Although cataract surgery may be considered an elective procedure, it remains the only effective method of treating advanced cataracts. Fortunately, health insurance providers understand this, and in most cases the cost of treatment is covered by Medicare, HMOs, and other health insurance plans. Without health insurance, the average price of cataract surgery is approximately $3,000 per eye. However, your ultimate cataract surgery cost will vary depending on:
- The maturity of the cataract
- The type of cataract surgery required
- Your choice of artificial intraocular lens (IOL)
- The location of the facility where your procedure will be performed
An appointment with a qualified ophthalmologist is the best way to receive precise details about what your cataract surgery would cost.
What Types of IOLs Are Covered by Health Insurance?
Typically, health insurance providers cover the cost of standard cataract surgery, which includes the placement of a monofocal IOL. Although patients experience sharper, clearer distance vision as a result of the surgery, reading glasses are typically necessary for "near" tasks. To free themselves from reliance on glasses, many patients opt for a premier IOL instead, which maintains the eye's ability to focus and both near and far distances.
If you choose a premier IOL, such as a multifocal or accommodating IOL, you will likely need to make a greater out-of-pocket contribution. Most often, insurance offers to pay the cost of a conventional IOL, and the patient is responsible for paying the difference. For example, if you choose a multifocal IOL for near, far, and intermediate vision with reduced dependence on corrective eyewear, you can expect the price of your cataract surgery to increase.
The Cost of Premier IOLs
Because premier IOLs reduce, and sometimes eliminate, the need for glasses after surgery, many patients are willing to pay the extra cost. These advanced IOLs are specifically designed to not only improve distance vision, but correct presbyopia (nearsightedness) as well. Choosing a multifocal or accommodating lens typically requires an additional contribution of approximately $1,900 per eye.
Examples of premier IOLs that may incur additional out-of-pocket expense:
- Multifocal IOLs, which allow for clear near and distant vision. Patients who choose multifocal IOLs often do not need glasses after surgery.
- Aspheric IOLs, which provide the most advanced contrast sensitivity, so images appear sharper and crisper.
- Toric IOLs, which correct astigmatism while providing the enhanced image quality of an aspheric lens.
- Accommodating IOLs, which function just like a natural lens, bend with the movement of the eye mucles in order to focus vision. Patients are able to enjoy clear vision at all distances.
The Cost of Surgery for Patients with Astigmatism
In order to have premier lenses placed, patients with astigmatism may require limbal relaxing incisions (LRIs) before having their IOLs implanted. The additional cost for astigmatism correction is approximately $500 per eye, and will be included in your overall cataract surgery cost.
If patients with astigmatism are willing to forego the presbyopia correction provided by multifocal and accommodating IOLs, they may benefit from a toric lens instead. While the patient will still need reading glasses after surgery, the toric lens corrects blurriness caused by astigmatism. Although it comes with additional cost-approximately $950 per eye-many patients consider it a small price to pay for clear vision.
Questions to Ask Your Insurance Provider
Although it's possible to estimate your cataract surgery cost based on reported averages, your healthcare plan is unique and will play a large role in determining your out-of-pocket contribution. If you are considering cataract surgery, here are some important topics to discuss with your insurance provider:
- How much is your deductible? If you have a high deductible, you may be required to pay a larger sum out-of-pocket before your insurance carrier will cover the remaining portion of the procedure.
- What will your co-pay be? For example, your carrier may specify that patients pay a $125 co-pay for an outpatient surgical procedure, such as cataract surgery. Depending on your plan, this figure may be considerably more or less.
- Are eyeglasses included in your coverage? Because cataract surgery patients may require reading glasses after treatment, plan to add the amount you spend on a pair of eyeglasses into your overall cataract surgery cost.
Remember that your insurance broker and your ophthalmologist are available to make the process as simple as possible, and provide you with any information you may need in order to help you make an informed decision regarding your treatment.
What Will Your Cataract Surgery Cost?
An appointment with an ophthalmologist will allow you to determine what type of cataract surgery you will need and what type of IOL your physician recommends-details that are key to determining your overall expense. Contact a caring, qualified cataract surgeon in your area today, who will help you determine your ultimate cataract surgery cost