Pain-free Cataract Surgery

May 9, 2016

  1. somarco
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    somarco GA Medicare Expert

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    Doing a bit of research for a client that will be having cataract surgery. I normally avoid consumer sites, especially in matters like this but was blown away by some of the comments here.



    Jacasa -
    I have medicare and a supplemental healthcare plan. Imagine my surprise when I found out medicare does NOT approve the anesthetic used during cataract surgery. Since medicare doesn't cover, the supplemental won't pay a dime.

    Ouch -
    Just assisted my mom - one special implant (Toric)- one not. Out of pocket was about $2500 total for both eyes . One Rx of eye drops (there are 3 different eye drops for pre & post op) was $175 PER OUNCE - no generics available - she needed 2 complete sets (one for each eye). Toric lens costs $900 that Medicare paid zero on. Be prepared - " Medicare pays 100% of nothing" is the best advice we were given. Will spend over $500 for eye drops alone - not covered.

    https://www.caring.com/questions/does-medicare-cover-cataract-surgery


    Where do people come up with this stuff? Makes me wonder if some of these comments come from people with MA plans.

    Had a client last year get cataract surgery. Don't recall which type of lens implant he got. Guy is a personal trainer. A 70 year old bull but I doubt he had surgery without anesthesia.
     
    somarco, May 9, 2016
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  2. insuranceconceptscindy
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    insuranceconceptscindy Guru

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    Medicare covers basic cataracts surgery- none of the special lenses. It doesn't cover the eye drops needed before and after surgery, however the PDP plan does. Some of the drops are really expensive, some not. It will cost you a few hundred dollars, even with plan F, due to the drops. I think they need antibiotic drops and maybe some for eye-pressure, but I'm not an ophthalmologist- I just play one on the internet.
     
  3. FLM2
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    FLM2 Guru

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    I can only speak for my own, personal experience with cataract surgery about 2 years ago while on a Coventry MAPD plan.
    • Copay for the outpatient surgery was $195
    • Copay for the eyedrops (3 different ones) was about $100 in total

    The MAPD plan covered everything else with the exception of the multifocal Crystallens I chose to have inserted (cost was $2750). A standard, single focal lens would have been part of the surgical procedure with no additional cost.

    I believe the anaesthesia used was Propofol which is supposed to put you into a 'twilight' mode but I have no memory of the surgery (which lasted 15 minutes) after the surgeon tilted my head to strap me in. I certainly had no pain before, during or after the surgery.

    I walked out of the surgical center seeing 20-20 out of the eye (it had been 20-200 prior to the surgery) and while I now use 1.5X reading glasses for my computer (it reduces eye strain when working for a full day) there have been no issues.
     
    FLM2, May 9, 2016
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  4. yogooglethis
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    yogooglethis Guru

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    Since MA covers everything that original medicare does , and often even more, i would say these comments are from people who don't understand the limitations of original medicare and the med supps that supplement original medicare as well.Biggest consumer misconception about med supps is that because they have hefty monthly premiums that they pay for any service provided their doctor- whether it's medicare approved or not.
     
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