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Does Vision Insurance Cover Cataract Surgery?

The National Eye Institute indicates that cataract surgery is one of the most common surgical procedures performed today. It is also one of the safest and most effective operations – about 90 percent of the individuals who undergo this kind of eye surgery report better vision afterwards. A cataract is the clouding of the eye’s lens. The clouding will cause vision loss.

How Vision is Affected by Cataracts

Clumps of protein reduce the image’s sharpness before it reaches the retina. When protein clumps, the lens clouds up, reducing the amount of light getting to the retina. When the clouding becomes severe, vision will become blurry. Small cataracts only affect a small portion of the eye’s lens, and vision changes will not be as noticeable. However, as cataracts slowly grow, the vision will worsen – becoming duller or more blurred.

How Cataract Surgery Works

When vision loss interferes with your daily activities, such as watching TV, reading, or driving, then you and your vision provider might decide it is time for cataract surgery. You would only need eye surgery when your vision is severely affected by the cataract. In some rare situations, even if the cataract isn’t affecting vision, surgery might be required. If a cataract prevents proper exams or keeps you from getting another eye problem treated, such as Diabetic Retinopathy, you should have the cataract removed.

Does Vision Insurance Cover Cataract Surgery?

Cataract surgery can cost a few thousand dollars per eye. Most insurance plans, such as health insurance, vision insurance, or Medicare do not cover the cost of refractive surgery because surgery to correct Presbyopia or Astigmatism don’t classify as medically necessary because corrective lenses will take care of the problem.

Insurance will cover the cost of medically necessary eye surgery, such as surgery for cataracts that are interfering with a patient’s daily activities. If a cataract causes visual disturbances, then the insurance will most likely pay toward the cost of the procedure. If there is a cataract, but it is small and not causing visual difficulty, then surgery would not be considered medically necessary.

To learn more about vision insurance and medically necessary vision procedures, contact the professionals at at (855) 401-8383. Our licensed insurance experts will be happy to answer any questions you have.

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