How much was your cateract surgery?

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May 28, 2014
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I'll be getting cateract surgery done in both eyes and was curious as to how much the surgery will cost approximately with insurance.
 
I would get the best qualified highest rated eye surgeon possible before worrying about the cost. you only have two eyes. My dearest friend is one of the highest rated eye surgeons in the U.S. , he just retired and I have been blessed to be in the operating room observing eye surgeries. So get the best of the best to work on your eyes
 
Depends on your insurance carrier, the contract they have with the hospital and doctor, your coinsurance rate and where you are in your deductible.

Call the hospital and the doctor and ask them to give you an out of pocket estimate.
 
Depends on the insurance you have.

Question is it absolutely necessary at this time? Having vision issues that warrant it now?

Do some reading + view some YouTube videos on the pro and cons.
 
I would make sure the doctor had a good reputation before cost. I had it done 12 years ago i lost my eye sight in that eye right after the surgery
 
I had cataract surgery on one eye about 6 years ago and had the other one done about 18 months ago. My out of pocket was iirc about $300 for each eye. I was covered on my wife's BCBS insurance with the USPS. According to her BCBS statements, about $7,000 for each eye. Actual procedure took less than 10 minutes per eye. He had 30 cataract procedures scheduled the day I had my second eye done.
 
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I had my right eye done, $5k out of pocket after insurance but I had the laser surgery and the custom lens. Going to go cheap on my left eye. Not impressed with the new lens at night.
 
I have a Medicare Advantage plan and the surgery on both my eyes did not cost me any out of pocket including follow up visits. However, I did have an initial $40 co-pay for my first visit to the eye doc when he approved me for the surgery.
 
wow.. my mom and cousin had this done, and it was about $2000 per eye, which is what medicare would pay for.. Other's saying $9k wow..
 
My dad had both eyes done at different times. His doctor was very old and messed up the second eye. He had to have it fixed by a much younger and more skilled eye surgeon. If the more skilled surgeon had done it in the first place it would have been done correctly without having to have it redone.

One of the questions to ask is what is the name of the doctor they send people to to fix a bad eye operation?
 
It depends on the lens and type of surgery you pick. My wife just had it done with laser surgery and the most expensive lens. Before insurance it was $7K per eye. There were two cheaper lenses - exact prices I don't remember.
 
I think all costs included was $5k per eye (and there are a lot of costs).
My guy doesn't take insurance; you pay out of your pocket but they will help you fill out forms if you want to send them to your insurance company.
 
Originally Posted by tc1446
My Medicare covered it all but $200 per eye, but feedback I got was 9K per eye.


9k cuz they used the MOST expensive lens, which prolly has a 9000% markup by the practice.
 
Originally Posted by spackard
I think all costs included was $5k per eye (and there are a lot of costs).
My guy doesn't take insurance; you pay out of your pocket but they will help you fill out forms if you want to send them to your insurance company.


Wow, was he considered out of network by insurance?
 
Originally Posted by researcher
wow.. my mom and cousin had this done, and it was about $2000 per eye, which is what medicare would pay for.. Other's saying $9k wow..

In healthcare, there are different dollar amounts. There is gross charges, which is what their price is. No one pays that, except those without insurance. Then there are contracted prices that different insurance companies negotiate that are lower than the gross charge. Then there is out of pocket expense which is what insurance companies have their customers pitch in.
 
I had a necessary toric lens inplant in 2014. Out of pocket cost for the more expensive lens was about $1500. I only needed one lens. Both my wife and I got "near vision" lens. Makes it easier to use the computer and watch TV and you still see well enough to drive.
 
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Originally Posted by stockrex
Originally Posted by spackard
I think all costs included was $5k per eye (and there are a lot of costs).
My guy doesn't take insurance; you pay out of your pocket but they will help you fill out forms if you want to send them to your insurance company.


Wow, was he considered out of network by insurance?


It's a long story, but the office administrator did some calculations one month and found the doctor was net about $30 a patient, and dealing with insurance was harder and harder. They decided they had to drop all insurance
companies and make a go on a cash-only basis. Happened in 2010, if I recall correctly.

I signed an acknowledgment that said I'm responsible for the bills, that any reimbursement I want from my insurance
is something I'm responsible for handling.

Plus side for me is I know exactly how much everything involved with his office is going to cost. Pay once, up-front, his cost.
He's a resident at a hospital where he performs the surgery. Hospital's costs are probably $3k of the $5k, and bills trickle in (anesthetists are the slowest, takes about 6 months to get their bill).

Insurance treats him as out-of-network (he's not a member of any insurance network).
They still send me the itemized statement, claiming to "discount" his prices by some fictitious amount,
then claim they reimburse 50% of that discounted amount. So, insurance probably only reimburses 30% of his costs.
They do better on the hospital in theory, because the hospital inflates, insurance deflates, then reimburses at 80%.

He's a good doctor; travels to different countries to teach others his technique.
Go at the right time of day and you can hear the kids shouting karate yells from the suite next to him.
So, a modest office in a good community. I was referred to him from an optometrist in a Costco.

Didn't seem fair to me the guy who's got the skill only netted $30 per patient.
 
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@spackard the hospital bills are likely to be separate from the doctors fees. Ask and make sure - there are a number of arrangements for surgeries but the most common is that the hospital and surgeon bill separately.

The net $30 is probably after surgeons salary. They gross starting at $500k/year in my area.
 
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