Cataract surgery cost depends on four main variables:
- Type of procedure
- Type of cataract surgery facility (hospital vs. ambulatory surgery center)
- Location of cataract surgery facility (cost-of-living affects healthcare prices and cataract surgery cost)
- The intraocular lens (IOL)
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.
It is more cost efficient to have cataract surgery 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 copay.
When patients choose to use an ambulatory surgery center, most find the process is much more convenient and personal. ASCs offer a relaxed environment with everything in 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 percent less than in a hospital, saving on average over $140.
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 you’re considering 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.