Posted on June 25 2013
What is the cost of cataract surgery? There are many variables that affect the cost of cataract surgery; the type of procedure, the type of intraocular lens implant (IOL) and even the area where you live. According to a study done by a leading industry analyst for allaboutvision.com , the average cost for cataract surgery is $3429 per eye if you are paying for everything yourself. If you want the more sophisticated high tech lenses the cost jumps to an average of $4269 per eye. Of course, most people having cataract surgery have either Medicare or some private insurance that pay some or even all of the costs that they consider to be “medically necessary.” During cataract surgery the cloudy, hardened natural lens of your eye is removed and replaced with an IOL. That is medically necessary. They type of lens you choose will determine how much out of pocket expense you will incur.
Let’s talk about the lenses for a moment.
The standard IOL will correct your distance vision. You would usually need to wear reading glasses. The insurance companies consider this medically necessary and will pay for both the surgery and the lenses.
The multifocal lens will correct both your distance and near vision freeing you up from glasses for most things. Here’s where things can get confusing. The insurance company still considers the surgery to be medically necessary and will pay for that. However, they do not consider these high tech lenses to be medically necessary so extra cost is solely the responsibility of the patient. The additional cost averages about $1978 per eye.
The Toric lens which corrects astigmatism is also not considered medically necessary and though insurance will still pay for the surgery, the out of pocket for the patient averages about $1292 per eye.
COST OF CATARACT SURGERY *DS
So to summarize, here are the potential costs for cataract surgery.
You may be responsible for a portion of the covered medically necessary charges. This is your co-insurance or co-pay.
You may be responsible for a yearly deductible.
You will be responsible for the entire cost of any specialty lenses. These are NEVER covered by insurance despite what their benefits representative might tell you.
You will be responsible for any co pays associated with pre and post op drops. These are sometimes not on formulary and can be expensive.
So do your homework, ask the questions and by all means shop around. Prices vary from practice to practice.