How much for a cataract?

[cbo111]

So, I have a friend of who needs a cataract removed in one eye, but has no insurance. She is in late 50's, too far from medicare. I was wondering if anyone out there has paid out of pocket for the surgery? Depending on the cost, I am considering gifting her the procedure. Anyone out there pay for a cataract recently?

 

[MRG]

Here's an idea at a point in time:

https://restorationeyecare.com/2014/the-cost-of-cataract-surgery/


There are many variables in the cost of cataract surgery: type of intraocular lens (IOL), type of preoperative testing (basic or basic*plus refractive), geographic location (urban vs rural), and length of postoperative care.

According to AllAboutVision.com’s 2012 report, the average, basic cataract surgery in the US would cost roughly $3,429 per eye if you paid everything yourself. If you wanted an advanced technology lens which corrects astigmatism or presbyopia, expect to pay an additional $449 or $895 per eye.




I'm guessing if you offered to pay what Medicare does in cash they'd be able to make the surgery happen.

What would happen if things went badly?

 

[braumeister]

When I had my cataract surgery five years ago, the hospital billed about $6,300, the anesthetist $300, and the surgeon $1,500 (all those are per eye). Medicare approved amounts considerably less than half those numbers. I had basic lens implants.

DW had hers done recently, so we don't have the billed amounts yet, but the extra wrinkle was that she had severe astigmatism and needed toric lenses. They cost $1,600 each and are not covered by Medicare so we paid out of pocket in advance for them.

 

[W2R]

Perhaps she should broach that subject with her surgeon, and with the facility he uses. She needs to know.

On the other hand, getting cataract surgery is not optional, IMO - - it is needed, especially if she has one in her other eye too that is not as large but growing. You can't drive when your cataracts get bad enough, and eventually you can barely walk because you start running into things. I let mine go a long time out of fear, and got to that point. I think one would eventually become legally blind.

If her surgery costs too much for you to pay for it, you and she need to find some way for her to afford it. Maybe the doctor would do it as an act of charity. Maybe some charitable organization (Lighthouse for the Blind?) could at least point you in the right direction.

I was 67 when I had my cataract surgery, and with Medicare plus my insurance I did not pay one cent except for my share of the cost of the eyedrops, which was $142.50. I don't remember what they billed Medicare, but those numbers are probably all fictional anyway. Medicare pays what it is going to pay.

Once she has her surgery or surgeries done, she may need your help around the house now and then for a week or two, for things like grocery shopping, picking up heavy things (which isn't allowed for a while), being driven to appointments with her surgeon, and maybe even doing laundry. Frank was an absolute Godsend at that time, making sure I was resting and recovering and helping with the stuff I felt I couldn't or shouldn't do.

 

[powerplay]

Here is a list of resources to check out and see if one of them may be able to help your friend.
https://nei.nih.gov/health/financialaid

Good luck!

 

[MissMolly]

I just had cataract surgery last month (and this month also). My charges for January were:

X-ray - billed $286. Allowed by insurance $50.96
Anesthesia - billed $280. Allowed by insurance $153.55
Surgery (doctor) - billed $1827. Allowed by insurance - $1,207.11
Hospital services - Billed $4,199. Allowed by insurance - $4,199.

I would imagine once all the bills come in for this month's surgery they will be similar.

 

[Winemaker]

DW had laser surgery for her cataracts in November/December of 2017. She was quoted $2500 per eye, but one eye did not require astigmatism correction so $1000 credit. If she had "normal " surgery, it would have run $300 total, as insurance doesn't cover the laser method.

 

[Sunset]

OP - Sounds like the perfect go-fund me type of thing. Perhaps include a photo close up of the eye so folks can see it. Probably best if you have some quotes from hospitals as target amount to collect.

Another thought, if paying cash, shop around the country as surgery costs vary a huge amount by State (and even hospital).

 

[zinger1457]

The BCBS-AZ health cost estimator shows a range of $1989-$3979 for a cataract removal and lens replacement, depending on the local facility used.

 

[FIRE'd@51]

When I had my cataract surgery five years ago, the hospital billed about $6,300, the anesthetist $300, and the surgeon $1,500 (all those are per eye).

Why would the hospital charge be per eye? Also, don't most opthalmologists perform the surgery in their office?

 

[braumeister]

Why would the hospital charge be per eye? Also, don't most opthalmologists perform the surgery in their office?

Because they were done a month apart.
No.

 

[MichaelB]

I had cataract surgery 4 years ago. The total cost for cataract removal and simple lens replacement was $3700 per eye. Eye drops (pre and post) were another $200.

The hospital gave me an estimated total cost before the surgery, and this is the only time for DW or me that the amount billed by the hospital 1) included everything in one invoice, and 2) was the amount covered by the insurer, with no subsequent price adjustments.

 

[ShokWaveRider]

Cost me $100 CoPay (No Deductible) 4 years ago for each eye with my ACA plan (Outpatient surgery). Drops were about $15 I think. The Actual Costs were about $2700 per eye and I think the anesthetic was a separate charge, I cannot remember exactly. So I will take Michael's quote above as pretty accurate for the time.

 

[cbo111]

Thanks for all the good feedback. I think the best plan is to let my friend know that I am willing to contribute a fixed $$ amount, then let her find a surgeon and handle the details.