Does Anthem Cover Cataract Surgery?
- Cataract surgery can significantly improve your vision. Find out if Anthem covers cataract surgery and other cataract care services, including deductible costs.
Cataracts are cloudy patches on the tiny lenses in your eyes that can cause blurred vision and blindness. Fortunately, cataract surgery is a relatively safe and straightforward procedure that can correct the visual problems associated with the condition.
Treating cataracts can significantly improve your quality of life, but many people worry about how to cover the costs. Medicare beneficiaries may be happy to know that Anthem Medicare Advantage (Medicare Part C) plans cover medically necessary cataract surgery.
Does Anthem Pay for Cataract Surgery?
All Medicare Advantage plans must cover any services included in Original Medicare (Medicare Parts A and B), including cataract treatment. Therefore, Anthem Medicare Advantage plans also cover cataract surgery.
Medicare also covers several other cataract care services, such as:
- Cataract diagnosis
- Lens implants
- Corrective lenses and glasses
Generally, you can expect your Anthem plan to cover an intraocular lens implant or cataract correction performed using established surgical or laser techniques. However, it may not cover more advanced lens implants and experimental treatments.
Original Medicare doesn't cover prescription drugs, so beneficiaries must pay out-of-pocket for any medications required after surgery. However, many Anthem Medicare Advantage plans can include prescription drug coverage (Medicare Part D) and cover over-the-counter medications.
Does Anthem Cover Vision Care?
An Anthem Medicare Advantage plan may cover additional services beyond the scope of Original Medicare if the plan includes vision coverage.
Medicare Advantage vision coverage may include services, such as routine vision exams, contact lenses and glasses. It may also cover other vision treatments excluded from Medicare Parts A and B, such as LASIK.
Benefits can vary from one plan to the next, however, so be sure to consult with your plan documents or check with your plan carrier.
How Much Is Cataract Surgery?
How much cataract surgery costs depends on several factors, including how much the individual surgeon charges and the treatment method used. Prices can also vary by area. Overall, you can expect to pay between $3,500 and $7,000 per eye for cataract surgery if you don't have healthcare insurance.
Depending on your Anthem plan, it may be more affordable to receive cataract treatment from an in-network healthcare provider. It's essential to make sure your provider accepts Anthem policyholders before scheduling your surgery.
Is There a Deductible for Cataract Surgery?
Most people will have cataract surgery as an outpatient procedure, which is covered by Medicare Part B. You'll need to pay the Part B deductible if you qualify for coverage and have Original Medicare. Members of an Anthem Medicare Advantage plan may have different coinsurance or deductible costs than Medicare Part B.
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