Cataracts

[Aceon6]

@A.H.Black Yup, something is wrong. DH once got a pair at a chain that had someone else’s script in the frames. Fortunately, he noticed as soon as the tech put them on to check the fit.

 

[A.H.Black]

One thing I immediately noticed after my cataract surgery was that things seemed artificially close to me. My doctor assured me that I was seeing things correctly for the first time. I've gotten used to , but when I think about it, it still seems odd.

I think I'm coming at it from the opposite experience. I'm used to things being their right size and closeness. These glasses are just the opposite.

Turns out the only problem with the glasses is me. Took the glasses into the doctors this morning and the optical shop checked them for me. They are the right prescription, with the right lenses and distance. They also told me that prescriptions for contact lenses are totally different than those for glasses - as contacts sit on the eye itself.

Fifty years since I have worn glasses - it will take a while. I'm trying to wear them for a bit before a nap or before bed as sleeping is the only thing that cures the dizziness. Thanks for the tips and ideas.

 

[A.H.Black]

Update. This is way too much about me, but maybe someone will find it helpful.

Could not get used to the glasses - stumbled into steps, bumped into things, dropped things. Just by instinct, I put on my readers over the glasses - it was immediately better! Still awful (like being in the mirrors at the fun house) but the pressure in my head eased considerably. I thought maybe I would wear both pair: then I realized that if the readers helped, something must be wrong.

Made an appointment with the optical doctor at the eye center. He said he could make the prescription weaker and still keep it strong enough for me to drive - but he wanted to do his own check of my eyes first. By the time he finished, he said "this prescription is way too strong for you". He gave me a much weaker prescription. (Now I'm a bit concerned they get the prescription right for the eventual surgery).

My experience with Zenni has been good. I called on Friday and the service rep gave me a one-time return refund for the price of the glasses minus the shipping - sent a mailing label immediately. Saturday, I shipped the glasses back. Monday, the refund was issued. Tuesday, I re-ordered the glasses with the new prescription. Darn good for an online company.

I am now waiting for the new glasses.

 

[Aceon6]

@A.H.Black Something similar happened to DH. His first post surgery pair didn’t feel right, so we went to the optical shop to have them checked. What they checked was whether the lenses matched the prescription. They did. It took a trip to his eye doctor to learn that it was the script that was incorrect. 2nd attempt was MUCH better.

 

[A.H.Black]

Went to the eye surgeon yesterday. It's been a month of work arounds with the second pair of glasses. They are still awful but they don't make my head feel like it's in a vise. I have mostly been going around blind (my version) except for driving and walking outside. The glasses are still helped by putting my readers over the top or when I put on the clip-on sunglasses.

I was afraid the surgeon would want to wait another month. He did - sort of. I am scheduled for surgery, but not till after the first of the year. I have to go in again at the end of the month to have my eyes measured again. At that point he will decide if they are ready.

There will be a total of 9 appointments (at least) until this is done. 2 are for covid testing. 1 is the extra one for measuring. 4 are follow-up appointments after the surgery. The other 2 are the surgery itself. On the surgery day I have to go to the doctor's office first, they do pre-op stuff there, then I go to the surgery center. Someone has to drive me to the surgery center and from the surgery home. I HATE imposing on someone to spend 3 hours with me (or on call) for that day. I'm hoping I can drive for the second eye, but I don't know about that. I will miss about a week's worth of work. Since I am self-employed, that is significant. Not that the eyes aren't worth it but, it is time I can't make up and I won't get paid for.

The big surprise for me is the cost. I have medicare and a supplemental insurance. If I had the basic surgery, there would be a $300 co-pay for each eye. Of course it's not that simple. The surgeon told me I can have significantly better sight post surgery if I have the toric lens. Turns out I have astigmatism that I didn't know about. Also there is the laser assist surgery, which also increases the chances of better sight. Both the toric lens and the laser assist are elective upgrades and must be paid for out of pocket. Finally there are the 3 different eye drops that together cost north of $450, although coupons will bring that price down.

