Cataracts: 20.5 Million Americans and What Medicare Covers

Cataracts are the most common age-related eye condition in the United States, affecting an estimated 20.5 million Americans aged 40 and older, or about 17.2 percent of that population, according to CDC data. By age 80, more than half of all Americans either have cataracts or have had cataract surgery. It is one of the most treatable causes of vision loss, and cataract surgery is one of the most common surgical procedures performed on Medicare beneficiaries.

Despite how common cataracts are, many people do not fully understand what they are, how they progress, what surgery involves, or what Medicare will and will not pay for. This article breaks down the numbers, explains the condition, and walks through the coverage details so you can make informed decisions about your eye care.

What Are Cataracts?

A cataract is a clouding of the natural lens inside the eye. The lens sits behind the iris (the colored part of the eye) and the pupil and works like the lens of a camera, focusing light onto the retina at the back of the eye. When the lens becomes cloudy, light cannot pass through as easily, and vision becomes blurred, hazy, or less colorful.

Cataracts develop gradually over months or years. In the early stages, you may not notice any change in your vision. As the cataract grows, symptoms become more noticeable. Most cataracts are age-related, caused by the natural breakdown of proteins in the lens over time. However, other factors can accelerate their development.

Common symptoms of cataracts include:

• Blurry or cloudy vision that worsens gradually
• Colors appearing faded or yellowish
• Difficulty seeing at night or in low light
• Sensitivity to light and glare, especially from headlights
• Seeing halos around lights
• Needing brighter light for reading and other close-up tasks
• Frequent changes in eyeglass or contact lens prescriptions

Cataracts by the Numbers

The prevalence of cataracts in America is significant, and the numbers continue to grow as the population ages:

• 20.5 million Americans aged 40 and older have cataracts, representing about 17.2 percent of this age group (CDC VEHSS).
• By age 75, approximately half of all Americans have cataracts or have had cataract surgery.
• Cataract surgery is one of the most frequently performed surgeries among Medicare beneficiaries, with millions of procedures performed each year.
• Without insurance, cataract surgery costs between $3,500 and $7,000 per eye for standard lenses.
• Success rate: Cataract surgery has a success rate of over 95 percent, making it one of the safest and most effective surgical procedures available.

How Cataract Surgery Works

Cataract surgery is an outpatient procedure that typically takes less than an hour. The surgeon makes a small incision in the eye, breaks up the cloudy lens using ultrasound (a process called phacoemulsification), removes the lens fragments, and replaces the natural lens with a clear artificial lens called an intraocular lens (IOL). Most patients go home the same day.

Recovery is generally quick. Most people notice improved vision within a few days, though full healing may take four to six weeks. During recovery, you will use prescription eye drops to prevent infection and reduce inflammation. Your doctor will schedule follow-up visits to monitor healing.

If you have cataracts in both eyes, the surgeon will typically operate on one eye at a time, with the second surgery scheduled a few weeks after the first eye has healed. This approach reduces risk and allows your vision to adjust between procedures.

What Medicare Covers for Cataracts

Medicare provides important coverage for cataract surgery, making it accessible to the vast majority of seniors. Here is a detailed breakdown of what Medicare covers and what it does not:

Covered by Medicare Part B:

• Cataract surgery with standard monofocal IOL implant (80 percent of Medicare-approved amount after Part B deductible)
• Pre-surgical and post-surgical care, including eye exams related to the cataract
• One pair of corrective eyeglasses (standard frames and lenses) or one pair of contact lenses after surgery with an IOL implant, from a Medicare-enrolled supplier

Not covered by Original Medicare:

• Routine eye exams to check for cataracts or monitor their progression (unless your doctor orders a diagnostic exam)
• The additional cost of premium IOLs (multifocal, toric, or accommodating lenses) beyond the standard IOL amount
• Additional pairs of eyeglasses or contact lenses beyond the one pair covered after surgery
• Upgraded frames or progressive lenses (you pay the difference between standard and upgraded)

Your Out-of-Pocket Costs

Understanding your potential out-of-pocket costs helps you plan financially for cataract surgery. Your costs depend on whether you have Original Medicare alone, a Medigap policy, or a Medicare Advantage plan.

With Original Medicare alone, you pay the annual Part B deductible (which was $257 in 2025) plus 20 percent of the Medicare-approved amount for the surgery. If the total Medicare-approved amount for the surgery and related services is, for example, $3,000, your 20 percent coinsurance would be $600 per eye, on top of any remaining deductible.

With a Medigap (Medicare Supplement) plan, much or all of the 20 percent coinsurance and the Part B deductible may be covered, depending on your plan type. This can reduce your out-of-pocket cost for cataract surgery to very little or even zero for the standard procedure.

With a Medicare Advantage plan, your costs depend on your specific plan's copayments and coinsurance for outpatient surgery. Many Medicare Advantage plans charge a flat copay for outpatient surgery, which may range from $100 to $500 depending on the plan. Check your plan's summary of benefits for specific details.

Medicare Advantage Vision Benefits for Cataract Patients

Medicare Advantage plans often offer vision benefits that go beyond what Original Medicare provides. These additional benefits can be especially valuable for people with cataracts or those who have had cataract surgery.

Many Medicare Advantage plans cover annual routine eye exams, which can help detect cataracts earlier and monitor their progression. Some plans also offer annual allowances for eyeglasses or contacts, typically ranging from $100 to $300. This can help cover additional pairs of glasses beyond the one pair Medicare covers after cataract surgery.

If you are comparing Medicare coverage options, consider how well each plan covers vision care. Cataracts are just one of several age-related eye conditions that affect millions of Americans. Having comprehensive vision coverage can help you stay on top of your eye health as you age.

Prevention and Early Detection

While cataracts cannot be entirely prevented, there are steps you can take to reduce your risk and slow their progression:

• Protect your eyes from UV light: Wear sunglasses that block 100 percent of UVA and UVB rays whenever you are outdoors.
• Quit smoking: Smoking significantly increases the risk of cataracts. Quitting at any age provides benefits.
• Manage diabetes: High blood sugar accelerates cataract development. Keeping your diabetes well controlled helps protect your eyes.
• Eat a nutrient-rich diet: Fruits and vegetables high in antioxidants, particularly vitamins C and E, may help slow cataract progression.
• Get regular eye exams: Comprehensive dilated eye exams can detect cataracts early, allowing you and your doctor to monitor their progress and plan for surgery when it becomes necessary.

Cataracts are a common and very treatable condition. With Medicare covering the core costs of surgery, most seniors can access this vision-restoring procedure without facing overwhelming expenses. The key is not to delay: if you are experiencing symptoms of cataracts, talk to your eye doctor about your options. Early evaluation gives you more time to plan, both medically and financially, for the best possible outcome.