Cataract surgery costs
Without insurance, the cost of cataract surgery is around $3,000+ per eye. It's free in the public sector under Medicare, and private health insurance can help cover it in the private system.
How much does cataract surgery cost?
Prices for cataract surgery vary based on the hospital, health insurance policy, surgeon, lenses and individual circumstances. Your ophthalmologist will recommend the best procedure and lenses for you. 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.
Typical costs of cataract surgery in Austrlia
|Cover type||Cost (out-of-pocket)||Details|
|Public hospital under Medicare||Free.||Waiting lists for surgery in a public hospital can be long, often 6 to 18 months. You may need to pay extras for premium lenses.|
|Private hospital without cover||$1,600 - $3,000+ per eye.||Waiting period for surgery depends on surgeon availability. In many cases, the procedure can be performed immediately.|
|Private hospital cover||$400 - $2,500+, plus your policy excess.||2-month waiting period before you can claim, or 12 months with a pre-existing condition. The waiting period for surgery will depend on surgeon availability. Out-of-pocket cost will vary based on your fund, surgeon, and excess.|
Cost of cataract surgery under Medicare
If your cataract surgery is medically necessary, Medicare will cover the cost of surgery in a public hospital, at no cost to you. However, there may be some costs that Medicare may not cover, including:
- Premium lenses that correct vision issues. These can cost from $2,500 per eye.
- Some specialist fees, leading up to your surgery.
Note that while Medicare will pay for your surgery, you won't be able to pick your surgeon, and you'll be subject to the public hospital surgery waiting lists. For cataract surgery, the waiting list is around 6 to 18 months. To avoid the wait, you'll need to use the private system.
Cost of cataract surgery with private health insurance
Health insurance for cataracts generally requires a gold-tier hospital policy, although it's also available on many Silver Plus policies as well. For cataract surgery in the pricate sytem, Medicare will pay part of the cost, and your health fund will also pay a benefit. The 'gap' or out-of-pocket cost is whatever is left, which you'll be required to pay. The gap amount depends on a lot of factors, but here are two estimates from HCF and MEdicare:
HCF: HCF's cost calculator estimates a total service cost of $5,986 and an out-of-pocket cost of $587, plus your policy excess. This is assuming you use a HCF participating private hospital and doctor for treatment.
Medibank: Medibank's estimation for the cost of cataract surgery is $4,090, with an out-of-pocket cost of $400, plus your policy excess. This is assuming you use a Medibank participating private hospital and doctor for treatment.
Cost of cataract surgery without insurance (in the private system)
If you want cataract surgery in a private hospital, but don't have private hospital cover, then you'll need to pay for the entire procedure by yourself. The cost of surgery will vary based on your surgeon, but here are a few estimates we were able to find:
OKKO: OKKO Eye Specialist Centre says that cataract surgery costs around $3,000 per eye without insurance.
MCES: MCES eye surgery in Melbourne charges from $1,600 per eye for cataract surgery, although this does not include the cost of anaesthetic.
Compare health insurance that covers cataract surgery
You can find a health insurance policy that covers cataract surgery from around $38 per week. Here are some policies that cover cataract removal from Finder partners. All have a 2-month waiting period before you can claim, or 12 months if it is a pre-existing condition. All prices are based on a single individual with less than $90,000 income and living in Sydney.
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?
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. Along with laser eye surgery, cataract surgery is one of the most commonly performed surgical procedures in Australia.
Quick facts about cataract surgery
Procedure time: 10 to 30 minutes per eye.
Anaesthetic type: Local anaesthesia.
Recovery time: Vision typically improves within a few days but full recovery takes 4 to 6 weeks.
Finder partner clinics that offer cataract surgery
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