Does Medicare Advantage cover Cataract Surgery?

Yes. Medicare Advantage plans must cover the same medically necessary services as Original Medicare. Cost sharing differs - usually a flat copay instead of 20% coinsurance. Medicare Advantage plans may require prior authorization even when Original Medicare does not.

What is the Medicare Part B deductible in 2026?

The 2026 Part B deductible is $257. You pay this amount once per year before Medicare starts covering its 80% share. A Medigap supplement policy (Plan G, Plan N, etc.) can cover this deductible for you.

Does Medigap (Medicare supplement) cover my coinsurance?

Yes. Most Medigap plans (Plan G, Plan F, Plan N) cover the 20% coinsurance you owe after Original Medicare pays its 80% share. Plan G is the most comprehensive supplement currently available to new Medicare enrollees.

Eye Surgery

John Caruso, FSA, MAAA • June 26, 2026 • 7 min read

Medicare Part B covers Cataract Surgery at 80% after the Part B deductible. Here's the full cost-sharing breakdown, admission status rules, and Medicare Advantage differences.

If you’re staring at a confusing bill right now, our free bill screener tells you what’s missing before you pay for anything.

Does Medicare Cover Cataract Surgery? (2026)

Q: Does Medicare cover Cataract Surgery?

Yes. Medicare Part B covers medically necessary cataract surgery. You pay 20% coinsurance after the $257 Part B deductible (2026). Original Medicare has no annual out-of-pocket cap - Medigap supplements fill this gap.

Yes. Medicare Part B covers medically necessary cataract surgery at 80% after the Part B deductible. You pay 20% coinsurance. Medicare covers a standard intraocular lens (IOL) - premium lenses are an out-of-pocket upgrade. One pair of prescription eyeglasses or contact lenses after surgery is also covered.

Quick answer:

Medically necessary cataract surgery + standard IOL: Part B - 80% after $257 deductible
Premium lens upgrade (multifocal, toric): Not covered - you pay the upgrade amount
One pair of glasses post-surgery: Covered - at 80% of the Medicare allowed amount
Prior authorization: Not required under Original Medicare

What Medicare Part B Covers

Medicare covers the medically necessary components:

Insurance covers cataract surgery - but the premium lens it won't cover can add $1,500–$3,000 per eye.

Your personalized cost report includes:

✓ Why the standard lens is covered but a toric/multifocal upgrade is billed directly to you
✓ The four separate bills (facility, surgeon, anesthesia, lens) and which to scrutinize
✓ Why an ambulatory surgery center usually costs less than a hospital for the identical operation
✓ How anesthesia ends up out-of-network even at an in-network surgery center
✓ A real patient billing breakdown, line by line

Free for patients - takes 30 seconds to get.

We'll send a sign-in link to your email - click it to get your guide. No account required, no spam.

Cataract extraction (CPT 66984 or 66982)
A standard monofocal intraocular lens (IOL)
Anesthesia (billed separately)
Facility fee (hospital outpatient or ambulatory surgery center)
One pair of eyeglasses or contact lenses after cataract surgery (Medicare's only routine vision benefit)

What You Pay Out-of-Pocket

Component	Medicare pays	You pay
Facility fee (ASC or hospital)	80% of allowed amount	20% after Part B deductible
Surgeon fee	80% of allowed amount	20% after Part B deductible
Anesthesia fee	80% of allowed amount	20% after Part B deductible
Standard IOL	Bundled into facility payment	$0
Premium IOL upgrade	$0	Full upgrade cost ($1,000–$4,000/eye)
One pair of glasses (post-surgery)	80% of allowed amount	20%

Medicare Advantage Cataract Surgery

Medicare Advantage plans must cover the same medically necessary cataract surgery. Cost sharing differs:

Most MA plans charge a copay per outpatient surgical visit rather than 20% coinsurance
Some MA plans offer enhanced vision benefits that may partially offset premium lens costs
Check your plan's Summary of Benefits for the specific cataract surgery benefit

Related Cost Information

Interested in understanding healthcare costs and managing your medical expenses?

Deductible vs Out-of-Pocket MaximumLearn how insurance cost-sharing works and what you actually pay
Cost ExplorerBrowse procedures and compare prices across the country
CT Scan Cost GuideFind detailed CT scan pricing for your state
MRI Cost GuideCompare MRI pricing and understand imaging costs
X-Ray Cost GuideCompare X-ray pricing across states - one of the most affordable imaging procedures
Colonoscopy Cost GuideUnderstand colonoscopy pricing and your out-of-pocket costs by insurance type
New GuidesExplore our latest healthcare guides on costs, insurance, and medical billing

About the Author

John Caruso, FSA, MAAA

Healthcare actuary with 20+ years of experience in insurance pricing, medical billing systems, and healthcare cost analytics.

Connect on LinkedIn →

Ready to take control of your healthcare costs?

Use the free cost estimator → · Get your bill screened for free → · See the family plan →