Should Multifocal IOLs Be Covered by Medicare?

Cataract surgery involves the replacement of a clouded natural lens with a clear plastic one, known as an intra-ocular lens (IOL). As we age, the proteins in the lens degrade, which leads the clouding, and there is no way to restore clarity to the lens once clouded. The only solution available, therefore, is to replace the clouded lens with an artificial one that does not face the risk of clouding. Traditionally, monofocal IOLs--lenses focused at a particular distance--were used because technology did not exist to make lenses that could allow the eye to accommodate, or focus, at different distances. Because cataracts can lead to near-blindness in sufferers, cataract surgery is considered medically necessary and is covered by Medicare.

Now, multifocal IOLs, artificial lenses that allow the eye to focus at different distances, are available for use. The goal is to free people who have undergone cataract surgery from the need to wear glasses in order to see clearly at any distance other than the one determined for their monofocal IOL. Many patients with multifocal IOLs, such as the ReSTOR or ReZOOM lenses, are able to drive, read, and perform many other tasks without resorting to the use of glasses.

However, these new lenses are more expensive than the older monofocal IOLs, and Medicare considers the choice for a multifocal IOL to be an indulgence, so it does not cover them. But should it? Medicare part B pays for glasses following cataract surgery. The majority of people who have multifocal IOLs do not need glasses most of the time, making it reasonable for Medicare to drop the coverage of eyeglasses if it covers the multifocal IOL. Although not a perfect trade-off for the government in terms of cost, it is not so dramatic a cost difference as it seems, and if the price of multifocal IOLs continues to come down, we may see the two options leveling out. Covering both would allow patients to choose the lens right for them following cataract surgery.

If you are interested in receiving multifocal IOLs following your cataract surgery, contact us today to schedule a multifocal IOL consultation with a local cataract surgeon.