In most cases, both private insurance and Medicare will cover the cost of the procedure after a patient has met their deductible and copayment responsibilities. The exact cost of cataract surgery depends on 3 main factors.
Cataracts Effect on Everyday Activities
Your Lens Choice
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Insurers might decline to cover the cost of cataract surgery if the insured’s vision has not deteriorated to the point where their ability to engage in everyday activities has been impaired. While patients who choose to undergo surgery before their cataracts fully develop may pay more, the lifestyle benefits might outweigh the cost.
An ophthalmologist can still clear an individual for cataract surgery even if they don’t meet insurance preset requirements or their vision has yet to greatly deteriorate. It is your choice on how to proceed with your treatment.
The intraocular lens (IOL) a patient selects also influences the price of cataract surgery.
- Monofocal lens implants are typically covered for most patients, though some will have to pay deductibles and/or copays as stipulated in their insurance policies.
- Premium lens types — such as a toric IOL (that corrects astigmatism) or multifocal IOL — may increase the cost of cataract surgery for those who want to take advantage of the lifestyle benefits they provide. Insurance providers don’t generally consider your desire to stop wearing glasses as a “medical necessity”, they consider it a personal choice, so that is why they typically only cover the cost for only standard replacement lenses.
Advanced surgical techniques that use lasers are not covered by insurance providers and tend to cost more than traditional surgical techniques which use blades. That said, laser cataract surgery can provide supplementary benefits for patients such as a more precise procedure and decreased time for recovery. It is ultimately your choice.
When considering cataract surgery, you should start by getting a clear picture of your condition and treatment options, by seeing an ICON Ophthalmologist for a cataract evaluation. From there, our specially trained team on surgical counselors can help you explore your insurance coverage and review the payment options available.
Cataract Surgery Financing Options
Patients with employer-provided health insurance may be able to pay for cataract surgery using a flexible spending account. To spread the cost of surgery over time and make it more affordable, cataract surgery patients can also work with us to develop a payment plan that fits their monthly budget.
At ICON Eyecare, we offer several patient-friendly financing options, including 0% financing for up to two years with no money down and low monthly payments (subject to credit approval). Our surgical counselors will meet with you during your consultation to help you navigate the insurance process and determine how to make cataract surgery most affordable for you.
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