Cataracts are a disorder of the eye in which the lens becomes thicker over time. This thickness blocks light from passing through the lens and also prevents the lens from focusing light on the back of the eye (retina). Cataracts are one of leading causes of blindness in the world yet they can be treated with early diagnosis and surgical intervention. For those that have adequate health insurance, the cost of cataract surgery is mostly or fully covered. Unfortunately for those people that are uninsured or underinsured, cataract surgery may cost as much as $5,000 per eye. This article examines some of the main types of cataract surgery and cost.
Cataract surgery requires that the abnormally thickened, native lens be removed and an artificial lens can be inserted in its place. This standard lens provides good distance vision but does not assure that near or reading vision will be possible without glasses. While there are additional procedures that improve both near and far vision correction during cataract surgery, only the standard distance vision procedure is covered by health insurance. Does this seem unfair? Well, the cost of corrective contact lenses or eyeglasses is less than the cataract surgery that improves near vision and accommodation. Consider patients that opt for LASIK vision correction surgery; these patients pay for LASIK completely out of pocket since the procedure is deemed cosmetic rather than medically necessary. Therefore, if a patient wants a “premium,” vision-correcting procedure at the time of cataract surgery, the cost is paid out of pocket.
The median range of cataract surgery costs for one eye is $2,500 to $3,500, with the average cataract surgery cost being $3,363 per eye. This cost covers cataract removal and restoration of far vision only. For those with health insurance, this standard cataract procedure is usually covered in full, minus any co-pay or deductible.
If you have presbyopia, a common condition in older patients especially in those that have cataracts, a special lens can be inserted at the time of cataract surgery, instead of the standard monofocal artificial lens. This cataract surgery costs approximately $4,000 without insurance and the average premium for patients with insurance is around $1,900.
Even with the premium, prespbyopia-correcting, intraocular lenses, any astigmatism that has developed from the cataract may persist even after cataract surgery. This astigmatism can be corrected at the time of the cataract surgery, but as you might now expect, it is considered a “premium” service as well. The basic surgery for astigmatism raises cataract surgery cost by an additional $500.
When considering cataract surgery, you should have a frank discussion with your eye surgeon regarding the exact state of your eye, the likely benefits of basic cataract surgery, and the maximum improvement that can be achieved with various, additional cataract surgery procedures. After those issues and corrective procedures have been clearly laid out, you may then obtain an estimate of the cost of each procedure and determine what portion will be covered by your specific health insurance. If your surgeon does not know what cataract surgery costs will be covered, then contact your insurance company directly using the specific names of the cataract surgery procedures to find out premium, deductible, and co-pay amounts.