How can you pay for your cataract surgery costs?

The costs of private cataract treatment are an essential consideration for all patients when doing their research. Cataract surgery costs vary depending on whether you are privately insured or self-funding your treatment.

Using private medical insurance to cover cataract surgery costs

If you have private medical insurance, then you or your employer will have been paying monthly sums for that cover. As cataract surgery is the most commonly performed operation in the UK, it is highly likely that your medical insurance will cover this. Your insurer will issue a pre-authorisation code to cover the service and pre and postoperative tests. The cataract pathway cannot proceed without this.

Insurers will usually specify that you have a surgeon and an anaesthetist who is “fee assured.” That means that the surgeon and anaesthetist will not charge you any top-up fees above the agreed remuneration from the insurance company excluding any excess you may have on your policy. That is very reassuring as you can be confident that there will be no bill surprises from your surgical team after the procedure.

Is your doctor fee assured?

Because the contracts between surgeons, anaesthetists and the insurance companies have changed a lot in recent times, not all surgeons are fee assured – mainly consultants who graduated some time ago. If any doctor involved in your care is not fee assured there will be top-up fees to pay and these must be made clear to you from the beginning of your cataract journey.

I am fee assured, and I work with all the major insurers so you can be confident that there are no hidden charges relating to the surgeon’s fee when under my care.

Self-funding your cataract surgery costs

If you are self-funding your cataract surgery costs, then a good specialist will see you in a consultation first and make a detailed personalized plan for your surgery. As a cataract and a glaucoma specialist, I may do more than a standard cataract operation in patients as they may need glaucoma micro-stents, laser treatment or bleb protection at the same time as the cataract operation. It is crucial that you have an itemized breakdown of the proposed surgery with the relevant codes. A good specialist will always provide written documentation on this.

The pre and postoperative consultations will also involve:

  • tests or investigations (e.g. biometric measurements) to decide the best lens to implant
  • OCT scans of the eye to ensure the retina is healthy before surgery (especially necessary in patients with diabetes, retinal blood vessel problems or glaucoma)
  • autorefraction to assess the strength of the glasses prescription before the procedure and to see how good the new lens implant is after surgery

The NHS would carry out all of these are standard tests if you were having the same operation in an NHS hospital. They are not optional extras added to increase remuneration for the clinic or the surgeon. I would be concerned at carrying out surgery without all of the relevant tests before and afterwards that are part of the high-quality care pathway we use in the NHS. It is vital that these tests are included in your quote before you decide to go ahead.

Contingency planning

You need to take into account and plan for extra testing or follow up consultations if you have other factors relating to your eye that make cataract surgery higher risk. In some cases, this may be the reason you chose to have surgery privately in the first place. For example, if you have other eye problems that make cataracts more unstable or wobbly to operate on (e.g. trauma or pseudoexfoliation, glaucoma or diabetic eye disease) patients often chose to have surgery privately to guarantee they will have the same highly skilled surgeon for all parts of their care. All surgery including cataract surgery carries some risk.