New Choices, New Fees
Prior to May 2005 the cost for cataract
surgery to Medicare patients was rather simple. Medicare,
through its managing Centers for Medicare & Medicaid
Services set the price for cataract treatment and then paid
80% of that price. The vast majority of cataract surgeons
and surgery centers participated in this plan.
A vitally important component of
successful modern cataract surgery is the intraocular lens
(IOL). After the natural defective lens within the eye is
surgically removed, an IOL is implanted to help provide
clear and focused vision. Medicare pays for the IOL, however
the amount provided by Medicare is limited, thus making only
conventional IOLs affordable under the payment plan.
Surprisingly, Medicare would not allow patients to pay more
out of their own pocket to purchase a higher technology IOL.
The only choice for a Medicare patient who wanted Medicare
to pay for the IOL was a conventional IOL, not high
technology.
As one new high technology IOL after
another was developed, Medicare decided an alternative was
required. In May of 2005 Medicare changed its rules and now
allow Medicare patients to pay from their own pockets for
high technology
presbyopia-correcting intraocular lenses (IOLs), if the
patient desires. Medicare will still pay what they would
have paid anyway and the patient is responsible for the
additional cost of the premium IOL.
The currently available high technology
IOLs available in the United States are the Crystalens®,
manufactured by Bausch & Lomb, the AcrySof®
ReSTOR®, manufactured by
Alcon Laboratories, and the ReZoom™, manufactured by
Advanced Medical Optics. These three IOLs all have something
common. They all are designed to reduce the effects of
presbyopia.
Presbyopia is when the eye is no longer
able to focus on near objects and reading glasses or
bifocals become necessary. The Crystalens, ReSTOR, and
ReZoom are designed to reduce or eliminate the need for
reading glasses after cataract surgery.
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