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Cost of cataract help/clarification

Posted , 4 users are following.

Shae280
Shae280

I live in NY(Long Island) I have Medicare and AARP Supplemental Part C. Does anyone have this Insurance and have had traditional/non laser surgery? What were your out of pocket costs?

0 likes, 6 replies

6 Replies

  • karen88658
    karen88658 Shae280

    Posted

    Medicare Part C plans are usually referred to as “Medicare Advantage” plans. All Medicare Advantage plans are run by private companies (e.g. BCBS, United Health etc), and they all combine coverage for hospital stays with coverage for doctor visits. You.choose a plan that includes prescription drug coverage, often at no additional premium, or you can choose a plan without prescription drug coverage. You usually have a deductable of $100 for each surgery, although some plans may differ, and they will cover everything for monofocal lenses (except your deductable). If you choose any speciality lens implants, like mutifocal or toric, it runs about $1500 to $2500 per eye, so roughly $3,000 to $5000 out of pocket expense. Hope this helps.
    • Shae280
      Shae280 karen88658

      Posted

      It is not a Medicare Advantage plan. It is not an HMO type of plan. It is a Supplemental Insurance plan that I pay for. I just want to know if there are any out of pocket costs for regular surgery with a regular lens. The Doctor I saw wants 300- for pre surgery measurements which does  not seem right. I am really looking for someone with Medicare/AARP supplemental plan who has had the surgery and can specifically tell me what they paid for out of pocket. 
    • lin59
      lin59 Shae280

      Posted

      You have a Medigap plan (Plan C). That pays for all your co-payments, etc. Medicare does not pay for refractions ever at all (not a penny of it) and a refraction has to be done before cataract surgery and after cataract surgery (so that's 2 refractions that Medicare doesn't pay for). Medicare does pay for A-scan testing before cataract surgery though. Find out the exact names of the tests you're being billed $300 for and call Medicare at 1-800-633-4227 to ask if you have to pay out of pocket for them (unless you're told the $300 is for 2 refractions).

       

    • lin59
      lin59

      Posted

      And other than that $300, you shouldn't have to pay anything except for maybe the eye drops which are very expensive and not covered in full (by my insurance at least - maybe Plan C will cover them though, I'm not sure). The suggestion to call AARP's insurance division is a good one also.

  • janice30449
    janice30449 Shae280

    Posted

    Call AARP Supplemental & ask how much they cover, I had to pay $300 for a regular lens in my left eye with my insurance & $900 for a TORIC lens in my right eye.

    • Shae280
      Shae280 janice30449

      Posted

      Do you have my exact insurance that you paid 300- for?
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