A cataract is a painless, cloudy area in the lens of the eye. The lens is enclosed in a lining called the lens capsule. During cataract surgery in San Clemente, your doctor separates the cataract from the lens capsule. In most cases, the lens is replaced with an intraocular lens implant (IOL). In most instances, with certain limitations, cataract surgery costs are covered under both private insurance plans and Medicare.
Private Insurance
Private insurance for cataract surgery is usually quite comprehensive but also quite variable. In most instances, private insurances cover a portion, if not all, of the Cataract Surgeon Fee, the Facility Fee, the cost of a Monofocal Lens Implant and the necessary follow up care after your Cataract Surgery. Private insurances vary in the deductible that they may require, the co-pay you might be responsible for and the percentage of each allowable expense that they might reimburse.
Medicare Insurance
Medicare for cataract surgery is also quite comprehensive. Medicare generally covers a portion of the Cataract Surgeon Fee, the Facility Fee, the cost of a Monofocal Lens Implant and the necessary follow up care after your cataract surgery. It is likely that you will be responsible for a co-pay or a deductible for the pre-surgery office examination, consultation and measurements for your cataract surgery. If you need a pre-surgery physical with your medical doctor, you may also be responsible for that physician’s co-pay as well. In addition, if you require anesthesia, while your insurance will cover the allowable anesthesia expense, you may be responsible for the anesthesia co-pay and/or deductible.
It is important to note that insurance may not cover the cost of advanced technology lens implants. The amount of coverage, deductibles and any co-pays are uniquely individual to each patient’s specific health insurance policy.
To find out if your insurance plan will cover the cost of cataract surgery in San Clemente, contact Harvard Eye Associates at 949-951-2020 or harvardeye.com.
