Cataract Surgery

[kristinaFL]

I have a 63 yr old female who needs cataract surgery. Can anyone recommend best carriers/plans on FL exchange? Am I correct in assuming as long as it's medically necessary falls under outpatient surgery? She is looking at Ambetter Standard Expanded Bronze HMO plan, but I can't locate EOC anywhere.

 

[adjusterjack]

Here's a link to their website which appears to have benefit summaries for their Florida plans.

2025 Brochures HMO

www.ambetterhealth.com

When my cataracts advanced to a medical necessity they were done on an out-patient basis.

 

[Jim Wright]

I have a 63 yr old female who needs cataract surgery. Can anyone recommend best carriers/plans on FL exchange? Am I correct in assuming as long as it's medically necessary falls under outpatient surgery? She is looking at Ambetter Standard Expanded Bronze HMO plan, but I can't locate EOC anywhere.

If someone needs outpatient surgery, I would not put them in a Standard bronze plan. They'll likely get no cost share because that deductible will be higher than the surgery.

If the provider is in Ambetter's network, the Elite bronze has a $0 ded so they can get the 50% coinsurance right away.