How Much Does Cataract Surgery Cost?
The average cost of cataract surgery is $7,150, according to 15 reviews from RealSelf members. Read on to learn all the factors that affect the price of this common vision correction surgery.
Is cataract surgery worth the money?
Of 15 RealSelf members reviewed their procedure, 91% say that cataract surgery was Worth It.
About 95% of people who have this safe, painless, and effective surgery have improved vision afterward. Better still, their enhanced vision typically lasts a lifetime because the new artificial lenses cannot form cataracts.
While waiting to have cataract surgery won’t damage your eyes or make the surgery more difficult, having it will probably significantly improve your eyesight and quality of life. “I tell patients that the time for cataract surgery is when you cannot see to do what you want to do,” says Dr. Mark Golden, an ophthalmologist in Chicago.
What affects the cost of cataract surgery?
The cost of cataract surgery varies widely, depending on:
1) The type of intraocular lens (IOL) implanted in the eye
During cataract surgery, your ophthalmologist replaces your natural clouded lens (a cataract) with an artificial transparent lens—called an intraocular lens, or IOL—to correct your distance vision.
Monofocal IOLs are considered standard. Premium IOLs (aka toric IOLs) that correct for astigmatism and lenses that correct for near vision cost more, as do newer multifocal lenses that correct both near and distance vision simultaneously.
2) The technology used during surgery
Traditional cataract surgery involves making a very small incision on the cornea to remove the cataract. A laser then breaks up the cataract so it can be suctioned out and removed.
Laser cataract surgery, which is typically more expensive, uses a laser to create the initial incision instead, reducing certain risks and improving the visual outcome of cataract surgery.
3) Your surgeon’s credentials and level of experience
Cataract surgery is performed by eye doctors (ophthalmologists) who are likely to be more experienced and more expensive because of their specialized training. Ophthalmologists who frequently perform this specialized surgical procedure may charge more than those with less experience, or they may be able to offer lower prices because they have developed efficiencies.
4) Their practice location
You'll pay more at an upscale practice in an area where the cost of living and demand for cataract surgery is high. If cost is a major concern, consider qualified providers in outlying areas with more modest surgery centers.
5) Pre- and post-operative care
While cataract surgery is a common outpatient procedure, it still requires care before and after surgery, such as pre- and post-operative visits, testing, and pain medication. You might need an EKG to determine your heart health before you undergo cataract surgery, as well as prescription eyeglasses, to enhance your vision after cataract surgery.
During your consultation, ask your provider about any additional needs that could increase your total cost.
Does Medicare pay for cataract surgery?
The majority of cataract patients in the U.S. are over 65 years old and qualify for Medicare coverage for cataract surgery. Usually, Medicare covers more than 80% of the cost of cataract surgery, particularly if you get standard monofocal IOLs.
“Advanced technologies such as the femtosecond laser, ORA, and premium lens implants (e.g. toric, multifocal, trifocal) are not covered by Medicare, the VA, or any other health insurance plans,” says Dr. Emilio Justo, an ophthalmologist in Sun City West, Arizona. “They should be considered as important upgrades on an individual basis.” Laser cataract surgery is usually performed when a premium presbyopia-correcting or astigmatism-correcting IOL is implanted.
While Medicare doesn’t usually cover glasses or contact lenses, Medicare Part B medical insurance helps pay the additional costs of corrective lenses, if you have cataract surgery to implant an intraocular lens.
Does private insurance cover the cost of cataract surgery?
If you aren’t eligible for Medicare but have private insurance, good news: Most cataract procedures performed in the U.S. are either fully or partially covered by health insurance. However, the extent of your deductible, copayments, and upgrade costs will vary widely between insurance companies and plans.
For standard cataract surgery, most health insurance covers the removal of the cataract, monofocal lens implants, and one set of prescription glasses or contact lenses.
However, if you select laser cataract surgery or need a premium lens implant, you will likely need to cover the difference with your own money. Prepare for sticker shock: These services can double or triple out-of-pocket costs.
Once you know the details of your eye surgery and what you'll need, check with your insurance provider to confirm their coverage level, so you can budget for out-of-pocket expenses. These are the most important questions to ask:
1) How much is my deductible? How much is my copay?
2) Does my insurance plan pay for eyeglasses?
3) Is my cataract surgeon a preferred provider? If not, do they need to be approved before the procedure?
4) Is the surgical center a preferred provider or approved by the insurance company?
5) Do you require advanced approval from a doctor to validate my cataract surgery as medically necessary?
6) What parts of the cataract surgery and associated costs will you cover?
7) Does my insurance plan pay for cataract surgery with astigmatism?
8) Does my insurance plan cover for laser cataract surgery?