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Cataract Surgery FAQ's
We are all born with a clear lens inside our eyes, and over time that lens becomes cloudy. The cloudy lens is called a “cataract”. The cataract can cause decreased vision, difficulty reading, as well as glare with bright lights. If not removed, a cataract can progress and eventually cause blindness. When a cataract is removed, it is replaced with a clear artificial lens implant (IOL). This helps in restoring vision!
What is a Cataract?
Which IOL (lens implant) is right for you?
When to have Cataract Surgery?
You're the boss. If you are struggling with your vision with or without glasses due to cataracts, then perhaps it's time to have them removed. But if you're seeing well with or without glasses, then chances are that cataract surgery can wait. If you're not sure and want some guidance, of course we'd be happy to help.
Am I awake during Cataract Surgery?
Sedation is given to help ease anxiety and make you sleepy. The amount of sedation given can be tailored to your needs. Some patients fall asleep from the sedation, while others feel relaxed but don't fall completely asleep.
How long is the recovery?
While many patients can see better within the first 24 hours after cataract surgery, the speed of healing varies from patient to patient. Complete recovery can take a few weeks and up to a couple months.
Does Cataract Surgery hurt?
Can I see what you're doing during Cataract Surgery?
For most patients, Cataract Surgery is painless. The eye is numbed using numbing eye drops and gel.
No. Most patients describe seeing bright light, colors, and shadows during surgery, like a kaleidoscope.
Do I need to wear an eye patch after surgery?
It's important to avoid rubbing your eye after cataract surgery. While patching your eye closed is not necessary, a clear shield that you can see through is provided. This serves as a barrier if you forget and try to rub your eye. We recommend sleeping with this eye shield for the first week after surgery.
How long does cataract surgery take?
Cataract surgery duration depends on multiple factors, such as patient cooperation, density of the cataract, the type of technology utilized, surgeon efficiency, staff efficiency, and the overall complexity of the patient's eye. Routine cataract surgery typically takes about 10-15 minutes to complete. Complicated cataract surgery takes longer. Most centers will ask that you arrive 1-2 hours prior to your surgery for preparation.
Does Cataract Surgery require an overnight stay at the hospital?
Can I drive myself home from surgery?
No. Cataract surgery is an outpatient procedure. Patients go home after the surgery has been completed.
We recommend that a family or friend drives you home from surgery. The sedation and surgery will impact your ability to drive that day. Safety first.
Which lens implant is the best?
There isn't a lens implant that is the "Best" for everyone. The main difference between all the lens implants out there is how you will see after surgery when you're not wearing glasses. If you don't mind wearing glasses at all, even the most basic lens implant can provide good vision quality. However if you want to see well without glasses, then there's advanced lens technology available to help you achieve that goal.
Is Cataract Surgery performed with Laser?
Sometimes. While cataract surgery can be performed safely with or without laser, there are certain advantages of using laser. Laser can be help perform key steps of cataract surgery with high precision. Laser can also be used during cataract surgery to help reduce astigmatism.
What Does Insurance Actually Cover for Cataract Surgery?
When a cataract is considered visually significant, health insurance generally covers:
Removal of the cataract using manual (non-laser) surgical techniques
Implantation of a basic monofocal intraocular lens (IOL)
The medically necessary care associated with the procedure
In general, “visually significant” means that the cataract is interfering with your vision enough that even with glasses or contact lenses, your vision is affecting your ability to perform important activities.
For example, you may have difficulty:
Reading a book or computer screen
Seeing street signs
Driving, particularly at night
Seeing clearly in low-light conditions
Dealing with glare from headlights or other lights
Seeing without requiring significantly more light than you previously needed
Your insurance company may have specific documentation requirements before cataract surgery is approved.
What About Laser Cataract Surgery and Advanced Lens Implants?
This is where there is often significant confusion.
Many patients assume that if they have a very good PPO, a comprehensive employer-sponsored plan, or Medicare with a supplemental policy, their insurance will pay for premium cataract technology.
Generally, it does not.
Elective cataract surgery upgrades—such as:
Femtosecond laser-assisted cataract surgery
Astigmatism-correcting toric lens implants
Multifocal or trifocal lens implants
Extended-depth-of-focus lenses
Light Adjustable Lenses
Other advanced-technology lens implants are generally considered non-covered or elective services rather than medically necessary components of standard cataract surgery.
I have dealt with hundreds of insurance plans over the years, and one of the most important things I try to explain to patients is this:
The insurance plan that gives you excellent coverage for medically necessary services does not necessarily give you any better coverage for elective cataract upgrades.
In other words, having a more expensive or comprehensive insurance plan generally does not mean that your insurance company will suddenly pay for a premium lens or laser cataract surgery.
These upgrades are typically an out-of-pocket expense, regardless of whether you have an HMO, PPO, Medicare, or Medicare with supplemental coverage.
What If I Have Medicare and a Medigap Supplement?
Medicare and a Medigap supplement can provide very comprehensive coverage for covered cataract surgery. However, that does not mean that Medigap will pay for every optional technology or lens.
Medigap is designed to help cover your share of Medicare-covered services. Medicare usually pays 80% of the covered services, leaving 20% to the patient. Supplemental insurance (Medigap) helps cover the remaining 20%. It generally does not turn an elective, non-covered cataract upgrade into a covered service.
Therefore, even a patient with Medicare plus an excellent supplemental plan may still be responsible for the additional cost of an advanced-technology lens or laser upgrade.
Why Can I Still Have a Bill If Cataract Surgery Is Covered?
This is another important distinction.
Covered does not necessarily mean $0 out of pocket.
Suppose your insurance covers cataract surgery, but you have not yet met your deductible. You may still be responsible for some of the allowed charges.
Your out-of-pocket responsibility can include:
Deductible
Copayment
Coinsurance
Out-of-network charges, depending on your plan
There may also be several different providers involved in your surgery, including:
The ophthalmic surgeon
The ambulatory surgery center or hospital
The anesthesiologist or anesthesia provider
Each may bill separately, and their network status can affect your financial responsibility.
In some situations, the anesthesia or facility charges can actually be greater than the surgeon's portion of the bill.
Once you have reached your plan's annual out-of-pocket maximum, your financial responsibility for additional covered, in-network services may be substantially reduced or eliminated for the remainder of that plan year, depending on the terms of your insurance plan.
So, Does Having “Better” Insurance Help?
Yes—but primarily for covered services.
Your insurance plan can make a significant difference in:
Which surgeon you can see
Which surgery center you can use
Whether your providers are in-network
Your deductible
Your copayment
Your coinsurance
Your annual out-of-pocket maximum
How much you ultimately pay for medically necessary cataract surgery
But the price of elective cataract upgrades is generally separate from these insurance benefits.
If you choose a premium lens implant or laser cataract surgery, your insurance company generally does not pay the additional elective fee simply because you have a more expensive insurance plan.
The Bottom Line
Think of cataract surgery as having two separate components:
1. The medically necessary portion
Your insurance generally covers cataract removal and a basic monofocal lens when the cataract is visually significant, subject to your plan's rules and your deductible, copay, and coinsurance.
2. The elective upgrade portion
Advanced-technology lenses and laser-assisted cataract surgery are generally not covered by health insurance and are paid for separately by the patient.
So, whether you have a basic HMO, a premium PPO, Medicare, or Medicare with a supplemental policy, your insurance can significantly affect what you pay for the covered portion of cataract surgery—but it generally does not change what you pay for elective lens or laser upgrades.
This is why I always recommend that patients ask their insurance company and their ophthalmologist to clearly separate the covered portion of cataract surgery from any elective, non-covered services before proceeding.
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