Does VSP Cover Cataract Surgery?

Last Updated: March 14, 2023

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VSP does not cover cataract surgery.

VSP is a vision insurance company that provides a range of services such as: regular eye exams, prescription glasses, and contact lenses. The company, however, does not cover cataract surgery.

What Is VSP?
What VSP Covers for Your Vision Health
Before & After Cataract Surgery
Using Your Insurance to Cover Cataract Surgery

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Cataracts are considered a public health issue therfore, Medicare and other health insurance programs are used to provide coverage for this operation. VSP covers services surrounding your cataracts, such as thorough eye exams and postsurgical checkups are covered.

What Is VSP? How Does It Cover Cataract Surgery?

VSP is a vision insurance company that was founded in 1955 with the sole focus of bringing affordable, high-quality vision care to more people in the United States. With about 88 million members all over the world, VSP is one of the top vision insurance companies that people turn to for a range of eye issues.

Cataracts are one of the most common age-related eye conditions in the world, with few options to slow or stop the progression. Getting regular eye exams allows your eye doctor to monitor the development of cataracts, before they begin to seriously impact your vision.

Again, VSP does not cover cataract surgery. Your medical insurance would generally be used.

If you need help understanding how VSP can help you manage cataracts and cataract surgery, you can contact a VSP representative or ask your optometrist for further details.

What VSP Covers for Your Vision Health

VSP’s vision plans cover regular, thorough eye exams, so symptoms of several diseases can be detected. This includes cataracts, glaucoma, and other illnesses like diabetes and high blood pressure all of which can lead to blindness or other serious visual impacts, without the proper treatment.

People often find it confusing that VSP does not cover cataract surgery itself because cataracts are specifically an eye issue and not a larger systemic problem, like diabetes. But cataract surgery is considered a serious enough medical issue that standard health insurance, including Medicare, will often cover this procedure instead. Your vision insurance like VSP will cover the needed steps before and after surgery.

For example, an eye exam is typically the first way cataracts are noticed. Your optometrist or ophthalmologist will help you decide when it is time to undergo surgery, which will include discussing:

Whether you can safely drive or if you have blind spots.
If your work or home life is affected by vision problems.
If you have double vision.
If you experience glares from bright lights that hurt.
If there is a big difference between vision in one eye compared to the other.
If you have a second vision-threatening eye issue like glaucoma or diabetes.

Cataracts are a cloudy or dark part of the lens of your eye, which can grow in size over several years until your vision is obscured. During cataract surgery, the cloudy lens is removed and replaced with an artificial device called an intraocular lens implant (IOL). Rarely, an IOL cannot be safely implanted, so you must wear glasses or contact lenses to compensate for having no natural lens to refract light to your retina.

Typically, cataract surgery requires topical anesthetic in the form of eye drops; you do not have to go under general anesthesia. You may also receive a mild sedative to help you stay calm during the procedure.

Immediately after your cataract surgery, your surgeon will talk to you about aftercare, symptoms to watch out for, and when you will get checkups to ensure your eyes are healing properly. You will also be given an eye patch to wear overnight to protect your eye and any medications you need to take, such as antibiotics. Medications will generally be covered by your standard health insurance plan.

Before & After Cataract Surgery, You Need Good Vision Insurance

VSP covers care with your eye doctor after you undergo cataract surgery, including:

A thorough vision exam with an optometrist or ophthalmologist, as recommended.
Any necessary materials covered in accordance with Medicare guidelines.

Your first eye exam will be one to two days after your cataract surgery. You will have another follow-up exam a few weeks after the first one. This helps your eye doctor keep track of your healing progress. If you have any complications, these regular exams can help to identify them, or you can report symptoms to your eye doctor and get an exam sooner.

About six weeks after the surgery, you will get a new prescription for eyeglasses. This will be covered by VSP as well.

Vision insurance like VSP also covers all the necessary steps before cataract surgery, particularly regular eye exams. You may also need to update your glasses prescription more often since cataracts can change your refractive error. For example, you may develop nearsightedness faster as a result of your cataracts, and glasses can help to mitigate that issue.

Medicare or other health insurance plans will cover the cataract surgery itself. Most people who develop cataracts are older adults who have Medicare along with a secondary health insurance option. Medicare covers traditional cataract surgeries, but they do not cover multifocal IOLs or other newer devices.

Cataract Surgery

Cataract eye surgery is a very common and medically necessary procedure to remove and replace the eye’s natural lens when the vision has been clouded by a cataract. We offer laser-assisted cataract surgery and lifestyle lenses as options for our patients.

Learn More About Cataract Surgery

Using Your Insurance to Cover Cataract Surgery

Between 85 to 92 out of every 100 adults who undergo cataract surgery have an excellent outcome, with a significant amount experiencing restored vision and an improved quality of life.

If you have VSP insurance, your optometrist or ophthalmologist likely has their information on file and will use them to cover any procedures before and after the cataract surgery. If you are concerned about something not being covered, ask your vision care provider for help.

References

History. VSP.
Plan Descriptions: What VSP Offers. VSP.
Cataract Surgery. (December 2019). Cigna.
Does Medicare Cover Cataract Surgery? (September 2020). Medical News Today.

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