What Does Cataract Surgery Cost?
Cataracts impact a staggering number of people in the United States. According to the CDC, approximately 20.5 million Americans over the age of 40 have cataracts. Fortunately, getting cataracts removed is a safe and common procedure. In fact, about 3 million cataract surgeries are performed across the United States every year. If you’re one of those patients considering cataract surgery, one of the primary questions on your mind is likely, “How much will it cost?” The simple answer is the average cost of cataract surgery in the United States ranges from approximately $3,500 to $7,000 per eye. However, this price can vary depending on a number of different factors. Everything from the specifics of your case, your insurance coverage, and the location where you receive treatment can impact your final bill.
At Cincinnati Eye Institute, we believe quality eye care should be as widely available as possible. Your vision is such an important part of your life. You shouldn’t have to suffer in silence as cataracts keep you from doing the activities you love like watching TV, reading, playing outdoor sports like golf or tennis, and more. Read on to learn more about what goes into pricing for cataract surgery, and the different ways to make it affordable.
Factors That Influence the Cost of Cataract Surgery
Cataract surgery is not a one-size-fits-all procedure, and its final cost can vary based on multiple factors. Everything from the type of procedure you need to the place you get your surgery can change the price tag on your cataract surgery.
Types of Cataract Procedures
There are a couple of different types of cataract procedures that are possible for you to get. Whichever one you choose can determine the cost of your cataract surgery as well as how you may be able to pay for it.
Traditional Cataract Surgery uses a handheld blade to create an incision and remove the clouded lens. Technology for traditional cataract surgeries has come a long way. A common type of traditional cataract surgery used is called phacoemulsification. During this surgery, a blade is used to make an incision in the cornea and then a handheld ultrasonic probe is inserted to break up the cataract into pieces which are then removed. Traditional surgery methods are often less expensive and usually covered by insurance.
Laser-Assisted Cataract Surgery uses advanced laser technology (femtosecond laser) to create precise incisions and break up the cataract, resulting in greater accuracy and faster healing times. The laser can also help correct astigmatism too. However, laser-assisted surgery is often more expensive because of the cost of the equipment and the training your surgeons need to operate it. Additionally, your insurance may not cover it because it is often seen as an elective procedure.
Ultimately, the surgical method you choose should be based on what you and your doctor think is best to meet your vision needs.
Lens Selection
During cataract surgery, the clouded natural lens is replaced with a brand new artificial lens called an intraocular lens (IOL). There are several different types of lenses that range from correcting a simple type of vision problem, such as nearsightedness or farsightedness, to correcting for multiple vision issues, or even having the ability to be adjusted after surgery. Before surgery, your doctor will give you a choice of IOLs to choose from. Based on what you select, your total surgical cost will vary to include the cost of the new lens.
There are two categories of IOLs:
- Standard (monofocal)
- Premium (multifocal/adaptive)
Standard or monofocal IOLs are covered by most insurance plans. They correct vision at one distance (far or near), and glasses may still be needed for reading or driving. If you only need correction for one type of vision and don’t have an astigmatism, monofocal lenses may be a well-rounded cost-effective option for your surgery.
Premium IOLs are a broad category that essentially consists of all other types of IOLs that correct for multiple types of vision issues, or are adaptive. These include multifocal lenses, toric lenses, extended depth of focus lenses (EDoF), and light-adjustable lenses (LALs).
Multifocal IOLs function similar to bifocals or trifocals. They correct for multiple vision issues by creating “vision zones” you concentrate on to see better close up, at medium distances, or long distances. For patients with presbyopia (aged eyes that have trouble seeing up close), multifocal lenses may allow you to go without reading glasses. However, these lenses are more expensive than monofocal IOLs.
Toric IOLs are designed to correct for astigmatism. The lens is shaped in a particular way to compensate for the irregular curvature of the cornea, allowing light to focus more directly on the retina. Extensive work goes into creating this lens to the patient’s needs, so it is more expensive than some other IOLs.
Extended Depth of Focus IOLs are used to correct for multiple vision fields like multifocal lenses. However, unlike multifocal lenses that have different vision zones, EDoF IOLs have a single, elongated vision field. This allows the lens to correct for multiple types of vision deficiencies at once.
Light Adjustable Lens IOLs (or LALs) are unique in that they’re designed to be adjusted further after surgery. During the surgery, the doctor implants the lens in the eye and adjusts it to generally correct for your vision issues. After the eyes have healed, the patient returns for a follow-up appointment during which the surgeon will use ultraviolet light to further shape the lens, providing even sharper vision. The additional ability to further customize vision correction after cataract surgery makes this lens highly adaptable to a patient’s vision needs, but also adds to the total price tag (including follow-up appointment costs).
