Insurance providers, including Aetna, offer information on the terms associated with cataract surgery on their official websites. Each provider has different terms regarding payment percentage and what parts of the procedure are covered under an insurance policy.
While there is no set formula or process to determine how much of the procedure insurance providers cover, most people undergoing cataract surgery qualify for Medicare. Though the cataract surgery itself may be covered, any screening tests, astigmatism corrections or additional procedures are typically out-of-pocket expenses. Under Medicare, the policy is to only offer coverage for the part of the procedure that is absolutely necessary.
The two main fees associated with a cataract procedure are the surgeon's fee and the facility's fee. Insurance companies have different policies regarding what fees are covered. For the most part, insurance companies use Medicare as a baseline for what parts of the procedure to cover. Potential patients should first ask insurance providers about their policies related to the surgery itself, and then ask about astigmatism procedures, screening tests and any related fees. In addition, the All About Vision website contains detailed information related to more specific costs associated with cataract surgery. Charts and lists are provided for different patient conditions.