• Insurance co-pay - $300 per eye
• Toric lens - $1800 per eye
• laser assist - $505 per eye
• eye drops - $125 (hopefully - with coupon)

I decided to do some comparison "shopping" today and called up 2 other eye centers where they do cataract surgery. I didn't get exact figures but it seems that my costs are on the low side, at least for my area. So my total out of pocket expenses for cataract surgery will be over $5300. Those costs are payable up front.

There is a way to finance the cost at no interest if you pay all of it within 24 months. This financing is available for things like hearing aides, cataract surgery, dental implants etc. I will probably look into it.

Too long. Sorry. Writing all this sort of helped me sort it out in my mind.

 

[acraven]

I have unusually good (for the US) medical coverage--Medicare and a federal-retiree plan that so far has covered all my co-pays. I paid out of pocket only for one Toric lens upgrade ($600 or $800, I believe). There was no cost for the drops except for one type I needed only because the pressure spiked in my bad eye, which I got from my drug store; the other drops were issued to me at the time of the surgery and covered by Medicare or insurance. I didn't have laser-assist (don't even know what that is), just unexpected laser treatment after the fact because there was a wrinkle in one of my implants. However, my total cost for Medicare ($$$) and the retiree plan ($) is rather high, and that's something I'll be paying every month for the rest of my life.

I wonder whether you're being quoted the total cost of the Toric lenses rather than the delta (which is all you should have to pay, I think). Or perhaps they've given you the figure for two lenses rather than the cost per lens. Otherwise, I don't see why that cost would be so much higher than mine.

I called an agency that supplies home health aides to get someone to pick me up after the surgery since they wouldn't let me go home by subway or taxi. It's not a cheap solution, but it's an option--at least for those in urban areas--if you don't want to impose on a friend. I was lucky that I was able to travel to my appointments under my own steam. I had to call several agencies to find one that would provide this service, so it's not something to try to arrange at the last minute. You can expect to be charged for a minimum number of hours; I think it was 4 hours in my case.

 

[A.H.Black]

That federal insurance is gold. I have family that has it and they just zoom through all this medical stuff.

I think the laser assist surgery is fairly new. It can only be offered in specific cases - like with astigmatism. It helps the surgeon make more exact cuts and, with astigmatism, it measures more exactly and makes the cut that relieves the astigmatism more exactly. I think I'm saying that right. Because of the exactness, the surgeon thinks he can give me a much better outcome that won't require glasses (for distance). I want everything I can get, so I will have to find a way to pay for it.

I thought of using an uber to get to and from but I'm not sure if they will let me. I do have neighbors that are willing to help. We are close enough to the eye center and surgical center that they shouldn't have to wait with me - I hope.

The cost of the lens is not combined; they were very specific. I think the price goes up as they improve the lens and make it better. For example, there are many sizes of Toric lenses now, not just one. The "for profit" place down the road quoted me $3900 per lens.

The one thing I am still considering is whether I will get both eyes done, or just one. I want to have time to see what happens with the first eye. There is no option that will save my 6 inch vision. I will have to have readers if I have both eyes done (maybe even glasses). So, I have scheduled the surgeries a month apart. Everyone tells me I will want to do both and I won't be happy with just one. However, my sister went 3 years between hers and was very happy with her decision. I think it may be like it has been when I lose a contact. I have dealt with that several times throughout the 50 years I wore contacts. If I am right, I will postpone the second surgery. If "they" are right I will try to find a way to pay for the second surgery.

Neither alternative is optimal. I wonder, though, if I wait 3 years, maybe there will be a way to save that 6 inch vision.

ETA - Just a note about the price of panoptic (Toric) lens for the multifocal choice - $3450 per eye. For anyone who is investigating cataract surgery.

 

[Aceon6]

Neither alternative is optimal. I wonder, though, if I wait 3 years, maybe there will be a way to save that 6 inch vision.