Keep in mind that insurance may not cover premium IOLs, so a portion of your surgical costs may need to be out-of-pocket.
Surgeon’s Experience & Facility Fees
Cataract surgery may be a safe and common procedure, but it still takes a lot of training to perform. Additionally, the type of facility where the surgery is performed can also impact the cost.
A highly experienced surgeon with thousands of cataract surgeries under their belt and who has been trained on the latest cataract surgical technologies will likely charge more than a surgeon with less experience.
Aside from doctor expertise, getting your cataract surgery in an ambulatory surgery center (such as the surgical centers at CEI) is typically less expensive than getting your surgery at the hospital. This is because hospitals charge fees to use their facilities and equipment, which are typically billed to the patient. Ambulatory surgical centers are operated in many cases by the ophthalmologists themselves and are just as well equipped, if not better equipped, than hospitals to do specific cataract surgery you need. Keeping fees lower means less costs for patients to worry about.
Pre- and Post-Operative Care
One factor that many patients don’t take into account when shopping costs for cataract surgery is what happens before and after the operation. Prior to your surgery, your doctor may ask to run tests, take imaging, or even digitally map your eye to allow for a smoother procedure. While these services may be billed separately from the surgery itself, it all adds up. Likewise, follow-up visits after the surgery, additional medications to help eyes heal and encourage healthy tear production, and protective eyewear after your procedure may all be required, further adding to the total cost of your surgery.
Keep this in mind when looking at cost averages, because those numbers don’t necessarily tell the whole story. But also understand that much of this is necessary to help achieve your best vision after cataract surgery.
Geographical Location
The location where you get your cataract surgery can determine its cost. Cost of living and average overhead for facilities are both factored into the cost of goods and services where you are, and cataract surgeries are no different.
For Ohio, the average price of cataract surgery is $2,630 at surgical centers, and $3,844 at outpatient hospitals. The median price per eye for cataract surgery in Cincinnati is $1,714.
Does Insurance Cover Cataract Surgery?
As briefly discussed above, insurance does generally cover some cataract surgeries and IOLs, though not all of them. Most eye insurance providers will cover medically necessary cataract surgery (cataracts are significantly obstructing your vision) and monofocal IOLs. It’s different from policy to policy.
Medicare Part B typically covers standard cataract surgery if it’s deemed medically necessary. Usually it will cover traditional surgical procedures and the cost of a monofocal lens. If patients want laser surgery or premium IOLs, they may have to pay co-payments, deductibles, and additional fees.
It’s important to understand what your insurance covers and what you are likely required to pay before your cataract surgery. To better understand what your insurance covers (and to give you more peace of mind) call your nearest Cincinnati Eye Institute to discuss what insurances we accept.
If you are uninsured, there are still options to make cataract surgery affordable. You may have a Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA) through your employer. These are specialized benefits that use pre-tax contributions to pay for medical needs. Cataract surgery is usually considered a qualified expense that allows you to use your HSA and FSA funds. Speak with your employer to learn more about what benefit plans you might qualify for.
Finally, for those that don’t have insurance or medical benefits, Cincinnati Eye Institute accepts the CareCredit credit card for out-of-pocket expenses. If approved, patients can take advantage of promotional financing options with convenient monthly payments.
Book Your Cataract Surgery Consultation at Cincinnati Eye Institute
Understanding the costs associated with cataract surgery is a crucial step in your vision care journey. While prices can vary, based on a number of different factors, many insurance plans cover standard procedures, and financing options are available for out-of-pocket expenses.
At Cincinnati Eye Institute, we provide expert care with leading-edge technology to ensure the best possible results for our patients. Our board-certified ophthalmologists are among the top specialists in the region with years of experience helping patients just like you reclaim their best vision with cataract surgery. While we offer phacoemulsification cataract surgery, our doctors are also trained in the latest advanced surgical techniques using the most advanced cataract surgery technology. For those who are worried they may not be able to afford cataract surgery, we provide transparent pricing, financial resources, and tailored treatment plans to meet your eye care needs. Cincinnati Eye Institute believes your vision should come first.
If you’re ready to take the next step toward clearer vision, contact Cincinnati Eye Institute today to schedule a consultation. Our expert team will assess your needs, provide a personalized cost estimate, and answer any questions about insurance coverage and financing options. Give us a call to book your appointment.