compounds these risks, so taking care of your health is an important step in preventing cataracts from forming.
Though most cataracts develop due to age-related issues, they may occur in other ways:
- Secondary cataract. These cataracts form after surgery that targets other eye issues, like glaucoma.
- Congenital cataract. Babies can be born with cataracts or develop cataracts later in life as children or adults.
- Radiation cataract. Exposure to certain types of radiation can cause cataracts to form.
- Traumatic cataract. Injury to the eye can cause cataracts to develop, though they may not develop for many years.
Identifying Symptoms of Cataracts
Cataracts can form in both eyes or just one. It may be difficult to detect the symptoms of a cataract when it’s in the early stages of development. Your doctor may recommend a dilated eye exam be performed every year to screen for possible signs of a cataract.
Here are the most commonly observed symptoms that you should look for:
- Double vision, blurry vision or low night vision.
- Colors don’t seem as saturated or may appear faded.
- Seeing a halo around lights, or perceiving certain lights as too bright.
- Requiring changes to your prescription eyeglasses frequently.
Procedures to Treat Cataracts
At certain stages of development, vision issues related to cataracts can be improved with prescription or specialty eyewear. Once your vision is compromised to the point of interfering with everyday tasks, like driving or reading, your doctor may recommend surgery.
Cataract surgery involves removing the natural lens of the eye and replacing it with an artificial one. Because the new lens is artificial, it cannot develop another cataract. If both eyes have cataracts that require surgery, only one eye will be treated at a time in order to preserve some vision while recovering.
This surgery is one of the most commonly performed surgeries in the US and is routinely considered safe and effective. It also has a high success rate with over 90 percent of patients reporting improved vision. Corrective eyewear may still be required after the surgery.
Medicare Coverage for Cataract Surgery
Cataract surgery that requires a hospital stay will fall under your Medicare Part A coverage rules. However, most cataract surgeries are performed as an outpatient procedure, which is covered by Medicare Part B benefits.
Although routine and regular vision care are not included in Original Medicare’s package of benefits, Medicare Part B does provide coverage for any corrective lenses you require to improve your vision after a cataract surgery is performed. As with Medicare Part A benefits, you will be responsible for any related copayments, coinsurance and deductibles. If you have purchased a Medigap, or Medicare Supplement, policy, you may have help paying for copayments, coinsurance, and deductibles related to cataract surgery.
Medicare Advantage (MA) plans may have coverage built into their benefits package that help you manage a certain amount of your share of costs related to cataract surgery. Medicare Advantage plans are required to provide at least the same Part A and Part B benefits as Original Medicare, but many offer additional coverage, including regular vision screenings and other vision-related services and care. MA plans differ depending on the insurer and location, so check with each plan’s list of benefits to understand what they offer.