Only you can decide if 3 years of less than optimal vision is worth it. The fancier, more experimental surgeries and lenses add cost and increase the variables. They also reduce the pool of health systems and ophthalmologists that are qualified to care for you.

 

[A.H.Black]

Only you can decide if 3 years of less than optimal vision is worth it.

Both options will be less than optimal. I'm never getting my 50 years of great vision, near and far, (with hard contact lenses) back. I'm just deciding which option to go with in the near future.

 

[sk8pics]

@A.H.Black Can you use HSA funds to pay the cost of the upgrades? I don't know if you have an HSA or not, I'm really just wondering for myself for the future.

 

[A.H.Black]

I could say "sure", but I don't really know. I'm sure it depends on your surgeon and the eye care center. I just checked my eye center for financing and it does mention HSA's. There is also an option like Care Credit that is interest free as long as you make the minimum monthly payments and pay the total withing the allotted time (up to 24 months) It is used for out of pocket costs. I have friends and acquaintances who have used it for things like hearing aids etc.

 

[sk8pics]

I could say "sure", but I don't really know. I'm sure it depends on your surgeon and the eye care center. I just checked my eye center for financing and it does mention HSA's. There is also an option like Care Credit that is interest free as long as you make the minimum monthly payments and pay the total withing the allotted time (up to 24 months) It is used for out of pocket costs. I have friends and acquaintances who have used it for things like hearing aids etc.

I don't think it has anything to do with the surgeon and eye care center. I have a debit card for my HSA account and every healthcare place accepts it. It's the account holder's responsibility to use it only for approved medical expenses. So for example, if you're getting cosmetic surgery you can't pay for any of the costs with your HSA card. I'm sure you could use your HSA to pay for the cataract surgery, but it's the "upgrades" I am wondering about.

 

[A.H.Black]

If it's up to you to be responsible, I don't see why not. The upgrades are there to insure the best outcome of the surgery. I can't imagine it wouldn't be an approved medical expense. After all, you would use it for out-of-pocket expenses that insurance doesn't cover - right?

 

[MacMadame]

If it's up to you to decide, I don't see why not.

It's not up to us. It's up to the federal government.

They have a list. Some of it is obvious but some of it is weird. I'd check first:

HSA Health Savings Account - Qualified Medical Expenses (QME)

Browse our list of HSA-eligible qualified medical expenses to pay for healthcare items like prescriptions and doctor visits.

www.wageworks.com

 

[sk8pics]

Yes, I'll check on what's allowable when I am close to the time for needing surgery.

 

[A.H.Black]

This is crazy. I literally just saw a TV add for Lasik that mentioned you could use your HSA for Lasik. If you can use it for Lasik, I would think you could use it for Cataract surgery.

 

[once_upon]

I admit I just skimmed this thread because I'm told that it will only be a matter of weeks to short months before I will need cataract surgery once the retinal hole repair surgery has healed.

I dont think I can have an HSA with Medicare and Supplemental insurance? This being an "emergent, essential" surgery, I didn't have time p7to do any cost stuff. The surgery center, at the time of check in, showed me what my insurance has agreed to pay but also said that with supplemental most would be covered. Of course, anesthesia, surgeon and drugs would be separate bills.

I was told that I could not have general anesthesia because they needed me to not be "floppy". I was given sedation to numb the eye and optic nerve.

I'm hoping cataract surgery is months away rather than weeks away.

 

[AxelAnnie]

OK. I had both eyes done one at a time. I opted for the very expensive lenses. medicare paid for the procedure and I paid for the lenses. l have astygmatism in both eyes. I knew the result would not be perfect...but it is dang good.
I have always terrified of having someone touch my eyes.
I was not sure I could go hrough with it and it was totally no big deal. Great meds.
Recovery fine.
An you wanted.until covid is over.... assuming there is such a time?

Good luck.

 

[A.H.Black]

I admit I just skimmed this thread because I'm told that it will only be a matter of weeks to short months before I will need cataract surgery once the retinal hole repair surgery has healed.

