How Much Does Cataract Surgery Cost
If you have cataracts, the first thing you’ll want to know is how much it costs to get a cataract removed. Compared to most surgical procedures that require a stay in a hospital, cataract surgery is relatively more affordable. In fact, studies show that the cost of cataract surgery has been reducing in recent years.
If you have no health insurance and have to pay for the entire procedure out of your pocket, the average cost for cataract surgery will be $3500 per eye for standard surgery.
Since most individuals in the U.S. with cataracts are over 65 years of age, they are covered under Medicare. People who aren’t Medicare eligible may still have some type of private insurance coverage which will vary from plan to plan. Note that there are certain factors, such as the type of technology, techniques and the type of IOL chosen, that may affect the cost of your surgery.
Factors That Affect Cataract Surgery Cost
A cost estimate will give you an idea of the price for surgery; however, the exact cost on paper may differ based on the following factors:
- The type of IOL you choose
- The region of the country where your surgery is performed
- The reputation, experience, and skill of the cataract surgeon
- Whether a laser is used
- Whether the surgery is performed in a hospital or an outpatient surgery center
- Whether your pre-op and post-op visits are covered
- Whether your post-op medications are covered
- How much of the surgery costs are covered by Medicare or a private insurance
The above factors can influence the cost of your cataract surgery on paper. However, the biggest influencer is the type of coverage you have.
With IOLs, the two basic categories are refractive IOLs to correct presbyopia and premium or toric IOLs to correct astigmatism. Cataract surgery with toric IOLs comes with an added cost of approximately $1,300. The average cost of refractive IOLs is around $2100. These premium lenses differ from the standard monofocal lens employed in basic cataract surgeries, which are designed to correct vision for only one distance and not rectify astigmatism.
Medicare and Private Insurance Coverage
Cataract surgery falls under Medicare Part B, as it is usually is an out-patient procedure. In most cases, cataract surgery is performed in a hospital or a doctor’s office, after which the patient can return home the same day. Medicare Part B covers doctor’s services and outpatient procedures, and it comes with a monthly premium within the $100-$135 range.
Although private insurances and Medicare cover the cost for standard cataract surgery using monofocal IOLs, they don’t cover additional costs, such as the use of premium IOLs or laser surgery.
In the case of standard cataract surgery without the use of premium lenses, Medicare covers the cost for removing the cataract, monofocal lens implants and one set of prescription contact lenses or eyeglasses following surgery. Note that choosing premium IOLs to correct refractive errors will eliminate your need for contact lenses or eyeglasses.
Cost Breakdown with Medicare
In the case of standard cataract surgery, Medicare covers about 80% of the cost – the remaining 20% will have to be covered by the patient after meeting the deductible. For example, if a standard cataract surgery costs $3,500, the Medicare coverage will be equal to $2,800. The remaining $700 plus deductible will lead to a total cost of $883. Purchasing a secondary policy from a private insurance company may help reduce your out-of-pocket costs.
If you’re looking to eliminate your need to wear contacts or eyeglasses, you will be required to cover the difference. For example, if you have astigmatism and wish to correct it with a premium toric IOL, you may have to cover a difference of $5,000. For correcting presbyopia with specialized lenses, the added cost will be around $3,000. Choosing laser-assisted surgery may add $1000 or more to the total cost.
Schedule a consultation with a surgeon to discuss your treatment option and cataract surgery costs. The surgeon will be able to provide you with an estimate based on your individual requirements.