Does Cigna Cover Cataract Surgery?

Cataracts are a symptom of aging, and around 1 in 5 adults over the age of 65 has at least one cataract. Cataracts are not only common, but they are also expensive to treat. Cataract surgery can cost between $3,500 and $7,000 per eye. 

Fortunately for members of Cigna Medicare Advantage plans, cataract surgery is typically covered. Cataract surgery is usually categorized as a “medically necessary” procedure and therefore is covered by most health insurance plans, including those offered by Cigna.

In fact, if a cataract surgery would be covered by Original Medicare (Medicare Part A and Part B), it would be required to be covered by a Medicare Advantage (Medicare Part C) plan, such as the Medicare plans offered by Cigna.

When Do Cigna Medicare Plans Pay for Cataract Surgery?

If you have a Cigna Medicare Advantage plan, your plan will provide at least the same coverage as that of Medicare Part B. Those benefits include coverage of cataract surgery using traditional techniques along with a basic lens implant. If a more advanced technique or lens is used, your benefits may or may not apply. 

Medicare Part B – and all Medicare Advantage plans including Cigna Medicare plans – cover at least the following for cataract surgery:

• Removal of the cataract
• A basic lens implant
• One set of eyeglasses or contact lenses following the procedure

Depending on the Medicare plan you have, you will likely be subject to an annual deductible along with copayments or coinsurance for the remainder of the balance of the procedure beyond your deductible amount. 

It’s worth noting that cataract surgery is covered by health insurance, but typically not by standalone vision insurance plans. Vision insurance typically covers routine eye exams, eyeglasses and contact lenses.

If a prescription drug is needed either before or after your cataract surgery, it may be covered by a Cigna Medicare Advantage plan that includes prescription drug benefits or by a Cigna Medicare Part D prescription drug plan. 

Check your Cigna coverage of cataract surgery by logging into your online Cigna account or calling the phone number on your Plan ID card.

How is Cataract Surgery Performed?

Cataract surgery is generally performed by using a local anesthetic to numb the eye before a small incision is made. An ultrasound tool is used to break up the cataract before it is then removed with suction. An artificial lens is then put in its place. 

You may have a temporary bandage or shield over your eye following the procedure and most people experience improved vision within just a few days. 

How Can You Enroll in a Cigna Plan that Covers Cataract Surgery?

Cigna health insurance and Medicare Advantage plans have specific eligibility rules and enrollment periods, so it’s recommended to check your eligibility and find out when you may sign up for coverage. 

Connecting with a licensed insurance agent will allow you to review your coverage options available from Cigna and other providers in your area to help you narrow down the best choice for your needs.