Cataract surgery is one of the most frequently performed surgeries. Medicare and private health insurance usually cover its cost if patients meet specific criteria.
Medicare typically covers standard cataract surgery using a monofocal lens with a deductible and copay; however, patients wishing to upgrade to premium lenses or surgical techniques may incur additional expenses that will increase costs significantly.
Costs
Cataract surgery is an increasingly common medical procedure and most health insurance plans, including Medicare Part B, may cover it if your physician deems it necessary. However, it’s essential that patients understand all costs related to cataract surgery prior to proceeding with their procedure.
Cost factors affecting cataract surgery vary depending on several factors such as lens material used, surgical technique and the location of the surgical center. Experience and name recognition may also have an effect on surgeon fees; new technology such as laser-assisted cataract surgery typically costs more than traditional phacoemulsification.
Private health insurance and Medicare typically cover standard cataract surgery using a monofocal lens. Some patients choose to upgrade their artificial lenses after the procedure in order to eliminate glasses or contacts and see at all distances without them, although this will increase out-of-pocket costs. It’s also worth taking note if the surgeon or surgical center you select is network with your health insurer; those with flexible spending accounts (FSAs) can utilize funds held within these accounts towards payment for surgery costs.
Insurance
Most cataract surgeries are covered by insurance. Individuals not eligible for Medicare can still take advantage of supplemental coverage options, like flexible spending accounts that allow you to divert pretax income from paychecks into savings accounts for out-of-pocket health expenses.
Cataract surgery is typically covered by Medicare Part B, which covers standard surgical techniques and the ophthalmologist’s fee for performing it. Once your annual deductible has been met, Medicare pays out 80% of the cost; you will only be responsible for 20%.
Many private health care plans, like Medicare, cover cataract surgery. Deductibles and copays differ according to plan type, so it is wise to contact your insurer in advance about what are allowed charges under your specific policy in order to prevent unexpected bills post-treatment and to pay less than necessary for cataract treatments.
Out-of-pocket expenses
If you have private health insurance, cataract surgery will likely be covered. However, its cost will depend on your specific plan and coverage level as well as any deductible payments due.
The standard cataract procedure is safe and effective. Your surgeon can guide you in choosing which surgical technique and lens best suit your goals for post-op recovery.
Intraocular lens (IOL) choice can play a significant role in determining total cost. More advanced IOLs, such as premium refractive or toric IOLs designed to correct astigmatism, tend to cost more than basic monofocal IOLs. Other factors affecting cost include surgical facility and surgeon experience; payment plans through their office as well as flexible spending accounts through work or HSA can help offset some costs while giving access to more advanced IOLs; there may also be charitable organizations offering free or low-cost cataract surgeries available through their organizations.
Recovery
Cataract surgery is usually a short and painless procedure that lasts only 30-45 minutes, typically performed as day surgery under local anesthesia.
As soon as your procedure is over, you will rest in the recovery room until your sedation wears off and feeling returns to your eyes. At that point, if someone drives you home safely and follows all doctor-recommended guidelines regarding eye drops and activities that put additional pressure on your eyes, you should return home.
After cataract surgery, your vision should start improving rapidly within days – although it may remain slightly blurry until the lens adjusts to its new position. Itching and dryness may occur as well; anti-inflammatory or pain reliever eye drops may be prescribed to combat infection and alleviate discomfort. A protective shield should be worn at nighttime so as to avoid rubbing of eyes during sleep.
