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Cataract Surgery and Insurance Coverage

Did you know cataract surgery is the most commonly performed, medically necessary surgery in Canada? In fact, according to the Canadian Ophthalmological Society, one and a half million people have this procedure every year in North America. Some surgeries, including LASIK and refractive aspects of cataract surgery, are considered “convenience procedures,” meaning they are primarily for the purpose of giving patients the same clear vision, but with reduced dependence on corrective contact lenses or glasses. These are much like cosmetic surgeries, which may not be medically necessary.

In Canada, patients are able to have their vision restored with cataract surgery that is high-quality, safe, and publicly insured. Because cataract surgery is so commonly performed in Canada, costs are covered under health insurance plans. Patients who require this procedure are frequently offered optional services during their cataract surgery to provide additional refractive correction.

Non-insured refractive correction services that are offered during cataract surgery can include special-feature intraocular lenses like multifocal and accommodating IOLs, femtosecond laser-assisted cataract surgery, surgical devices, laser therapies or specialized diagnostics. Any non-insured testing that may be done can provide more customizable, predictable procedure results and even enhanced quality of vision. These services are an additional cost to patients because they are not deemed medically necessary. Newer innovations aim to enhance refractive outcomes for patients who are hoping to be independent from glasses or contacts, but at a financial cost.

Over the past few decades, there have been many technological advancements in cataract surgery adopted by publicly funded insurance plans in Canada. These have completely revolutionized the procedure by allowing for safer, faster surgery with more successful outcomes. The non-insured services aim to improve the overall refractive outcomes rather than reduce complication rates of surgery, so public healthcare coverage is ultimately deemed unwarranted.

Are you interested in any of the above procedures? For additional information, contact us at North Toronto Eye Care today!

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*Use our secure online portal to refer your patients. It is easy to use, completely secure, and utilizes digital communications to update you on the status of all your referrals and allows you to have 2-way digital communication with NTEC/Prism. This same portal keeps your patients updated on their appointments.

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Main Line: 416-748-2020

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