Medically Reviewed by: Mark L. Mayo, M.D.
What is the Cost of Cataract Surgery in Texas?
One of the first questions many of our Houston patients ask when considering eye surgery is, “What is the cost of cataract surgery in Texas?”
If you have cataracts, the cost of cataract surgery should not be a barrier to the care that you need to regain useful vision. In almost all instances, cataract surgery costs are considered reimbursable expenses under both Medicare and private health insurance plans. That said, the average cost of cataract surgery with private health insurance is approximately $3,000 — though this price can vary based on whether you choose laser cataract surgery vs traditional cataract surgery and other individual factors including where the patient lives.
In this article, Eye Center of Texas will outline what you can expect to pay if you have private health insurance or Medicare in Texas for cataract surgery.
Questions to ask about laser cataract surgery cost
If you are considering bladeless cataract surgery in Houston financial factors you should become familiar with include:
- How much will I need to pay out of pocket?
- What deductibles might apply?
- What co-pays might apply?
- What services might not be covered or require additional payment?
For the vast majority of people, their insurance by itself or in conjunction with Medicare is going to cover the bulk of the cost of cataract surgery.
Cost of cataract surgery with insurance
When considering the cost of cataract surgery in Texas, it is important to understand how your insurance plan will cover treatment. Depending on the type of health insurance plan you have, your coverage of cataract surgery costs could vary depending on the deductible that you may be required to pay, the co-pay you might be responsible for, and the percentage of each allowable expense that they might reimburse.
For patients that have a high-deductible health plan (HDHP), the average cost of cataract surgery can be slightly higher. These plans often cover a certain percentage (usually 80%) of the cost after meeting a large deductible up-front. The remaining balance is then the responsibility of the patient to pay.
In most instances, private insurances cover a portion, if not all, of the:
- Cataract surgeon’s fee
- Surgery facility fee
- Cost of a Monofocal Lens Implant
- Necessary follow-up care after your surgery (learn more about what to expect during cataract surgery recovery)
Please remember: the deductibles, the percentage coverage, and any co-pays are individual to your specific insurance plan.
Is cataract surgery fully covered by Medicare?
For patients 65 and older, you may be eligible for Medicare coverage. Cataract surgery is a covered benefit under Medicare, and the cost is largely dependent on where the patient lives and what the Medicare-approved rate is in that area.
However, cataract surgery is not typically 100% covered by Medicare. In most cases, the patient is responsible for a co-pay at the time of service and a small copayment for their cataract lenses.
Medicare will pay 80% of the “Medicare allowed” charges for your Cataract Surgery costs and it is likely that you will be responsible for the 20% difference remaining. If you have secondary insurance, this can be used to cover the 20% of the Medicare allowable charges remaining. In this case, you’ll want to be sure you bring this up with your doctor prior to your surgery.
Keep in mind that “Medicare” determines what is “allowed” and the cataract surgeon needs to agree to this determination although you can typically expect Medicare to cover a portion, if not all, of the:
- Cataract surgeon fee
- Surgery facility fee
- Cost of a Monofocal Lens Implant
- Necessary follow-up care after your surgery
If you plan on utilizing your Medicare coverage for cataract surgery, please ensure that you are working with eye doctors that take Medicare.
Does medicare pay for all cataract surgeries?
Medicare will cover the cost of a basic Monofocal Lens Implant but requires that you pay individually (aka out of pocket) for the cost of Astigmatism Correcting Toric Lens Implants, Multifocal Lens Implants, and for the use of the LenSx Laser technology. Any additional fees for the cataract procedure will be reviewed with you by the staff and convenient arrangements for payment will be made.
Please note: advanced technology lens implants will require additional testing that is not covered by Medicare or private insurance. The cost is $95.00 per eye and is strongly recommended by our cataract surgeons Dr. Mark L. Mayo and Dr. Edward C. Wade.
Transparent billing at the Eye Center of Texas
What is the cost of cataract surgery? While the number varies greatly, at Eye Center of Texas, we strive to make cataract surgery available and affordable to patients with or without health insurance. We are committed to working closely with our patients and their insurance provider to maximize the coverage available for cataract surgery.
Our team will help you understand the differences between your health insurance coverage options so that you can make an informed decision about your cataract surgery. Any additional fees will be reviewed with you by the staff and convenient arrangements for payment will be made.
Call us today at 713-797-1010 to schedule a consultation or request an appointment online and discover the cost of cataract surgery in Texas.
More Helpful Articles by Eye Center of Texas:
- What Are The Symptoms of Glaucoma
- What You Need To Know About Laser Eye Surgery Dry Eyes
- ICL Eye Surgery Recovery Time
- What Are The Three Types of Cataracts?
- How to Relieve Contact Lens Intolerance
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