Does Humana Cover Cataract Surgery?
- Humana Medicare plans cover cataract surgery, and most Humana Medicare Advantage (Medicare Part C) plans cover additional vision benefits that Original Medicare (Parts A and B) don’t cover. Learn more and compare Humana Medicare plans available where you live that cover cataract surgery.
Yes, certain Humana plans cover cataract surgery.
The average cost of cataract surgery is between $3,500 and $7,000 per eye. But with a Humana Medicare Advantage plan, your actual costs will typically be far less.
That’s because all Humana Medicare Advantage (Medicare Part C) plans cover cataract surgery. Medicare Advantage plans are required to cover everything that Original Medicare (Part A and Part B) covers, which includes medically necessary cataract surgery. Because all Medicare Advantage plans must cover the surgery, that means Humana Medicare Advantage plans also cover it.
Many Humana Medicare Advantage plans also offer additional vision benefits that aren’t covered by Original Medicare. Learn more and find out how to compare Humana Medicare plans near you that cover cataract surgery and other vision benefits.
When Does Humana Pay for Cataract Surgery?
All Medicare Advantage plans are required by law to provide at least the same minimum coverage as Original Medicare, which is made up of Medicare Part A and Part B. And because Original Medicare covers cataract surgery, your Humana Medicare Advantage plan will too.
For cataract surgery, Original Medicare covers:
- Removal of the cataract
- A basic lens implant
- One set of prescription eyeglasses or contact lenses following the surgery
Your costs with Original Medicare will include the annual Medicare Part B deductible ($266 in 2023) along with a 20% coinsurance payment for the remaining balance of the Medicare-approved amount.
However, while Medicare Advantage plans must cover cataract surgery, they are allowed to implement their own deductible and cost-sharing requirements. Your exact costs will depend on the Humana Medicare Advantage plan in which you are enrolled.
You will also likely be required to have your cataract surgery performed at a health care facility that is part of your plan’s network, and you may also need to receive your post-operation eyewear from an eye doctor or other vision provider that’s part of the Humana network.
If you are currently enrolled in a Humana Medicare Advantage plan, call the phone number on your plan ID card to ask about the details of your cataract surgery coverage or check your summary of benefits online in your MyHumana account.
If you are not enrolled in a Humana Medicare Advantage plan, contact a licensed insurance agent to find out which Humana Medicare Advantage plans are available in your area and ask the agent about the cataract surgery benefits offered by each one.
Additional Humana Vision Coverage
It’s important to remember that cataract surgery will generally be covered by the medical insurance portion of your Humana plan and not the vision coverage portion of your plan.
Vision coverage is typically included in Humana Medicare Advantage plans at no extra cost.
Humana vision benefits can include:
- Annual routine vision exams
- Diabetic eye exams
- Glaucoma screenings
- Eyeglasses (lenses and frames) or contact lenses and fittings
- Discounts on LASIK eye surgery
Enrolling in Humana Medicare Plans That Cover Cataract Surgery
There are only certain times throughout the year in which you may be able to enroll in a Medicare Advantage plan, depending on your circumstances. If you anticipate the need for cataract surgery soon, get in touch with a licensed insurance agent who can review your Medicare Advantage eligibility, help you compare plans available in your area and walk you through the enrollment process if you’re eligible.