Cataract Surgery And Medicare: How Much Of The Surgery Is Covered?


When you are a retiree and you are faced with cataract surgery, you may be wondering what the cost out-of-pocket will be. Even though you have Medicare insurance from the government, there is still going to be some portion that you pay for. Here is how you can figure out what the surgery will cost you.

Check Medicare Parts A and B

Medicare Part A covers in-patient hospital stays, including any meals you will need and your room. Most of the time you will not need even half a day's stay for cataract surgery because the surgery is commonly performed on an outpatient basis. However, if there are complications, you will need to stay longer so your optometrist and your general physician can monitor and treat the problems. As long as you have met the deductibles required by the government, everything else is covered.

Medicare Part B covers your outpatient care, such as pain relievers and follow-up visits. Whatever co-pays you typically have for any of your doctor visits and medicines you can expect to continue paying after your surgery. Your doctor may suggest cheaper, over-the-counter alternatives to prescription medicines for which you would not have to file a Medicare claim.

Ask Several Optometrists What They Charge

Usually there are flat rates for most of the services provided by optometrists, and their administrative or billing staff can run a printout for you of all of the expected charges. In most cases you will find that the estimates for routine cataract surgery are neck-and-neck, with some optometrists charging slightly more and others charging slightly less. (If you opt to have laser cataract surgery, you will pay more than for traditional surgery with a scalpel.) Then you can use the coverage amounts found in your Medicare policy to estimate the total out-of-pocket expense before selecting your optometrist for surgery.

An example of the cost to you looks something like this:

The optometrist charges $5000 for the surgery, of which Medicare covers 80%. $5000x.8=$4000 covered by Medicare. That leaves you with $1000 for which you will have to pay.

Saving Money for Your Portion of the Bill

Given the previously-mentioned example, it may be very difficult for you to come up with $1000. If you schedule your surgery for about five months ahead, you can save about $200 every month until then. Most optometrists will not allow patients with cataracts to go longer than that so that the health of the patients' eyes is maintained. If you still cannot pay your portion of the expenses, you may be able to work out a plan with your optometrist and/or the hospital.


13 August 2015

Need an Optometrist? Improve the Health of Your Vision Here

If your vision isn't as good as it used to be, you need to see an optometrist. I developed an uncontrollable twitch in both eyes. The problem became so bad that it interfered with my sleep at night. I became cranky, irritable and extremely self-conscience about my problem. At times, I couldn't see anything, even if it was close to my face. But after speaking to my regular doctor about my twitchy eyes, they referred me to an optometrist for an eye exam. The optometrist diagnosed me with poor nerve function. If I didn't do something about it, I'd lose my vision. My eye doctor prescribed eyeglasses to help me see better until I underwent surgery to repair the damaged nerves in my eyes. Now, I see just fine. If you want to know more about protecting your vision, keep reading my blog.