Does Medicare Cover YAG Laser Capsulotomy?

As we age, we often experience vision issues such as cataracts. Cataract surgery is a standard procedure that can significantly improve your vision. However, some people may experience a secondary cataract after surgery, leading to a need for YAG laser capsulotomy. You may wonder whether Medicare covers YAG laser capsulotomy if you’re a Medicare beneficiary. This article will delve into this topic and provide all the necessary information.

What is YAG Laser Capsulotomy?

YAG laser capsulotomy is a non-invasive procedure for treating a secondary cataract, also known as posterior capsule opacification (PCO). This condition can develop after cataract surgery when the back of the lens capsule becomes cloudy, causing blurred vision.

During the procedure, a laser creates a small opening in the clouded capsule, allowing light to pass through and restore clear vision. The procedure is quick, painless, and typically offers immediate improvement in vision.

Does Medicare Cover YAG Laser Capsulotomy?

The good news is that Medicare generally covers YAG laser capsulotomy. This procedure is considered medically necessary to treat a secondary cataract resulting from cataract surgery. Here’s a closer look at how Medicare coverage works for this procedure:

Medicare Part B Coverage

Medicare Part B typically covers the YAG laser capsulotomy procedure. It also covers medically necessary services and supplies required to treat secondary cataracts, including doctor services, outpatient care, and preventive services.

Cost Sharing

While Medicare Part B may cover the majority of the costs for YAG laser capsulotomy, beneficiaries will still be responsible for certain out-of-pocket expenses, including:

  • Part B Deductible: Beneficiaries must pay the annual Part B deductible before Medicare begins to cover the procedure.
  • Coinsurance: After the deductible is met, Medicare usually covers 80% of the cost of the procedure, leaving the remaining 20% for the beneficiary to pay.

Outpatient Surgery Coverage

YAG laser capsulotomy is often performed as an outpatient procedure. Medicare typically covers the cost of outpatient surgery under Part B, so you can expect similar coverage.

How to Ensure Medicare Coverage for YAG Laser Capsulotomy

To make sure Medicare covers your YAG laser capsulotomy procedure, follow these tips:

  • Consult Your Doctor: Before undergoing the procedure, talk to your doctor to confirm whether it’s medically necessary.
  • Verify Coverage: Contact Medicare or your Medicare plan provider to verify that the procedure is covered and to understand your out-of-pocket costs.
  • Choose a Medicare-Approved Provider: Ensure your healthcare provider accepts Medicare assignments to avoid unexpected costs.


In conclusion, Medicare covers YAG laser capsulotomy when deemed medically necessary, making it a valuable benefit for seniors experiencing secondary cataracts. Make sure to confirm your coverage and out-of-pocket costs ahead of time to ensure a smooth process.

If you have any questions about your situation, contact your healthcare provider or Medicare representative for personalized advice. YAG laser capsulotomy can significantly improve your vision, so it’s worth exploring this option if you experience blurred vision after cataract surgery.