Cataracts: What You Need To Know About Their Symptoms, Treatment, And Insurance Coverage

Cataracts are a common problem for the elderly—more than half of those over 75 in the U.S. have cataracts. That makes it important to understand both the symptoms of cataracts and what treatments your insurance will cover.

What exactly are cataracts?

Cataracts are essentially formed by strands of protein that clump together on the retina of the eye, obscuring the images that you see. Because the proteins are opaque, it tends to dull both the color of objects that you see as well as their clarity—a lot of people describe the experience as being similar to having something oily smeared on their lenses.

Even small cataracts can interfere with ordinary daily activities, like driving, watching television, using a phone or computer, and reading. It isn't possible to correct cataracts without surgical intervention. Left unchecked, cataracts usually slowly progress until they lead to complete blindness.

How are cataracts treated?

The good news is that surgery can successfully remove your cataracts and restore your vision. It can also sometimes actually improve your residual vision and leave you less dependent on prescription glasses or contacts. Unless you suffer from additional health complications that require an overnight stay in the hospital, surgery is generally done as an outpatient. The surgeon will break up the cataract and gently remove the pieces. In most cases, the surgeon will then place an intraocular lens behind your iris and pupil to replace your natural lens.

Both traditional surgical methods and laser-assisted methods are used in cataract surgery, so you may have options about what type of surgical procedure is used. You may also have choice when it comes to what lens is used to replace your natural lens:

  • monofocal lenses, which are somewhat like monovision lenses in glasses, with the same power in all areas
  • fixed focus monofocal lenses, which are generally fixed for distance vision and may leave you needing reading glasses for close work
  • accommodating monofocals, which allow you to shift your focus from distance to near
  • toric lenses, which correct for astigmatisms
  • multifocal lenses, which have different powers at different points, like progressive eyeglass lenses

Your surgeon will discuss your specific situation with you and likely make a recommendation for both the type of surgery and the type of lens you should have. If you're unsure, make certain that you get a clear explanation of why a particular surgical method is being used and why the specific type of lens is recommended.

How can you pay for the surgery?

If you are over age 65 and have Medicare, cataract surgery is one of the few optical-related procedures that the insurance covers—however, it covers only the part of the surgery that is related to your cataracts. For example, if you have an astigmatism, the surgeon may be able to make surgical corrections that help improve your condition, but Medicare would ask the surgeon to bill you separately for that part of the procedure. 

In addition, while Medicare doesn't normally pay for routine vision correction, you will most likely need a new pair of prescription lenses after your surgery. Medicare will cover these. Medicare usually negotiates a reduced cost of for both the surgery and the prescription lenses, and you'll be responsible for 20% of that reduced cost (unless you have supplemental insurance that covers the difference).

For assistance, talk to a professional like Veltkamp Agency Inc.