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Lower Medical Bill Costs For Cataract Surgery

Patients can minimize their cataract surgery costs by selecting economical lenses and providers. There is lots of biased information available on cataract surgery costs because cataract lenses are a "big business" for manufacturers, surgeons, and surgery facilities. The Medicare program and Medicare people are the most frequent payors of cataract surgery costs.

Cataract surgery Pocketpussytoy lens costs

In case your cataract surgery lens expense is less than $150 per eye, then you definitely cannot be personally billed more for your lenses from the surgeon or surgery center under Medicare rules. If the cataract surgery lens price is a lot more than $150, then Medicare allows the facility to bill you since the patient with an amount within the $150.

Fortunately, the 3 most favored cataract lenses all cost less than $150. These are good lenses and will take care of the problem of cloudy vision. You can't be billed for your expense of these cataract lenses since they are cheaper than $150. The "xx" in the models below indicates a placeholder for size. Collectively, I estimate these three lenses are utilized in over 90% of cataract surgeries.

Most Popular Cataract Lenses:

Model: Acrysof IQ SN60WF "xx"
Company: Alcon
Cost: $150
Under Medicare Limit: Yes

Model: Sofport LI61AO "xx"
Company: Bausch & Lomb
Cost: $150
Under Medicare Limit: Yes

Model: Tecnis ZA9003 "xx"
Company: AMO
Cost: $135
Under Medicare Limit: Yes

Based on my estimates, Alcon's Acrysof IQ above is used within 50% of cataract surgeries and also the Bausch & Lomb's Sofport and AMO's Tecnis make up another 40% of cataract surgeries. These marketshare percentages provide my experience doing work in the ambulatory surgery business and I have not verified them against actual sales data.

Surgeons may attempt to "upsell" you into higher priced lenses that may also correct presbyopia or astigmatism, but you will must pay hundreds of dollars for each lens from the own pocket. Alcon's Toric lenses and ReSTOR lenses here are types of cataract lenses which have large patient out-of-pocket costs.

Cost per Eye of "Premium" Cataract Lenses

Model: Acrysof IQ Toric SN6AT3-5 "xx"
Company: Alcon
Provider Cost: $495
Patient Cost: $345
Under Limit: No

Model: Acrysof IQ ReSTOR
Company: Alcon
Provider Cost: $495-$895
Patient Cost: $345-$745
Under Limit: No

It is considerably less expensive to buy eyeglasses for $120 rather than to pay an extra $690-$1,490 for premium cataract lenses that will correct presbyopia.

Hospital and surgery center costs

Cataract surgery costs to Medicare patients are significantly reduced ambulatory surgery centers than they will be in hospital surgery departments. The surgery costs here are based on 2011 national Medicare rates that may be adjust slightly to your state.

Facility Cataract Surgery Fees for One Eye

Ambulatory Surgery Center
Medicare Pays: $761
Patient Pays: $190

Medicare Pays: $1,307
Patient Pays: $326

Patients will save you 42% off their cataract surgery costs on coinsurance by going to an ambulatory surgery center instead of a hospital surgery department. The Medicare program itself saves big bucks when patients have cataract surgeries performed in true ambulatory surgery centers as opposed to hospitals.

Total cataract surgery cost savings

Therefore if an individual goes to an ambulatory surgery center and chooses one of many three lenses under the Medicare allowable limit described in the following paragraphs, then he or she could save over $1,000 on the cataract surgery costs both for eyes.
  1. 2014/02/06(木) 23:29:11|
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Kaylene Dearborn

Author:Kaylene Dearborn
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