Health insurance for cataract surgery
Cataract surgery is covered by top-tier health insurance – compare costs, waiting times and out-of-pocket expenses.
Private health insurance that covers cataract surgery
Below are some policies from Finder partners that cover cataract surgery.
Cataract surgery is covered under some silver plus and all gold-tier policies. 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.
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How much is cataract surgery?
The cost of cataract surgery depends on whether you use the public or private system and whether you have private health insurance. The table below contains the key details.
|Cover type||Cost (out-of-pocket)||Details|
|Public hospital under Medicare||Free||Waiting lists for surgery in a public hospital can be long, typically 158 days (5+ months). You may need to pay extra for premium lenses.|
|Private hospital without cover||$1,700 – $4,000+ per eye||Waiting period for surgery depends on surgeon availability. In many cases, the procedure can be performed immediately. You may also need to pay for specialist consultations.|
|Private hospital cover||$700||A 2-month waiting period before you can claim or 12 months with a pre-existing condition. The waiting period for surgery depends on surgeon availability. The out-of-pocket costs vary based on your fund and surgeon.|
How does Medicare cover cataract surgery?
Cataract surgery is covered by Medicare, which means that public patients will have to pay nothing if they undergo the procedure in a public hospital. You will have to pay for the lenses if you want access to premium lenses not covered by Medicare.
The average waiting time for cataract extraction was 158 days in 2021–2022, according to data from the Australian Institute of Health and Welfare. 10.6% of people waited over a year for surgery. Australians in NSW and NT are likely to wait even longer, with median waits at 278 and 200 days respectively.
If you live in a state with a long waiting period or your vision is seriously affected, you might consider comparing private health insurance for shorter waiting times.
How does private insurance cover cataract surgery?
You can get private health insurance for cataract surgery with all gold-tier hospital policies and some silver plus policies.
Waiting periods vary depending on the surgeon but generally, it can be performed immediately. Unlike the public system, you will be able to choose your specialist as well as when and where you have the surgery done.
Costs generally range from $35 to $40 per week for gold-tier health insurance. This covers you for all 38 clinical categories.
Gold-tier policies are tailored to people with chronic illnesses and the elderly. They include lots of other services such as joint replacement and insulin pumps. Keep in mind that 12 waiting periods apply for pre-existing conditions.
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Frequently asked questions
- AIHW: Hospital Procedures
- AIHW: Surgery Waiting Times 2021–2022
- Bupa: Cataract Eye Surgery Cost
- HCF Cost Calculator: Cataracts
- Medibank: How much does a cataracts procedure cost?
- Medical Costs Finder
- Medicare Benefits Schedule: Item 42701
- Medicare Benefits Schedule: Item 42702
- MCES: Cataract Surgery Cost in Australia? 2021
- APRA: Private Health Insurance Annual Coverage Survey
- Finder: Consumer Sentiment Tracker (CST)
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