I dont think I can have an HSA with Medicare and Supplemental insurance? This being an "emergent, essential" surgery, I didn't have time p7to do any cost stuff. The surgery center, at the time of check in, showed me what my insurance has agreed to pay but also said that with supplemental most would be covered. Of course, anesthesia, surgeon and drugs would be separate bills.

I was told that I could not have general anesthesia because they needed me to not be "floppy". I was given sedation to numb the eye and optic nerve.

I'm hoping cataract surgery is months away rather than weeks away.

For your sake I hope it is a while away as well. Good luck with the retinal healing. I almost had to have something like that about six years ago - surgery scheduled and everything. In my case, luckily, the tear got better. The hardest part for me was cancelling the surgery.

 

[sk8pics]

Let me clarify. I was only asking whether you could use HSA funds for the various upgrades to lenses that were mentioned. I would not take the word of anyone on this board, of course, but was just curious if the original poster knew. I am sure the actual cataract surgery can be paid for with HSA funds.

Second clarification, @once_upon it is correct that once you are on Medicare you can’t CONTRIBUTE to an HSA but you can use your previously accumulated HSA funds for approved medical expenses. You can’t use them to pay your Medicare premiums but you can use them to pay your supplemental insurance premiums. Once you’re over a certain age, I believe, you can use them for other things that are not necessarily covered when you are younger.

I have been on high deductible insurance plans for years and have contributed the max pretty much every year to my HSA and only started spending the money after I retired last year. It’s a great deal if you have access to it.

 

[once_upon]

Second clarification, @once_upon it is correct that once you are on Medicare you can’t CONTRIBUTE to an HSA but you can use your previously accumulated HSA funds for approved medical expenses. You can’t use them to pay your Medicare premiums but you can use them to pay your supplemental insurance premiums. Once you’re over a certain age, I believe, you can use them for other things that are not necessarily covered when you are younger.

I have been on high deductible insurance plans for years and have contributed the max pretty much every year to my HSA and only started spending the money after I retired last year. It’s a great deal if you have access to it.

I retired in 2009, contribute max every year to HSA but also had some pretty expensive medical bills during those years. I think we spent the last of my HSA in 2018.

 

[Colleen]

I’ve decided to go ahead with lens replacement procedure...paying privately as two eye specialists have told me it will be years before I will need cataract surgery. I’m using my travel fund since it was untouched this year (sigh). Getting multi focal lens Replacemen. I’m waiting impatiently for mid January and throwing glasses aside. The surgeon is quite sure I won’t need readers and that I will have 20 20 vision. There are options for laser to make any minor corrections after healing.

 

[Colleen]

I’ve decided to go ahead with lens replacement procedure...paying privately as two eye specialists have told me it will be years before I will need cataract surgery. I’m using my travel fund since it was untouched this year (sigh). Getting multi focal lens Replacemen. I’m waiting impatiently for mid January and throwing glasses aside. The surgeon is quite sure I won’t need readers and that I will have 20 20 vision. There are options for laser to make any minor corrections after healing.

Adding to this - had the lens replacement yesterday. 24 hours later had a checkup - 20/20 vision! There is still some inflammation but I am thrilled with the result. I have astigmatism, extremely near sighted (10.25 prescription correction) and needed progressive lenses - the multi focal lens seems to have worked for all - I can even read the micro print on the info that came with the eye drops! The procedure was fine - lots of bright lights - I am happy I took them up on the Ativan that was offered - I was fairly relaxed throughout the procedure, which took about an hour. Time for a quick check, some water and a cookie and I was on my way home - in an out the door in two hours. Still some healing and improvement expected, but so far I'm excited about the result!

