Community Chat

[Mindy D]

Do you know which supplemental insurance she has? 

[Mindy D]

This is what the Medicare site says about this. I'm still confused.

"Cataract surgery

Who's eligible?

Medicare covers many medically necessary surgical procedures, like cataract surgery.

Your costs in Original Medicare

For surgeries or procedures, it's difficult to know the exact costs in advance because no one knows exactly what services you'll need. If you're having surgery or a procedure, you can do some things in advance to figure out approximately how much you'll have to pay.

Ask the doctor, hospital, or facility how much you'll have to pay for the surgery and any care afterward.
Make sure you know if you're an inpatient or outpatient because what you pay may be different.
Check with any other insurance you may have (like a Medicare Supplement Insurance (Medigap) policy, Medicaid, or coverage from your or your spouse's employer) to see what it will pay. If you belong to a Medicare health plan, contact your plan for more information.
Login to MyMedicare.gov, or look at your last "Medicare Summary Notice" (MSN) to see if you've met your deductibles.
Check your Part A deductible if you expect to be admitted to the hospital.
Check your Part B deductible for a doctor's visit and other outpatient care.
You'll need to pay the deductible amounts before Medicare will start to pay. After Medicare starts to pay, you may have copayments for the care you get.
Note
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.
Related resources"

from medicare.gov

[Teddixat]

@Allegheny

I am now on Medicare and when the time comes and my left eye need cataract removal I expect my costs to be paid in full by Medicare and my supplemental insurance.  (Note: Due to past eye procedures, I can only wear the standardized lenses paid for by Medicare)

I recently had cataract surgery on both eyes - 2 months apart and seeing again is wonderful.  I am on Medicare with United Healthcare and I had to pay $330 each time for the surgery center.  There will be some co-pay depending on your coverage

[kdgn]

My mother had a Senior Advantage plan when she had the cataract surgery on both eyes. The only out of pocket expenses were for the eye drops and the doctor's visit-at her normal co-pay rate. This was 13 and 11 years ago. eta: Her surgeries were at two different out patient centers that her surgeon used. Again, there were no charges to her: I wrote the checks. But again, it would depend on the Advantage plan. 

A friend had both eyes done more recently, with the last 3 years. She also has a Senior Advantage plan with a rather large HMO. She paid nothing more than her normal co-pays. All tests were done prior to the surgery with no out of pocket expenses. However, she did mention that if she had wanted special lenses she would have had some hefty out of pocket expenses-in the thousands. She did not require them nor did she want them. 

Medicare covers the basic cataract surgery. Whatever co-pays your doctors order would be covered as required either under Medicare or with your Advantage plan. If your Advantage plan requires co-pays for those tests or doesn't cover them, that's the plan's limitations. 

[SharkE]

I got a friend who is just on Medicare Part B can't afford Supplement her part was 400.

All I know.

[Mindy D]

I did find an explanation of all the possible costs; covered and uncovered, online. Thank you for your help. 

[Allegheny]

@Teddixat

Thanks for the information.  Just started Medicare this month, so I am making that transition between what/how regular insurance pays to Medicare and my supplemental will pick up.

My SIL had her cataract surgery (both eyes) shortly after my procedure.  At the time she was on Medicare and had same supplement I have now.  I can't recall what her final out of pocket was, but then she did select a more expensive lense.  

I know her doctor's office had a dedicated staff member who sat with her and went thru everything regarding what her benefits were and what the costs were going to be.

[Mindy D]

I found a full breakdown of all the charges that can be incurred without complications. The fee my husband will have to pay makes sense if you add up both eyes, special lenses and surgical copay fees. The lens costs were broken down by average charge for them and this made things much more understandable. 

[Coquille]

There's an old saying, " You get what you pay for". When I went on Medicare I purchased a supplemental plan F and it costs a pretty penny but it's worth it's weight in gold. In addition, it puts my mind at ease to know I'm completely covered. You never know what's around the corner. If one can afford it, do it! Stay well.

[hckynut]

@Mindy D

Even though my wife worked for insurance companies most of her adult life, from one company to another, they were all different for different reasons.

I had cataract surgery on both eyes. My Right eye, with a Mono-focal iol, was covered 100% by Medicare. My left eye, which I chose a Multi-focal iol, I paid $1700. It allowed me to get rid of my tri-focals, and no longer need glasses for any reason.

As for insurance coverage?  I have Medicare with my secondary being United Health Care.  

hckynut(john)