Cataract surgery cost depends on four main variables:
- The type of procedure you have
- Where you have the procedure
- The intraocular lens (IOL) you have implanted in your eye
- The area in which you live can also be a factor (cost-of-living standards help set the typical cataract surgery cost and health care prices in general)
Cost Factor: Cataract Surgery Location
While, you might not have a lot of choice over the type of procedure you need. You can determine where you have your procedure.
Where your cataract surgery is performed can affect what you pay. It is always more cost efficient to have cataract surgery performed at an ambulatory surgery center (ASC) rather than in a hospital. ASCs are typically able to perform your procedure at the same high level of care with the same specialized attention but at a lower cost – an especially nice advantage if you have a co-pay.
When patients choose to use an ambulatory surgery center, most find that the process is much more convenient, as well as more personal. ASCs offer a relaxed environment, with everything at one location, including patient registration, waiting rooms, surgical suites and recovery rooms. They focus on a limited number of procedures, and most patients find them easier to navigate than a hospital.
For Medicare patients without secondary insurance, patient copays in an ASC are 42% less than in a hospital, saving over $140.
But just like hospitals, ASCs are subject to tough standards. Every ASC must be accredited by Medicare, and is subject to surprise audits. Ask if the ASC has been accredited by Accreditation Association for Ambulatory Health Care (AAAHC), a voluntary process which assures you that the center is committed to quality care and patient safety.
Cost Factor: Your Intraocular Lens
When considering the different types of IOLs, you should be fully informed about what your insurance will and will not cover. Medicare will pay for standard monofocal lenses only. Because insertion of a premium IOL is seen as an elective procedure, most insurance will not cover it.
The fees for premium lenses can be highly variable. If you choose one of these options, make sure you fully understand the costs ahead of time.
When making your decision, compare the cost of the premium lenses to buying eyeglasses or contacts for the rest of your life. If you consider the cost of the eyeglasses/contact lenses and how often you have to replace them, premium lenses may be the most affordable choice.