 

[A.H.Black]

Adding to this - had the lens replacement yesterday. 24 hours later had a checkup - 20/20 vision! There is still some inflammation but I am thrilled with the result. I have astigmatism, extremely near sighted (10.25 prescription correction) and needed progressive lenses - the multi focal lens seems to have worked for all - I can even read the micro print on the info that came with the eye drops! The procedure was fine - lots of bright lights - I am happy I took them up on the Ativan that was offered - I was fairly relaxed throughout the procedure, which took about an hour. Time for a quick check, some water and a cookie and I was on my way home - in an out the door in two hours. Still some healing and improvement expected, but so far I'm excited about the result!

Congratulations. Did you have both eyes done at once?

 

[A.H.Black]

One eye done.

I had my left eye done about 10 days ago with a toric lens and using FLACS (Femtosecond laser assisted cataract surgery). I chose to have correction for distance. The surgery was about 5 hours in all - actual surgery was about 10 minutes total. I went to the doctor's office for the FLACS - that took about 1 hr/2 minutes. Then, I went to the surgical center for the rest. My nephew took me and stayed with me, which was nice. I had a bit of light sedation - I don't think I felt it. I don't think I needed it, but it's what they do. There was also some topical pain killer? When I got home it stung a bit, but by the time I took a nap, it had disappeared.

By the next morning my distance sight was 20/20 and it has remained good since. in the follow-up appointment, the doctor said my eye looked like it had been healing for a week and not just 24 hrs. He was also right when he told me I would need readers for close up vision. It starts getting blurry at about 17 inches. I am experimenting with different readers - seems the 2.0 is about right. Colors are different, not brighter, just different. I notice the uncorrected eye has a yellow/warmer cast to everything (which is what I was used to, I guess). I guess warmer color is the result of the cataract.

I have decided to postpone the right eye. I'm still in a quandary about whether to have it done for distance or close-up vision. Right now it's like I have lost a contact lens - which is manageable. The doctor has signed a form for the DMV so I can get my driver's license renewed next month. I am very happy to have things the right size, the right shape, and the right distance. I'm not bumping into things anymore.

I was mistaken about the different costs - the toric lens was $1300; the FLACS is $1000 - per eye. Neither cost is covered by insurance. My insurance co-pay is $300+. I find there is a debate going on in the opthamalogical community as to whether the FLACS is worth it - whether the outcome is better, whether it is worth the cost. However, most eye surgeons say they would have the procedure themselves. I think it was worth it for me.

The cost of the drops was much lower than I expected. The expensive one ($294 with insurance) was supposed to be $60 with the coupon I was given. The eye center also gave me a sample and the sample is plenty for the one eye so I didn't get the prescription filled. The cost of the other 2 drops was significantly reduced with insurance - I did my homework on those and asked at the pharmacy. What could have cost $350 dollars ended up costing less than $14. That was a nice surprise.

Now I have to find a good place to donate a slightly used pair of glasses.

 

[KatieC]

So happy to hear how well things went for you. My surgery was only about ten or fifteen minutes, it took longer to prepare.

 

[Colleen]

Congratulations. Did you have both eyes done at once?

Yes! i guess it’s another advantage of paying privately. I have 6 pairs of glasses to donate and will be shopping for fun sunglasses! Happy to see yours went well too!

 

[A.H.Black]

I also think it's the difference between correcting vision and having cataracts removed. It seems like it's standard procedure to do cataracts one at a time.

 

[Aceon6]

I also think it's the difference between correcting vision and having cataracts removed. It seems like it's standard procedure to do cataracts one at a time.

This is standard practice. Typically, they’ll do the worst eye first. If someone has complications, they can get by on the better eye for the time it takes to resolve any issues.

 

[Colleen]

This is standard practice. Typically, they’ll do the worst eye first. If someone has complications, they can get by on the better eye for the time it takes to resolve any issue.

This is standard practice. Typically, they’ll do the worst eye first. If someone has complications, they can get by on the better eye for the time it takes to resolve any issues.

That makes sense. I was happy to have it done in one swoop. I guess I would have had to pop out the lens in one side of my glasses if they hadn't done them both.