The Cost of Cataract Surgery: Understanding the Expense & Insurance Coverage

The cost of cataract surgery will depend on many things. These include the lenses you choose and any Medicare or Insurance you might have. Navigating all the multiple different options can be bewildering—let’s face it, all you want to know is what it’s going to end up costing you or if your insurance will pay for it.

While we can’t promise to remove all of the variables, the following will help you to understand the types of costs involved, the choices you need to make, and what is or isn’t covered by insurance policies.

Demystifying Cataract Surgery

• Understanding cataract surgery costs
• Understanding cataract insurance costs

Understanding cataract surgery costs

The cost of cataract surgery is determined by the following:

• Where in the country you are
• Your choice of surgeon
• Whether you have traditional or laser-assisted cataract surgery
• The type of intraocular lens you select
• Whether you need (or want) astigmatism at the same time

If you have any out-of-the-ordinary medical needs, then this may (or may not) influence the final total of such a procedure.

The greatest factor that will increase costs is whether the procedure is traditional or laser-assisted and if you choose a premium lens. If you do go for one of the more advanced lenses, then traditional cataract surgery isn’t an option. These lenses can only be fitted through the more advanced laser-assisted procedure. The same applies if you require astigmatism to be treated at the same time.

While every situation differs slightly, you can expect to pay around $3,000-$5,000 per eye for traditional surgery and $4,000-$6,000 for laser-assisted surgery.

Understanding cataract insurance costs

First, the good news. Regular Medicare does cover cataract surgery. However, this only applies to the traditional kind and the fitting of a monofocal intraocular lens. It also includes a single pair of eyeglasses.

Other insurance products may or may not cover laser-assisted procedures and more advanced lenses. Be sure to read your policy carefully to find out what is and isn’t paid for.

But… There’s another bit of good news. Normally, Medicare (and most other insurance policies) will let you opt for the more advanced procedure and premium lens, as long as you pay the extra charges over and above the cost of traditional treatment.

Whether or not to do this will be down to your individual circumstances. The advantages of premium IOLs that provide good multifocal vision might be something that you think is of great value. This is especially relevant if you live an active lifestyle—removing the need for eyeglasses or contact lenses can be truly life-enhancing.

However, these lenses aren’t suitable for everyone. This makes partnering with an eye doctor who’s highly experienced with the latest technology very important. Only then will you be able to make a truly informed decision as to whether they’ll be right for you. Be aware that if you’re one of the (very few) people who find they can’t tolerate a multifocal IOL, you will need a further operation to change it. If you’re self-funding, then this should be factored into your decision-making.

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