Cataract Surgery Costs: how much can you expect to pay?

The cost of cataract surgery depends on a variety of factors. These include the type of operation and the choice of intraocular lenses (IOLs). How much you have to pay will also be determined by your insurance cover and Medicare.

In short, a cataract operation on a single eye will come in at between $3,000–$7,000. The following looks at the different factors that determine the final price, and at what Medicare and private insurance will and won’t cover.

Everything You Need to Know about Cataract Surgery Costs

• Cataract surgery costs: the procedure
• Cataract surgery costs: the lenses
• What else affects the price
• What Medicare covers
• What other health insurance covers
• Paying for cataract surgery yourself

Cataract surgery costs: the procedure

Cataract surgery is carried out in one of two ways:

• Traditional cataract surgery: Whereby the surgeon makes a tiny incision near the cornea to allow entry to the inner eye. A probe is then inserted through and into the lens cavity and a laser is used to break down the diseased lens. A monofocal IOL is inserted in its place and the incision is closed without stitches.
• Laser-assisted cataract surgery: The overall procedure is the same. However, a computer is used to create an intricate 3D map of the internal structures of the eye. A laser is used to both make the incision and break down the lens. The IOL is then sited with extreme accuracy. This computer guidance means that more advanced lenses can be used, such as bifocal, toric, and more.

A laser-assisted procedure is the more expensive option. One further advantage of it over the traditional option is that treatment for astigmatism can be carried out at the same time.

Cataract surgery costs: the lenses

The type of IOL you choose will also have a great bearing on the cost. Monofocal lenses are the cheapest (and the only ones covered by Medicare). A monofocal lens will allow you to have good vision either near or far away, with this being supported by eyeglasses to enable good all-round eyesight. Premium lenses can be twice or even three times as expensive as monofocals. However, their popularity is high, thanks to the freedom they bring from corrective lenses post-surgery.

Such lenses include:

• Multifocal implants (bi- and tri-focal): These focus at near, far, and even mid-vision without the use of glasses.
• Toric lenses: Lenses that correct astigmatism.
• Presbyopia-correcting and accommodative lenses: These use the muscles of the eye to focus, and there are various different types.
• Extended vision lenses: As well as allowing great vision at near and medium distances, they also protect the eyes from blue light and UV rays.

Not all lenses are suitable for everyone. Your surgeon will discuss the lens choices with you before the operation, helping you to decide which type will be most suitable and advantageous. The right lens for you will be determined by:

• Your lifestyle
• Your natural focusing ability
• Your insurance cover and/or the price you’re willing to self-fund

What else affects the price

Apart from the type of procedure and the lens you choose, there are some other elements that have a bearing on the cost. These include:

• Pre- and post-op care: A non-complex cataract operation with 1-2 pre-operative visits, regular pain-relieving and antibiotic medications, and 1-2 post-op visits is generally what’s needed. However, co-existing medical and/or eye conditions can increase the need for clinical care and medication. In such cases, the cost of the operation will be higher.
• Where you have the operation: Having the operation done as an outpatient at a hospital can sometimes be more expensive than at an ambulatory surgical clinic.
• Your choice of surgeon: Highly experienced and reputable clinicians can (but not always) command a higher fee.
• The type of surgery you choose: Traditional cataract surgery is less expensive than laser-assisted cataract surgery, which is necessary if you choose premium intraocular lenses and/or you want to have astigmatism treated at the same time.

Cataract Surgery: insurance, Medicare, and paying yourself

• What Medicare covers
• What other health insurance covers
• Paying for cataract surgery yourself

What Medicare covers

You’ll be happy to hear that for most people, at least 80% of the cost of cataract surgery is covered by Medicare. However, it only covers traditional cataract surgery (not laser) and monofocal lenses.

In general, Medicare covers the removal of the diseased lens through traditional surgery, a monofocal lens, and a single pair of eyeglasses. If you choose to undergo laser-assisted cataract surgery and have any advanced, premium intraocular lens fitted, then you will have to pay the difference.

You’re advised to speak to Medicare or your insurance provider to find out what they’ll pay for before committing to any treatment option.

What other health insurance covers

Other health insurance may or may not cover cataract surgery. It’s important to look at your policy to find out what is and isn’t built in. Top-level cover may well include advanced laser cataract surgery and the latest intraocular lenses. However, some policies don’t cover incidentals, such as:

• Screening tests
• Eye exams
• Anesthesia
• Post-op care
• Prescription glasses

Even with insurance or Medicare cover in place, you’ll likely have to pay some out-of-pocket expenses surrounding medication and other deductibles.

Paying for cataract surgery yourself

Self-funded surgery might mean paying for everything related to a cataract surgical procedure, or paying the deficit between what’s covered and what’s not.

A cataract procedure costs, on average, between $3,000–$7,000 per eye. As we’ve already mentioned, all of the factors above will impact where in that range your own operation falls — above all, the type of surgery and the lens you choose.

Being as the procedure is one of the most commonly carried out in the world, the cost might not be as prohibitive as you think. And while selecting laser-assisted surgery and a more advanced lens might seem expensive, most people are delighted with the resulting improvement in their quality of life.

Use our directory to find a top cataract surgeon near you and compare real patient reviews before you decide.