No. Not all cataracts require surgery. If best vision is worse than 20/40 or glare is significantly affecting VA, most surgeons prefer to do surgery sooner but depends on pt's sx, risk factors, preferences; also, though no guarantees with any surgery, many patients are less dependent on or free of glasses after surgery; clear lens removal also possible in some pts; info: eyedoc2020.blogspot.com.
See below. Insurances and medicare will not pay for cataract surgery until they reach a certain level. This is usually based on ones visual acuity but there are other factors that contribute. However, the natural lens can be removed at any time. This is called refractive lens exchange and is usually done for people wanting to avoid glasses. This is an out-of-pocket expense.