Cataract Surgery, Cataract Removal & Lens Implant (IOL) Cost Considerations

If you have Cataracts, the cost of Cataract Surgery and Cataract removal should not be a substantial barrier to gaining access to the care that you need to regain useful vision.  In almost all instances, with certain limitations, Cataract Surgery costs are considered reimbursable expenses under both private insurance plans and Medicare. If you are considering Cataract Surgery to remove a Cataract you should become familiar with the range of costs, how much you might need to pay out of pocket, what deductibles might apply, what co-pays might apply and what services might not be covered or require additional payment. For the vast majority of people, their insurance by itself or in conjunction with Medicare if they are eligible, is going to cover the bulk of the cost of Cataract Surgery.

Private Insurance and Cataract Surgery Costs
Private insurance for Cataract Surgery is usually quite comprehensive but also quite variable. In most instances private insurances covers a portion, if not all, of the Cataract Surgeon Fee, the Facility Fee, the cost of a Monofocal Lens Implant and the necessary follow up care after your Cataract Surgery. Private insurances vary in the deductible that they may require, the co-pay you might be responsible for and the percentage of each allowable expense that they might reimburse.

NOTE
THE DEDUCTIBLES, PERCENTAGE COVERAGE AND ANY CO-PAYS ARE UNIQUELY INDIVIDUAL TO YOUR INSURANCE AND YOUR SPECIFIC HEALTH INSURANCE POLICY

When you visit your Cataract Surgeon and schedule your Cataract Surgery, a member of the staff will review the details of your insurance coverage and let you know right up front what your coverage is and what out of pocket expenses, if any, will be required of you. It is likely that you will responsible for a co-pay or a deductible for the pre surgery office examination, consultation and measurements for your Cataract Surgery. This will depend on your insurance. If you need a pre surgery physical with your medical doctor, you may also be responsible for that physician's co-pay as well. In addition, if you require anesthesia, while your insurance will cover the allowable anesthesia expense, you may be responsible for the anesthesia co-pay and/or deductible.

One item to be aware of is that insurance companies typically only cover the use of a basic Monofocal Lens Implant to correct vision after Cataract Surgery. Some do cover a portion of the additional expense of an Aspheric Lens Implant however most if not all require that you individually pay for the cost of Astigmatism Correcting Toric Lens Implants, Near Vision Presbyopia Correcting Lens Implant or Multifocal Lens Implants that help to you regain a normal range of vision and see up close without eyeglasses or bifocals after Cataract Surgery. Any additional fees for Aspheric Lens Implants, Astigmatism Correcting Toric Lens Implants or Near Vision Correcting Lens Implants will be reviewed with you by the staff and convenient arrangements for payment will be made. The insurance company will typically ask the Cataract Surgeon to bill you separately for these advanced types of Lens Implants. Generally, the estimated out of pocket costs for Astigmatism Correcting Toric Lens Implants can range from $900-$1500 per eye and the estimated out of pocket costs for Near Vision Lens Implants can range from $1500-$3000 per eye. Your Cataract Surgeon's staff will review these fees with you in detail and help you arrange convenient payment.

Medicare and Cataract Surgery Costs
Medicare for Cataract Surgery is also quite comprehensive. Medicare covers a portion, in not all, of the Cataract Surgeon Fee, the Facility Fee, the cost of a Monofocal Lens Implant and the necessary follow up care after your Cataract Surgery. It is likely that you will responsible for a co-pay or a deductible for the pre surgery office examination, consultation and measurements for your Cataract Surgery. If you need a pre surgery physical with your medical doctor, you may also be responsible for that physician's co-pay as well. In addition, if you require anesthesia, while your insurance will cover the allowable anesthesia expense, you may be responsible for the anesthesia co-pay and/or deductible.

Medicare will pay 80% of the "Medicare Allowed" charges for your Cataract Surgery. Medicare determines what is "allowed" and the Cataract Surgeon agrees to this determination. Under Medicare coverage it is likely that you will be responsible for the 20% difference remaining between the fee collected by the Cataract Surgeon from Medicare and the actual "Medicare Allowed" charges. Many Medicare beneficiaries also have secondary insurance to cover their "20%" of the Medicare Allowable charges. If you do please make sure to bring this to the attention of the staff.

Medicare will cover the cost of a basic Monofocal Lens Implant or an Aspheric Lens Implant to correct vision after Cataract Surgery. Medicare requires that you pay individually for the cost of Astigmatism Correcting Toric Lens Implants, Near Vision Presbyopia Correcting or Multifocal Lens Implants that help to you regain a normal range of vision and see up close without eyeglasses or bifocals after Cataract Surgery. Any additional fees Astigmatism Correcting Toric Lens Implants, Near Vision Correcting Lens Implants or Multifocal Lens Implants will be reviewed with you by the staff and convenient arrangements for payment will be made. Medicare will asks the Cataract Surgeon to bill you separately for these advanced types of Lens Implants. Generally, the estimated out of pocket costs for Astigmatism Correcting Toric Lens Implants can range from $900-$1500 per eye and the estimated out of pocket costs for Near Vision Lens Implants can range from $1500-$3000 per eye. Your Cataract Surgeon's staff will review these fees with you in detail and help you arrange convenient payment.

Please note that the additional cost of advanced technology lens implants reflects not only the additional testing and measurement time required for these types of Lens Implants but also reflects THE ADDITIONAL COST OF THE LENS IMPLANTS CHARGED BY THE MANUFACTURERS WHICH CAN RANGE FROM $600-$1200 MORE PER LENS IMPLANT.

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