How to Find out If Insurance Covers Cataract Surgery

Have corrected vision is important. You rely on your eyes for work, play and general living. If you have a protein buildup in one of your eyes, called a cataract, you might have problems seeing and require surgery. You need to know how to find out if your insurance covers cataract surgery, as it is currently the only way to correct this problem.

Instructions

Difficulty: Moderately Easy

Things You’ll Need:

• Health insurance coverage booklet

Find out If Insurance Covers Cataract Surgery

1. Look through your health insurance brochure and see if there is a general list of surgeries that are covered. Since cataract surgery corrects vision problems, it might be listed or included in the broad category of vision corrective surgeries.
2. Give your insurance company a call and talk to a representative to get more information. Oftentimes eye surgery isn't listed in your brochure, but that doesn't mean that you aren't covered.
3. Get the all the details about your coverage. Your insurance might only cover your surgery if you use a certain doctor. Get a list of covered surgeons from your insurance and set up consultations with them to find one that your like.
4. Find out what documentation you need to send to your health insurance company in order to receive coverage. You might only need a referral from your primary eye doctor, but some insurance companies will require documentation of the severity of your eye problems.
5. Argue for your coverage. Some insurance companies might be reluctant cover your cataract surgery. If you can prove to them that your cataract was the result of an acute eye injury, disease or that you need to have the surgery to continue working, you might be able to persuade the company to cover you.

Tips & Warnings

• Fax the required documents to your insurance company as soon as possible. The sooner the company has all of the information, the sooner you can have your surgery done.
• If you believe that you should be covered under your insurance plan and your provider refuses, talk to an attorney. He should be able to go over the fine print of your policy with you and determine if you have a case against the company. Some attorneys offer a free consultation for claims related to health insurance.
• As a last resort, you can consider changing insurance providers although the long-term financial benefits of this choice will need to be carefully considered.
• In the event of a surgical complication, you want to be sure that your insurance covers any corrective procedures.