Which lenses for cataract surgery are covered under Medicare?
Since a cataract is a cloudy natural lens, every cataract operation involves replacing it with a new, artificial lens implant: an IOL (Intraocular Lens Implant).
The cost of the "entry level" IOL is included in the packaged fee that Medicare pays to the ambulatory surgical center (ASC) or hospital. These are what are called "single-vision" IOLs, the only kind of IOL available 25+ years ago. IOL technology has continued to improve, though, so we are now have IOLs that can also correct astigmatism, nearsightedness, and even presbyopia. But the new technology, despite being much more expensive and requiring more time-consuming work, are not covered by Medicare (or most all 3rd party insurance).
The Medicare program recognizes this and makes an allowance for patients to pay more money out-of-pocket than would be the case with the older, simpler technology. Many people refer to the newer technology IOLs as "premium IOLs."
Written by J. Trevor Woodhams, M.D. - Chief of Surgery, Woodhams Eye Clinic
