Costs for Premium IOLs

Because the IOL manufacturers devoted years of research to develop the premium IOLs, the purchase price for the lenses is often higher than the total amount many surgery centers and hospitals are paid by Medicare to provide cataract surgery.  Medicare, Medicaid and all other major insurance companies pay for traditional lens implants after cataract surgery, but few payers have indicated they will pay for these more expensive lenses.

Medicare does allow Medicare patients to pay out-of-pocket an additional amount to eye surgeons to have access to these new lenses.  After contacting most major local insurers, Midwest Eye Care has developed the following fee schedule for new-technology cataract surgery.  The patient financial responsibility must be paid one week prior to the surgery.

Patient financial responsibility

Insurer

Astigmatism Correction

Toric IOL

Other Premium IOLs

Other Premium IOLs with Astigmatism Correction

Medicare, Medicare Complete, Medicaid, Mutual of Omaha, United Healthcare, Coventry, Humana

Standard surgical co-pay, deductible, and additional $1,300 per eye for the lens cost

Standard surgical co-pay, deductible, and an additional $1,595 per eye for the lens cost

Standard surgical co-pay, deductible, and an additional $1,995 per eye for the lens cost

Standard surgical co-pay, deductible, and an additional $2,945 per eye for the lens cost

Blue Cross Blue Shield of Nebraska (if the employer plan includes this type of coverage)

Standard surgical co-pay with deductible

Standard surgical co-pay with deductible

Standard surgical co-pay and deductible

Standard surgical co-pay and deductible

Self-pay (no insurance coverage)

$3,295 per eye

$3,495 per eye

$4,795 per eye

$5,295 per eye