Cataract surgery costs

If you're uninsured, you can choose to have the procedure bulk billed at a public hospital or pay an average price of $2,500 per eye to have the procedure done at a private hospital. But if you have health insurance, you're looking at next to no out of pocket expenses — you'll also get to choose your own doctor and the comfort of your own room.

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What are cataracts?

Cataracts are cloudy patches that form on the lens of the eye. A cataract blocks light from passing to the back of the eye, making it more difficult for a person to see clearly. While it is possible to have a cataract in one eye, they typically develop in both eyes.

Cataracts usually form due to ageing. According to the Australian Institute of Health and Welfare, more than 31% of Australians over 55 and more than 70% of Australians over 80 have developed cataracts. They are more common in men than women. Risk factors include age, sun exposure, diabetes and cigarette smoking.

What is cataract surgery?

Along with laser eye surgery, cataract surgery is one of the most commonly performed surgical procedures in Australia.

Cataract surgery is used to treat cataracts that have advanced and are affecting a person's eyesight and quality of life. The surgery involves removing the clouded eye lens and replacing it with an artificial lens. Depending on the surgeon and your individual circumstances, the procedure may be performed on both eyes at the same time or on one eye at a time with a few weeks for recovery in between procedures.

Cost overview

Prices for cataract surgery vary based on the hospital, insurance cover, surgeon, lenses and individual circumstances. Your ophthalmologist will recommend the best procedure and lenses for your eyes depending on your health, needs and lifestyle. Some premium lenses can also be used to correct common refractive errors including short-sightedness, long-sightedness and astigmatism, though they are more expensive than standard lenses.

Cost without insurance

If you don’t have insurance, you can choose to have your cataract surgery at a public or private hospital.

• Public hospitals

  While cataract surgery can be bulk billed, public hospitals have much longer waiting periods than private hospitals.

  • The average waiting time for cataract surgery at a public hospital is 6 to 18 months.

  If you need surgery on both of your eyes, there may be an additional waiting period between the procedures for each eye. The exact time you will have to wait for your procedure depends on your location and the number of other Australians who are waiting for the same procedure.

  Medicare generally covers cataract surgery, but won’t cover the cost of premium lenses and lenses that also correct refractive errors.

  • Premium lenses can cost $2,500 per eye or $5,000 for both eyes.

• Private hospitals

  • The average cost of cataract surgery for uninsured patients at private hospitals is around $2,500 per eye.

  If you are uninsured and choose to have your cataract procedure at a private hospital, Medicare will generally cover only a portion of the surgeon’s fee and anaesthetist’s fee.

  • The fees involved with cataract surgery at a private hospital typically include a theatre or operating room fee, the surgeon’s fee, the anaesthetist’s fee and the cost of the lenses.

Cost with insurance

Every health insurance policy is different, and not all policies cover cataract surgery.

• Policies that cover major eye surgery generally start at around $138.95 per month.

Make sure to check what is included in your policy before scheduling any procedures. If you do not already have insurance and want to take out a policy before your cataract surgery, keep in mind that a waiting period will likely apply.

• Waiting periods typically range from a few months to one year.

• Public hospital cover

  Public hospital cover generally does not cover cataract surgery. If you choose to have your procedure at a public hospital, you will have the same costs as an uninsured patient. While you will still be subject to public hospital waiting periods, reports suggest privately insured patients in public hospitals have shorter waiting times than public patients.

• Private hospital cover

  Your surgery may or may not be fully covered. Whether or not you will have out-of-pocket costs depends on your level of cover, your excess, the hospital, the lens you choose and the amount your surgeon charges. Contact your insurance provider directly for details about your level of cover and if there is any excess.

  Private hospitals have much shorter waiting times than public hospitals. You will be able to choose your surgeon and have a choice about when to schedule your procedure, depending on the surgeon’s availability.

Pensioners

Pensioners may be eligible for discounted surgery at private hospitals, depending on the hospital. Medicare will pay for a portion of the surgeon and anaesthetist fee. Seniors on the pension without insurance typically pay less than $2,000 per eye.
Find out the cost of laser eye surgery