Kinds of cataract surgeries and their costs
As a common eye disease, cataract now affects a large number of people in the world. Patients suffering from cataracts of an early stage are still possible to ask prescription eyeglasses or contact lenses for help, because these devices can offset vision blurriness. The problem is that cataract hardly stops its progression and eventually become out of control by Rx eyewear devices. At that point, cataract surgery is the right solution. There are different procedure types and one of the most important factors to consider is their prices.
The expense of standard cataract surgery is fully covered
Even though the cost of a cataract surgery varies in different procedure types, intraocular lenses (IOLs) and cost-of-living standards, it can be as high as $4,000 per eye. Currently, single-vision monofocal IOLs are considered to be medically necessary, since the patient always needs an alternative lens for normal vision. In this case, both Medicare and most of the insurance companies cover this type of IOLs.
Multifocal IOLs require extra expense
However, if the patient chooses a presbyopia-correcting IOL, he or she 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 and intermediate vision. These common vision benefits can be gained simply by wearing eyeglasses or contact lenses.
Detailed services that require extra costs
Since the extra costs of premium IOLs vary significantly between different eye care practitioners (ECPs), it is always necessary to ask their exact prices before receiving the surgery. Another part of extra cost 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 items that have been covered in the claimed price.
About reimbursement from Medicare and insurance companies
For a standard cataract surgery, it is for sure to simply get reimbursement covered by 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 for treating postoperative complications is not covered by most insurance plans.
Check the exact items that are covered
According to the above description, 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.
Refractive lens exchange serves as an early treatment for cataracts
Another application of cataract surgery is called refractive lens exchange (RLE), which requires the patient to pay all of its cost. RLE aims to correct potential cataract in advance, which replaces the functioning lens with an IOL. Some people choose RLE to reduce their dependence on eyeglasses. Sometimes, they just want to treat cataracts as early as possible.
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