Does United Healthcare Cover Cataract Surgery?
- Some UnitedHealthcare Medicare Advantage plans may be able to help cover cataract surgery for qualified plan members. Learn more about cataract surgery and Medicare coverage.
UnitedHealthcare covered more Medicare Advantage (Medicare Part C) beneficiaries than any other top insurance company in 2024.1
Medicare Advantage plans are required to cover everything Original Medicare (Part A and Part B) covers. Many plans may also offer additional benefits, such as routine vision care and eyeglasses and contacts. Because Original Medicare covers cataract surgery, all Medicare Advantage plans – including UnitedHealthcare plans – are required to the surgery.
In this article, we outline how UnitedHealthcare Medicare Advantage plans cover cataract surgery and how much you may be required to pay for your surgery.
Do UnitedHealthcare Medicare Advantage Plans Cover Cataract Surgery?
Original Medicare doesn't cover routine vision care, but it does include treatment for cataracts. Therefore, you can expect your UnitedHealthcare Medicare Advantage Plan to cover cataract surgery. Your plan will likely cover other cataract care services as well, such as corrective glasses and lenses.
Some UnitedHealthcare plans also include additional vision care benefits. Many policies come with Part D prescription drug coverage, but you can purchase Part D coverage separately if your plan doesn't include it. While Original Medicare doesn't cover prescription medications, your UnitedHealthcare plan may help pay for covered drugs you need after surgery.
How Much Is Cataract Surgery?
Cataract surgery prices can vary significantly depending on where you live and who performs the surgery. The technique your surgeon uses can also impact the overall cost of your treatment.
If you have a UnitedHealthcare Medicare Advantage plan, your coinsurance, deductibles and other costs may vary depending on your plan. Be sure to talk with your doctor and your Medicare Advantage insurance carrier to find out your costs before getting surgery.
How Much Does Cataract Surgery Cost With a UnitedHealthcare Medicare Advantage Plan?
How much you'll pay for cataract surgery depends on which UnitedHealthcare Medicare Advantage plan you have.
Generally, Medicare Part B covers cataract surgery because it's usually performed in an outpatient clinic, and most people won't require a hospital stay afterward. Medicare pays 80% of the treatment costs, and the beneficiary contributes 20% after first paying the annual Part B deductible.
Some UnitedHealthcare Medicare Advantage plans require you to use an in-network provider, and it's often cheaper to have surgery through an in-network provider, even if your plan covers out-of-network treatment.
How Much Is Cataract Surgery With a UnitedHealthcare Medigap Plan?
Purchasing a Medicare Supplement Insurance (Medigap) plan through UnitedHealthcare is an alternative to a Medicare Advantage policy. Medicare Supplement plans work alongside your Original Medicare coverage to pay for out-of-pocket Medicare costs such as deductibles, copays and coinsurance.
It's important to note that Medicare Advantage plans and Medicare Supplement plans are very different, and you can't have both types of plans at the same time.
UnitedHealthcare Medigap plans supplement your Original Medicare coverage. Therefore, your regular Medicare plan covers 80% of the cost of your surgery, minus the deductible.
Depending on your plan, an AARP/UnitedHealthcare Medigap policy could save you money on the cost of your cataract surgery. Plan G, for example, can help pay your Part B coinsurance costs, your Part A deductible and coinsurance (if you receive inpatient care) and other costs.
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Freed M, et al. (Aug. 8, 2024). Medicare Advantage in 2024: Enrollment Update and Key Trends. https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2024-enrollment-update-and-key-trends.