Cataract Surgery

Aetna covers preoperative diagnostic testing for cataract surgery (comprehensive/brief/intermediate exams, A‑scan, and B‑scan when visualization is limited or for Morgagnian cataract) and medically necessary cataract removal with lens implantation, but considers contrast/glare/PAM testing integral (not separately reimbursed). Key limits: many "deluxe" IOLs (e.g., accommodating, multifocal, toric, extended‑depth/trifocal, light‑adjustable, Clareon Vivity) and Optiwave Refractive Analysis are non‑covered/not medically necessary, piggyback IOLs are investigational, and surgery is not covered when vision is adequate with glasses, lifestyle is uncompromised, or the patient is medically unfit.

"Brief or intermediate examination as a diagnostic test prior to cataract surgery."

Sign up to see full coverage criteria, indications, and limitations.