Routine Cataract Surgery CataractRemovalAnimation-WebRes56k
The cost of routine cataract surgery for Medicare patients is approximately $2,500.00. The cost may vary depending on the area of the country that you live in. A person with Medicare coverage and a supplemental insurance policy will have all or the majority of the costs covered except for deductibles. Medicare pays 80% of the Medicare allowable charges. Doctors that accept assignment from Medicare charge the allowable amount designated by Medicare for an office visit or procedure. Doctors that do not accept assignment may charge up to 25% above Medicare allowable charges. The supplement insurance will usually cover the other 20% except for deductibles. Commercial insurance will pay according to the plan that you have purchased but usually cover routine cataract surgery well.
Cataract Surgery with Non-Medicare Additional Testing
There are several new technologies that can be used to determine the health and status of the eye. These tests can be used to make recommendations about the newer type of intraocular lenses used for in more advanced cataract surgery. These types of work-ups using these new technologies are more involved and take longer to complete. The data from these tests provide the eye surgeon with information that will be used to help with your choice of the new intraocular lens technologies. These tests are not covered by Medicare and/or insurance for cataract surgery work-ups. The patient will have to pay for these tests out-of-pocket.
These tests may include:
The costs for these tests could be from $250.00 to $750.00 depending on the number of test performed and the eye surgeon’s fees.
Toric Intraocular Lenses
Patients who have astigmatism will still need to wear glasses for distance and near after cataract surgery. Patients without astigmatism have an excellent chance of seeing well at distance and only need reading glasses after cataract surgery. If you have astigmatism and wish to have good distance vision without glasses, you will a toric or astigmatism correcting intraocular lens used during the cataract surgery. Medicare and most insurance companies do not cover the cost of these types of intraocular lenses. The cost of these lenses typically run from $900.00 to $1,500.00 and you will have to pay out-of-pocket if you wish to have this type of lens. You will only need to wear over-the-counter reading glasses after the surgery.
Presbyopic Correcting Intraocular Lenses
These are considered the ultimate premium intraocular lenses. They correct for distance and near either by having a bifocal incorporated into the lens or designed to move inside the eye allowing the lens to focus from distance to near. The costs of these types of lenses run from $2,500.00 to $3,900.00 per eye. If you are a good candidate for this type of lens after the testing is performed, you have an excellent chance of being glasses free.
When choosing an insurance plan you need to make sure you are aware of any c0-pays, deductible amounts, and other out-of-pocket costs. You also want to make sure that medicines you are taking are covered by the prescription plan. You need to make sure your doctors on in the network of the insurance company. Ask your doctor about their experiences with insurance companies in your area.
Regular cataract surgery is very well covered by Medicare and insurance companies. The premium types of intraocular lenses are not covered by Medicare and insurance companies. They do cover the regular costs associated with having cataract surgery but not the costs charged by the doctor for premium intraocular lenses.