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Without insurance, the average cost of cataract surgery is between $3,500 and $7,000 per eye in the United States.
However, Medicare and private insurance plans often cover all, or a portion of the costs.
This can reduce your out-of-pocket expenses by 80 percent or more.
The main factors that affect the price of cataract surgery include:
These variables will affect the on-paper cost of your cataract surgery.
But the biggest factor in determining your out-of-pocket cost is your health insurance coverage.
Yes, basic cataract surgery is covered by Medicare. Your doctor or ophthalmologist must determine that the surgery is medically necessary for your health.
Medicare typically covers 80 percent of expenses related to cataract surgery. It also covers one pair of eyeglasses or contact lenses after the eye surgery.
Medicare Part A covers hospital stays and other inpatient procedure costs. Most cataract surgeries will not require the patient to remain overnight. But if yours does, your hospital expenses should be covered by Part A.
Medicare Part B covers medically necessary health care procedures and services.
Part B will cover:
Here are some things to take into consideration regarding Medicare coverage:
These services can double or triple out-of-pocket expenses.
It is possible to purchase a โMedigapโ insurance policy from a private health insurance company. These plans are meant to provide supplemental coverage for health services not covered by Medicare. They often cover premium cataract eye surgery.ย
Speak directly with your Medicare representative before having cataract surgery to determine the total cost of your operation.
Most health insurance providers consider cataract surgery to be medically necessary. Therefore they will cover at least a portion of the costs associated.
Cigna, Aetna, United Healthcare, and other smaller insurance providers will all cover a significant part of your cataract surgery.
Speak directly with your healthcare provider to find out what is covered by your plan.
Policies vary widely from one insurance provider to the next.
Here are some questions you should ask your health care representative regarding cataract surgery:
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