Kinds of cataract surgeries and their costs

Even though the cost of a cataract surgery varies from procedure types, different IOLs and cost-of-living standards, it can be as high as $4,000 per eye. Currently, single monofocal IOLs are considered to be medically necessary, since the patient always need an alternative lens for normal vision. In this case, both Medicare and most of the insurance companies cover this type of IOLs. However, if the patient chooses a presbyopia-correcting IOL, he needs to pay the discrepancy or the extra expense. Insurance providers keep in mind that these premium lenses are not medically necessary, since they provide additional vision benefits such as perfect near vision. These common vision problems can be corrected simply by eyeglasses or contact lenses.

Since the extra costs of premium IOLs vary significantly between different ECPs, the patient should always ask their exact prices before receiving the surgery. Another part of extra costs comes from the procedure of eliminating astigmatism during the surgery, which is also excluded by insurance plans. Those special IOLs that can correct astigmatism are named toric IOLs. Once implanted, they can offset the vision distortion caused by the lens’ irregular shape. Patients should ask the surgeon’s billing representative about all of these extra costs and the aspects they cover.

For a standard cataract surgery, you can simply get reimbursements covered by your Medicare, while the reimbursements from private insurances are slightly more complex. Under some vision insurance plans, the patient should pay a certain portion of some items that are not parts of the procedure itself, such as an EKG, a comprehensive eye exam, eyeglasses and follow-up procedures. For example, a laser procedure named YAG laser capsulotomy to treat complications is not included in most insurance plans.

The patient should consult the insurance company and Medicare representative carefully to figure out all items that are covered, such as the copayment rate, deductible amount, eyeglasses coverage, surgeon recommendation, prior approval from the company, just to name a few.

Another application of cataract surgery is called refractive lens exchange (RLE), which requires the patient to pay all of its costs. RLE aims to correct potential cataract in advance, which replaces the functioning lens with an IOL. Some people choose RLE to reduce their dependency on eyeglasses. Sometimes, they just want to treat cataracts as early as possible.