Many Houston patients ask, “How much does cataract surgery cost?” If you have cataracts, the cost of cataract surgery should not be a barrier to the care that you need to regain useful vision. In almost all instances, cataract surgery costs are considered reimbursable expenses under both Medicare and private insurance plans. If you are considering bladeless cataract surgery in Houston you should become familiar with:
- How much you might need to pay out of pocket
- What deductibles might apply
- What co-pays might apply
- What services might not be covered or require additional payment
For the vast majority of people, their insurance by itself or in conjunction with Medicare is going to cover the bulk of the cost of cataract surgery.
Private Insurance and Cataract Surgery Costs
In most instances, private insurances cover a portion, if not all, of
- The cataract surgeon’s fee
- The surgery facility fee
- the cost of a Monofocal Lens Implant
- The necessary follow up care after your surgery
Coverage of laser cataract surgery costs vary in the deductible that you may be required to pay, the co-pay you might be responsible for and the percentage of each allowable expense that they might reimburse. Please remember: the deductibles, the percentage coverage, and any co-pays are individual to your specific insurance plan.
What to Expect at the Eye Center of Texas
When you visit Eye Center of Texas a member of our staff will review the details of your insurance coverage and let you know what your coverage is and what out of pocket expenses, if any, will be required of you. It is likely that you be will responsible for a co-pay or a deductible for your evaluation, but this depends on your insurance plan.
One item to be aware of is that insurance companies only cover the cost of a traditional Monofocal Cataract Lens Implant to correct vision after cataract surgery. Most, if not all, require that you individually pay for the cost of Astigmatism Correcting Toric Lens Implants, Multifocal Lens Implants and the use of the LenSx Laser technology. Any additional fees will be reviewed with you by the staff and convenient arrangements for payment will be made.
Medicare and the Costs of Cataract Surgery
Medicare coverage for laser cataract surgery is also quite comprehensive. Medicare covers a portion, if not all, of:
- The cataract surgeon fee
- The surgery facility fee
- The cost of a Monofocal Lens Implant
- Necessary follow up care after your surgery.
It is likely that you will be responsible for a co-pay or a deductible for the initial evaluation.
Medicare will pay 80% of the “Medicare Allowed” charges for your Cataract Surgery costs. Medicare determines what is “allowed” and the cataract surgeon agrees to this determination. Under Medicare coverage, it is likely that you will be responsible for the 20% difference remaining between the fee collected by the surgeon from Medicare and the actual “Medicare Allowed” charges. Many Medicare beneficiaries also have secondary insurance to cover their “20%” of the Medicare Allowable charges. If you do please make sure to bring this to the attention of our staff.
Medicare will cover the cost of a basic Monofocal Lens Implant. Medicare requires that you pay individually (aka…out of pocket) for the cost of Astigmatism Correcting Toric Lens Implants, Multifocal Lens Implants and for the use of the LenSx Laser technology. Any additional fees for the cataract procedure will be reviewed with you by the staff and convenient arrangements for payment will be made.
Please note: advanced technology lens implants will require additional testing that is not covered by Medicare or private insurance. The cost is $95.00 per eye and is strongly recommended by our cataract surgeons, Dr. Mark L. Mayo and Dr. Edward C. Wade.
Now that you can better understand how much cataract surgery prices and costs, it’s time to take the next step. Schedule a cataract consultation, or call us today: 713-797-1010
If you have more questions about cataracts, visit our FAQ page that answers common cataract surgery questions and helps you know what to expect with cataract surgery.