Cataract surgery is a safe and common procedure. The cost of cataract surgery varies due to several factors, including the technology used, the type of surgery, the lens implanted, and the health insurance coverage. As a result, there is no fixed cost for cataract surgery.
As cataracts become more common, the demand for cataract surgery also continues to grow. This increasing demand drives the development of advanced technologies for cataract treatment, leading to more effective and efficient options.
What Are The Different Types of Cataract Surgery?
Cataract Surgery is a safe and effective procedure. During cataract surgery, your surgeon will remove the clouded lens and replace it with an artificial lens, known as an IOL (intraocular lens). There are multiple types and techniques for Cataract Surgery, listed below.
- The most prevalent form of cataract surgery is phacoemulsification cataract surgery, which involves foldable intraocular lenses (IOL) implants. In this procedure, an ophthalmologist removes the cloudy cataract lens with an ultrasonic probe and replaces it with a folded lens implant that unfolds once in position.
- Extracapsular cataract surgery involves the removal of the natural eye lens while leaving a portion of the posterior lens capsule intact. This approach allows for the implantation of an artificial IOL without a significant incision, restoring the patient’s vision.
- Intracapsular cataract surgery, a less common method, entails the removal of both the eye lens and the entire eye lens capsule, which is then replaced with an IOL. This procedure requires a larger incision, resulting in a higher risk of complications.
- Laser cataract surgery serves the same purpose as conventional cataract surgeries. Still, it employs advanced femtosecond lasers (infrared lasers capable of pulsing quickly and accurately) instead of handheld instruments for eye lens incisions. As the most technologically advanced option, laser cataract surgery can also be the most expensive.
Factors including the type of surgery, surgeon expertise, and the IOL used also influence the total cost of cataract surgery. Standard surgery can range from $3,000 to $5,000 per eye out-of-pocket. It is important to note that Medicare insurance covers standard cataract surgery for individuals aged 65 and older. This means that most people do not have to pay out-of-pocket expenses for basic cataract surgery. Read on for information to ask your insurance carrier about your surgery cost.
While most insurances will cover the majority of standard cataract surgery, there are advanced cataract surgery techniques and technologies, including laser-assisted surgery or procedures using advanced multifocal IOLs. These options may provide you with a better result and allow to you have improved vision without the use of glasses after your cataract surgery. These surgeries do come at a higher out-of-pocket cost, usually ranging from $3,000 to $5,000 per eye in addition to your insurance coverage.
During a consultation at Barnet Dulaney Perkins Eye Center, our surgery counselors will walk you through our available packages and help you understand which options for advanced technology you may want to consider. Together with your surgeon, you will be able to find the perfect lens and surgery options that best fit your desired results and budget.
Does Medicare Cover Cataract Surgery?
Medicare health insurance covers standard cataract surgery, and most private insurance plans will also cover this procedure. The coverage amount depends on the specific Medicare plan, the type of cataract surgery, any pre-existing conditions the patient may have, and the location of the procedure (surgery center, clinic, or hospital). In the case of Barnet Dulaney Perkins Eye Center, all laser cataract procedures take place in our own ambulatory surgery centers.
Although health insurance can cover a significant portion of the cataract surgery cost, patients may still be responsible for out-of-pocket expenses, such as physician/surgeon fees, copayments, or deductibles. Additionally, patients will be responsible for any costs related to premium IOLs, toric lenses, or multifocal lens implantation if they choose these options over a standard monofocal lens. See a list of insurances we accept
Medicare covers medically necessary aspects of cataract surgery, with patients responsible for any non-essential additions.
Medicare health insurance covers:
- Cataract extraction
- Standard monofocal lens implantation
- One pair of prescription eyeglasses or contact lenses
Under Medicare Part B, patients will pay 20% of the Medicare-approved amount for lenses that correct refractive errors, such as astigmatism, nearsightedness, or farsightedness.
Cataract Surgery Cost Breakdown with Medicare:
Medicare Part B covers standard cataract surgery, ophthalmologist fees, and surgery center fees. However, it only covers Medicare-approved amounts and does not cover the entire cost of the procedure.
Patients are responsible for meeting their deductible and paying a 20% Medicare Part B copay.
For example, if a standard cataract surgery in a clinic or surgery center costs approximately $4,000, a patient with Medicare insurance would be responsible for $800 (a 20% copay). The out-of-pocket cost also includes the deductible amount, which varies based on the patient’s specific insurance plan.
If you wish to know the price of your procedure, use this Medicare tool to get an idea. The costs are based on national averages and incorporate both facility and doctor fees. However, there may be additional charges. For a common and uncomplicated procedure (Code: 66984) in an ambulatory surgical center, you pay $316 after Medicare has covered its part. If you have the same procedure in a hospital outpatient department, the average patient cost is $524. Please note that these costs are for one procedure on one eye only. Although this tool can give you an estimated amount, keep in mind that the costs in your area and the complexity of your procedure may differ.
Without Medicare or private insurance coverage, the average cost of cataract surgery can amount to the full $4,000 for procedures at a clinic.
Questions to Ask Your Insurance Provider About Cataract Surgery
When searching for an ophthalmologist in Phoenix, it’s essential to consider the cost of cataract surgery and the coverage provided by your insurance company. You can reduce out-of-pocket costs and improve your overall treatment experience by asking the right questions.
Each insurance company offers different plans with varying deductibles, copayments, and monthly payments. To accurately determine the cost you can expect for cataract surgery, make sure to ask your insurance provider the following questions:
- What is my copayment amount?
- What is my deductible cost?
- Does my plan cover prescription eyeglasses after the procedure?
- Is the cataract surgeon a preferred provider with my insurance company?
- Is the clinic or surgery center in-network with my insurance plan?
- Does my insurance provider require verification that the procedure is medically necessary before treatment?
Typically, failing to verify your procedure’s coverage or using a surgical center or cataract surgeon not in-network with your insurance plan may result in higher costs. Ensure you ask the necessary questions to avoid unexpected bills after treatment.
At Barnet Dulaney Perkins Eye Center, our goal is to make sure our patients feel confident about their surgery and the care we provide. We also want to ensure that they are informed about everything to expect about their procedure, including the cost and their options for advanced technology.
If you are interested in learning more about Cataract Surgery at Barnet Dulaney Perkins Eye Center, consider scheduling a Cataract Evaluation with our experienced team.