Has your optometrist said you need to see an ophthalmologist for a cataract consult? I want to take a minute to break down your options as well Your eyeglass benefits.

Let’s start with the referral   Many times an optometrist refers you to a particular surgeon (Opthalmologist) for a reason, but it’s not always the best reason

Here are a few of the reasons….

1. They are friends with the surgeon.  While it’s not uncommon to recommend people to friends or family in many businesses, sometimes the friend isn’t the best option or might not be a great surgeon in general.  I know an optometrist who referred all of their cataract and lasik candidates to a friend who, in my opinion, had a lot of unhappy patients.

2.  The optometrist is getting a “kickback” from the surgeon for their referrals.  Again, doesn’t mean the surgeon is bad or the optometrist is just out to make extra money.  It’s a concern only if it’s the ONLY reason they are referring to the surgeon.

3.  The optometrist has looked at your individual situation and, after considering the many surgeons they refer to, feel there is one in particular best for you.  This is obviously the best reason a particular surgeon is recommended.

At the end of the day, I still suggest doing some homework on your end as well.  Ask your friends who have already had cataract surgery.  Look at the reviews (if there are any) online.  Understanding you have a choice in the ophthalmologist you see for any surgical needs, not just cataract surgery, is the first step to finding the right one for you.

About a month after your cataract surgery, either your ophthalmologist (or your optometrists) will do a final refraction to determine if you need any eyeglass correction or not.  There are a variety of options when you have cataract surgery now and depending on the options you choose, you may, or may not, need eyeglasses.  If you have Medicare, they will cover the cost of one pair of glasses following cataract surgery.

Here is how that breaks down.  They will cover $65 towards a frame.  Any optical location who bills Medicare for post cataract surgery glasses have to have some frames priced to be covered in full.  This doesn’t mean you will like the selection and you have the right to choose any frame you want, just be aware you will be responsible for any cost of the frame over $65.00.  Medicare will also cover the cost of single vision or lined bi-focal / tri-focal lenses.  Anything above and beyond the basic lens is at your cost.

Post cataract surgery will almost always leave you a little more sensitive to glare and sun so make sure you talk to your optician about a good quality anti reflective coating (no glare) and either a second pair of polarized sunglasses or a custom clip on so you have proper protection. They will cost you a little out of your pocket but your eyes will thank you.

Not everyone will bill Medicare for glasses after cataract surgery. Some places will only bill Medicare if they are your prescribing optometrist or the surgeon who performed the cataract surgery. If your optometrist does NOT bill Medicare for your eyeglass benefit, you are welcome to ask other optical locations. You do not have to fill your prescription at your optometrists office. You can even ask other private offices if they will accept your insurance. There are a lot of reasons offices won’t bill Medicare so don’t feel frustrated. If your surgeon’s office has an optical attached to it, ask them if they bill.

One thing to know is Medicare does not allow for any discounting of any additional items not covered by them. The office isn’t trying to charge you more. This is 100% a Medicare thing. You are always welcome to see if the office offers discounts and would you save more money using their discounts instead of billing Medicare. I know I’m always willing to calculate it both ways for a patient.

The most important thing to remember is you have options. Don’t be afraid to ask!

Have a great day everyone! 🤓

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s