Need cataract surgery..CONFUSED

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MY mother is 81 and has bad cataracts. I live on Long Island in NY. She had been told for years she needed surgery but put it off because she could still see well enough until now. I took her to a local Doctor who was recommended. I figured he would just examine her and we would set up the surgery. Well I was unaware of all the choices she would have to make. The Doctor was only pushing laser cataract surgery which costs 1600- per eye.

I was made to feel laser is the only way to go. Is traditional cataract surgery not good anymore? Then the office wanted me to come in for a pre cataract appointment to discuss the options. I was told the measurements taken at this appointment would cost 300- per eye but if I chose to do the laser they would waive that fee. I never heard of all these charges before. What is the cost out of pocket for traditional cataract surgery? Am I supposed to pay for measurements prior to surgery? Is there anyone who lives in Nassau County, LI that can recommend a Doctor? As I said I am so confused. I just want the best care for my Mother. 

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14 Replies

  • Posted

    I live in Canada where cataract surgery is completely covered by our healthcare system - no financial incentive for our opthamologists to talk patients into extra fees. Does your mom have an optometrist who could refer her to a good opthamologist? That's where I started. Just had cataract surgery on one eye a week ago (traditional method using phaco). It's my understanding no studies have been done proving laser assisted cataract surgery gives a better end vision result. I would shop around for an opthamologist.

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    • Posted

      The Doctor she saw is an opthamologist. When my Mom was in the hospital & rehab facilities recently we asked around and the Doctor she saw came highly recommended. I have read alot online in the past month and I think she should just get traditional surgery but then the Doctor said her cataract is bad and that laser would be easier (for him) not necessarily for my Mother. How was your surgery? How do you feel? Were you sedated? I am also concerned because my Mom has had vertigo and cannot lie flat. I told her she has to lay flat. That is why I am asking about sedation.

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    • Posted

      I was given Ativan to help with my nervousness. It did help somewhat although still felt nervous. The surgery itself doesn't hurt. Small amount of pressure on my eye is all I felt. I think my nervousness came a lot from my fear of the outcome although I am happy with the result (still one eye to go next month).

      I know people can ask for conscious sedation (IV) but the surgeon does need you to be awake. I think your mom will be pleased too to see so well. Cataracts aren't fun to live with. I am 53 and didn't realize how distorted colours were as well as clarity until I had one eye done. I wish your mom well.

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  • Posted

    I am 71. I had cataract surgery on both eyes 2 years ago and it was entirely covered by Medicare. You need to find an opthamologist who accepts Medicare and can explain exactly how the coverage works for your mother. She probably does not need any of the optional choices currently being pushed. Just select monofocal lenses and regular surgery. No big deal. Also, Medicare covers the pre-op exams, if your chosen doctor accepts Medicare. Good luck.

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  • Posted

    In USA, Medicare pays for the cataract surgeries and the monofocal lenses, including all the examinations, except for the usual deductibles. If you have  a medicare supplement, the deductibles will be less. With a MedAdvantage plan, the deductibles will be slightly different than pure medicare.

    It does not matter whether the laser is used as a part of the cataract surgery or not.

    The deductible for the doctor visit for the examination before the cataract surgery should be the same as she pays for any other specialist as part of her plan. It is typically $40 or $50 or $0, depending on the plan.

    The monofocal lenses are covered, but toric, multifocal and other lenses are not covered by Medicare or the associated plans because the purpose of those is to minimize the use of reading or distance glasses after cataract surgery.

     

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    • Posted

      She has Medicare and AARP supplemental plan so I thought it would all be covered 100%.
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  • Posted

    Your mother would surely be on medicare ? Medicare covers basic cataract surgery and I think you would not have to spend a single penny. At least that is what my 81 year old sister who lives in Florida was told.
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    • Posted

      Yes..not only does she have Medicare but an AARP supplemental plan.

      When I was going to make a pre surgery appointment to discuss the surgery I was told the appointment would cost 300- for taking measurements as Medicare does not cover this. Does not sound right at all. 

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    • Posted

      Stay from this surgeon. As I mentioned before, all costs assciated with cataract surgery and monofocal lenses should be covered by Medicare and the AARP supplemental plans, except for the usual deductibles.

      It is possible that this surgeon does not like to take care of the people on medicare. Most of the cataract surgeons don't have that issue.

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    • Posted

      I agree with you. Unfortunately I have no friends or family that I can ask for a recommendation. I take care of my Mother full time so I have  no outside interactions. I have my own health problems and can only take her to a Doctor near my house. I live on Long Island with thousands of supposedly good Doctors. I just do not know what to do. It is hard.
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    • Posted

      You may want to talk with her or your personal physician, dentist, optometrist etc. Also, probably many of her friends in the area have already had cataract surgery and will be good contacts.

      You can also google about the cataract surgeons in your area and call their offices to chat about having your mother get a cataract surgery done.

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  • Posted

    Hi Jillie

    I live in Scotland, just about everyone in this country are covered by the NHS, National Health Service, I had my cataracts removed by conventional surgery, im 75, I asked if I could have the cataracts removed by laser and was told, No, my question re laser surgery would be "how do they insert new lens", everyone who has replied to you have given you good advice and I am hoping that you have consulted someone ie an Optician who will recommend a surgeon who will cover your Mums health plan.

    Please let us know how you get on, I can appreciate how difficult this is for you under you circumstances, do your  best to find someone who can help, her in Britain we have organisations whom you can speak to for advice, ours in called the Citizens Advice Bureau (CBA) and there are other also that you can telephone for advice.  Its also probably a good idea to pay for a taxi to take you to someone who can help, again please let us know what you decide and the outcome

    Kindest regards Agnes

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  • Posted

    Medicare does not pay for refractions (like what an optometrist does when they test your vision for glasses). The $300 is probably for all refractions (before and after) and the A-scan measurements. Medicare pays for A-scans. It sounds like your mother has an AARP Medicare Advantage Plan, so you have to find a doctor who accepts that insurance. Call the insurance company and ask what the co-payment would be for the surgery plus ask them for a list of doctors who take that insurance. You should also be able to log into the AARP Medicare plan's website to access which doctors take that insurance. I think with straight Medicare there's a co-payment for cataract surgery, but I'm not sure what the amount is. I have insurance and for each eye with standard lenses I think the total amount including eye drops, etc. will cost me a maximum of $750 per eye.

    PS - she doesn't need laser cataract surgery or any of the upgraded IOLs (intraocular lens) they may try to push on you that can cost up to $2,500 more for each eye. Find a regular cataract surgeon who doesn't try to push people into upgrading so they can get more money out of it.

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    • Posted

      Also, if she has regular Medicare and the AARP plan is a supplement Plan F, that means she has to use a doctor who takes regular Medicare (and I think most do) and then the Plan F supplement will pay for all co-payments, etc. except for any refraction(s).
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