It seemed to me that Medicare would almost certainly cover his cataract surgery, but there was a problem. Medicare regulations do not allow providers to balance bill beneficiaries for the extra cost associated with deluxe IOLs. In other Medicare regulations, Medicare does permit beneficiaries to select a deluxe frame, deluxe hearing aid or deluxe wheelchair and pay the difference between the purchase price and the Medicare allowable.
Regrettably, that is not the case for IOLs. As I described these esoteric rules to Mr. Singh, he was a little disappointed but not deterred. He asked who he should contact at the Centers for Medicare and Medicaid Services to plead his case.
I told Mr. They recommended that the old legacy rules about IOLs be updated to give Medicare beneficiaries the opportunity to choose this new IOL. After the meeting, we did not know how CMS would respond, but we hoped that they would appreciate why the old regulations no longer worked. A few weeks later, Mr. Singh called again. He gave me a list of CMS staffers he had spoken with about his case. The staffers had all been generous with their time but not particularly clear about how he might proceed.
At that point, I e-mailed Mr. I explained that the purpose of an ABN is to inform a beneficiary when a service might not be covered by Medicare and give the beneficiary a chance to choose whether or not to proceed. In Mr. Technical challenges lie ahead for lens refilling. Not long after this call, I spoke with the billing office manager for Dr. This competent individual instantly recognized our mutual acquaintance, Mr.
She confirmed that this special patient was intelligent, persistent, and very well-informed. Singh could not have the Crystalens because no doctor, hospital or ASC could afford to absorb a financial loss on this premium IOL, and his generous offer to pay for the Crystalens was out of the question. Singh was stuck in limbo.
You may notice a difference in your vision from one eye to the other after your eyes heal. This is normal. If the difference in your vision is significant, your doctor may recommend additional corneal refractive surgery. This is often done for the correction of astigmatism after implant surgery. Most people will be able to see clearly in the distance, have excellent middle vision, and will be able to read a newspaper without glasses, but some people may be more comfortable with additional correction for very near work such as needlepoint.
It is important to remember that implant surgery cannot resolve pre-existing visual conditions such as floaters, flashes, or visual field loss that are a result of conditions of the eye and not related to the lens. Your doctor will thoroughly discuss the rejuvenation of your vision after surgery and will recommend a specific plan for optimizing your uncorrected vision for near and far.
It is important to remember that while virtually everyone experiences much improved vision after cataract surgery, some people will have better uncorrected vision than others. The difference from standard lenses is that most people will not be dependent on these supplemental vision aids to function normally.
The long-term safety and effectiveness of this lens have not been established. These symptoms can be produced or exacerbated by cataract surgery. Many people report these problems before cataract surgery and even after surgery; however, they are rarely debilitating.
Sensitivity to light is often a temporary symptom. As with any intraocular lens, glare can be a problem at night when the pupil widely dilates and occasionally light can reflect off the edge of the implant and create a flash or halo of light.
This typically does not occur in your central field of vision, but rather in the periphery. People who have worn contact lenses in the past may be familiar with this phenomenon.
Again, glare is rarely debilitating and if it does bother you, there are a number of things that your doctor can do to improve your vision at night including medications or night driving glasses. Typically, you will be able to return to normal activities within several days after implantation with some limitations. Your eye may be sensitive to touch and bright light, but you should be able to drive and return to work in two to three days.
Your doctor will provide you with medications to prevent infection and decrease inflammation, and may provide a protective shield to cover your eye while sleeping. A pair of plastic, disposable sunglasses will decrease your sensitivity to light as well as providing protection during the day. It is important that you avoid heavy lifting or straining that would increase the pressure in your eye for several days after surgery.
You also must avoid rubbing or pushing on your eye. You should refrain from activities that could increase your chances of getting hit in the eye. Wear your protective sunglasses when outdoors. You can shower and wash your hair as long as you avoid getting soap or shampoo in your eye. Refrain from using eye makeup, lid liner, and mascara for several weeks after implantation. You should avoid public swimming pools, hot tubs, or other sources of bacterial contamination for several weeks.
Consult your doctor on recommendations for specific activities. Your doctor will advise you as to how often your eyes need to be checked. Typically, the doctor will see you one day after surgery, after 2 to 4 weeks, and again around 3 to 6 months after surgery. Thereafter, an annual exam is usually sufficient unless you have a specific problem. Once your cataracts are removed and replaced with an implantable lens, you will never have to have cataract surgery again.
Occasionally, several months after the lens has been placed in the eye, the vision may start to become cloudy once again. Please note that this is merely an estimate; your exact amount will vary depending on many factors.
If premium IOLs are desired to significantly reduce dependence on glasses and contacts, then the patient will have to cover the difference.
Essentially, premium cataract surgery can nearly double or triple the potential out-of-pocket costs. Medigap plans supplement Medicare coverage and help to offset the out-of-pocket cost of care. They function very much like traditional insurance policies, just on a much more narrow scale. That means they have their own deductible that must be met before coverage kicks in. The best way to determine what cataract surgery will cost you is to schedule a consultation with a surgeon to discuss treatment options.
You can also speak with your insurance carrier for more specifics about what your policy covers. Medicare patients can visit Medicare. Read More. Let s explore this vision care issue. Ready to see clearly without cataracts, corrective lenses, or other obstacles? Continue reading to decide which type of intraocular lens IOL is right for you. In addition to the IOL you select, there are several other aspects of cataract surgery that can influence the total cost of treatment, including:.
Undergoing cataract surgery is an investment in your vision and quality of life, allowing you to experience a range of benefits during every waking moment. To learn more about the costs of cataract surgery, schedule a personal consultation with Dr. Byrd today.
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