Is Eye Care and Cataract Surgery Covered By A Medigap Plan?

Medigap insurance is sold by private companies to help pay for things like copayments and deductibles that Medicare doesn’t cover. This policies are only available to individuals over the age of 65 who already have Original Medicare Parts A and B. Those with Medicare Advantage, Part C or are younger than 65 and on Medicare due to disability cannot enroll or buy a Medigap policy.

There are eleven standard Medigap policies in the United States each lettered A through G, and K. Insurance carriers can only sell one of the plans, and if you are married and your partner is covered by Medicare, they will need to buy a separate policy to get a Medigap cover. Standard Medigap policies generally cover some or all of the costs of:

  • Your Part A deductible and coinsurance for hospital stays
  • A portion of your Part B doctor’s bills services
  • The first 3 pints of blood annually
  • As we as your hospice care coinsurance

Medigap policies do not cover

  • Long-term care
  • Private duty nursing
  • Prescription drugs or any out-of-pocket costs for Part D
  • It also doesn’t cover dental care, hearing aids, eyeglasses and vision care

Cataract is the clouding of the clear lens of the eye, which makes seeing seem like looking through a fogged-up window. Most cataracts are as a result of aging, injury or an inherited disorder and surgery is important especially when the slow progression of the disease begins to affect an individual’s quality of life. If your doctor determines that cataract surgery is medically necessary and you have Medicare coverage, you may be responsible for certain deductibles, copayments, or coinsurance costs otherwise, Medigap supplement insurance covers the procedure to remove the cataract.

Medigap plans fill in the gaps of Original Medicare and once you pay for your deductible, you will receive coverage from Medigap but will be required to pay any copayments. You can get a rough idea of your estimated cost by first ascertaining that your doctor accepts Medicare assignment. You also need to find out whether you will be inpatient or outpatient for the surgery, and whether you will need prescription drugs afterward. This way you can check the cost of the drugs or determine if you will need to get Medicare Part D. Also check your out-of-pocket limit in case you need to pay for anything past that amount.

Learn more about Medigap plans and rates at  Medigap Insurance brokers will help you compare Medigap Insurance rates and plans.  To talk to an expert in Medigap coverage call toll free 888-452-7949!


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