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    Home » What You Need to Know About Medicare Coverage For Eye Surgery
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    What You Need to Know About Medicare Coverage For Eye Surgery

    samantha.higgins.writes@gmail.comBy [email protected]July 5, 2022No Comments4 Mins Read
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    Medicare coverage is a complex system that requires careful planning. Even if you’re not yet ready for Medicare, it’s important to get educated on how the rules work to plan your finances in 2022. It’s good to walk through some common questions about Medicare coverage to how they relate to 2022 and beyond.

    Contents hide
    1 What Are Cataracts?
    2 Medicare Coverage for Cataract Surgery
    3 Medicare Coverage for Cataract Surgery In 2022
    4 Choosing a Lens Type
    5 Part A and B Deductibles and Coinsurance
    6 Medicare Advantage Plans
    7 Conclusion

    What Are Cataracts?

    Cataracts are one of the most common causes of vision impairment and blindness. They’re caused by a clouding or opacity of the lens inside your eyes, which blocks light from entering and reaching your retina.

    When a cataract develops, we call it a nuclear cataract because it’s visible as a dark spot on the lens (or “nucleus”). This is where they get their name—they look like little black spots on each other. Because these spots block out enough light from passing through them to reach your retina, you’ll start having impaired vision or even complete loss of peripheral vision if left untreated for too long.

    Medicare Coverage for Cataract Surgery

    You may be asking “what does medicare cover for cataract surgery?” Medicare coverage for cataract surgery will remain the same in 2022 as it is now, with a few exceptions. Medicare Part B covers cataract surgery as part of a comprehensive eye exam and treatment plan, but only if you have a medical necessity that glasses or contact lenses cannot correct. 

    If you are eligible for Medicare Part A and Part B, your deductible will apply to your cataract surgery costs before Medicare begins to cover them.

    If you have only Medicare Advantage (MA), MA plans may require you to pay for some or all of your out-of-pocket expenses before they begin paying for any covered services through their plan networks.

    Medicare Coverage for Cataract Surgery In 2022

    Part B covers the cost of cataract surgery but doesn’t cover the cost of glasses. Cataract surgery is an outpatient procedure usually in an eye surgeon’s office and can be performed using local anesthesia or intravenous sedation. 

    It involves removing the cloudy lens from its capsule and replacing it with an artificial intraocular lens (IOL). Medicare Part B provides coverage for one IOL per eye per lifetime, including replacement lenses if needed after removal due to infection or dislocation or other complications not related to wear and tear over time.

    Choosing a Lens Type

    If you have a cataract, your doctor will assess the severity of your cataracts and determine whether you are a candidate for surgery. If you still have good vision, you may choose between mono-focal and multifocal lenses. However, if other health issues preclude this option for you, then bifocal or toric lenses may be more appropriate.

    Part A and B Deductibles and Coinsurance

    Medicare Part A and Part B have deductibles and coinsurance. A deductible is the amount of money you’ll pay for Medicare-covered services before your plan begins to pay its share. Coinsurance is another way that many health plans require patients to share costs with their insurance companies. 

    For example, if your surgery costs $15,000, but your plan has a 20% coinsurance requirement on all outpatient surgeries (called “outpatient hospital care”), you will owe 20% of the total cost ($3,000) before your plan starts paying its portion of the bill.

    Medicare Advantage Plans

    Medicare Advantage plans (also known as Medicare HMOs) are insurance policies offered by private companies that contract with Medicare. You can choose one of these plans if you need extra help paying for health care costs and want to work with a specific provider network.

    Medicare Advantage plans provide you with all the health benefits of traditional Medicare, including coverage for hospital stays, doctor visits, and prescription drugs. In addition to these services, these private insurance policies also offer additional benefits such as dental or vision care. These supplemental benefits can be included in your monthly premium or paid out of pocket; this depends on the plan you choose when applying for coverage through Medicare’s website.

    Conclusion

    Medicare is an important part of the healthcare system, and it’s good to understand how it works. As you can see, Medicare covers many expenses and has many different plans for you. You should be able to find the right plan for your needs in 2022, so make sure to take advantage of all the great benefits that come along with having this coverage!

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