Cataract Surgery Costs and Medicare: What to Expect
A guide to cataract surgery costs at Northern Eye Consultants, Bundoora — Medicare rebates, private health insurance, and out-of-pocket expenses explained.
Cataract surgery costs in Australia depend on several factors including whether you have private health insurance, the type of lens implant chosen, and your individual health fund and level of cover. This page provides a general overview of what patients can expect to pay at our cataract surgeons at Northern Eye Consultants. A detailed written quote is provided at your consultation, and our team is available to answer any questions about costs before you book.
Does Medicare cover cataract surgery?
Yes. Cataract surgery attracts a Medicare rebate in Australia when performed for vision impairment caused by a cataract. Medicare covers a portion of the surgeon's fee and the consultation fees associated with your pre-operative assessment and post-operative reviews. Medicare alone does not cover the hospital facility fee or the anaesthetist fee, which is why private health insurance is relevant for patients who want to minimise out-of-pocket costs.
What does private health insurance cover?
Private health insurance with hospital cover typically covers the hospital facility fee and a portion of the anaesthetist fee for cataract surgery at Northpark Private Hospital. The level of cover depends on your specific fund and policy. Most policies that include eye surgery or general surgical procedures will provide cover for cataract surgery at Northpark Private Hospital, Bundoora.
If you have private health insurance, we recommend contacting your fund before your consultation to confirm your level of cover for cataract surgery and lens implants. Our team can provide you with the relevant procedure codes to assist with this enquiry.
What are the out-of-pocket costs for cataract surgery?
Out-of-pocket costs vary depending on your health insurance, the lens implant chosen, your surgeon's fee, and the anaesthetist's fee. The following provides a general guide.
With private health insurance
The typical out-of-pocket gap is approximately AUD 500 to 1,500 per eye, depending on your health fund, your level of cover, the type of lens implant selected, and the anaesthetist's fee. The anaesthetist is a separate specialist who bills independently, and their gap fee varies and is not set by Northern Eye Consultants.
Self-funded (no private health insurance)
The all-inclusive cost for standard monofocal cataract surgery is approximately AUD 2,500 to 3,500 per eye. This includes the surgeon's fee, hospital facility fee, anaesthetist fee, standard lens implant, and routine post-operative care.
Premium lens implant upgrade
Extended depth of focus and trifocal lenses attract an additional upgrade fee of approximately AUD 1,000 to 2,500 per eye above the standard lens cost. The specific upgrade fee depends on the lens selected and will be discussed at your consultation.
These figures are a general guide only. A detailed written quote will be provided at your consultation before you make any decision to proceed with surgery.
Are premium lens implants covered by Medicare or private health insurance?
Medicare covers a standard lens implant as part of the cataract surgery rebate. Premium lens implants such as extended depth of focus and trifocal lenses attract an additional out-of-pocket cost that is not covered by Medicare or private health insurance. This upgrade fee is paid by the patient regardless of health fund status and reflects the additional cost of the premium lens technology.
Whether a premium lens is appropriate for your eye and your visual goals is discussed at your consultation. There is no obligation to choose a premium lens, and standard monofocal lenses provide excellent visual outcomes for the majority of patients.
What about the consultation fee?
Your pre-operative cataract consultation at Northern Eye Consultants attracts a Medicare rebate. A gap fee may apply depending on the complexity of the consultation and the assessments required. Our team will advise you of any expected gap at the time of booking.
A referral from your GP or optometrist is required to access the Medicare rebate for your consultation and surgery.
How do I get a detailed quote?
Contact Northern Eye Consultants to speak with our patient services team. We can provide a detailed breakdown of expected costs once we know your health fund details and the type of surgery being planned. A formal written quote is provided at your pre-operative consultation before you make any decision to proceed.
Referrals can be addressed to Northern Eye Consultants, Northpark Private Hospital, Bundoora, or to a specific surgeon by name. For a full overview of what cataract surgery at Northern Eye Consultants involves, see our cataract surgery guide.
Frequently Asked Questions
Is cataract surgery covered by Medicare in Australia?
Yes. Cataract surgery attracts a Medicare rebate when performed for vision impairment caused by a cataract. Medicare covers a portion of the surgeon's fee and consultation fees but does not cover the hospital facility fee or anaesthetist fee.
How much does cataract surgery cost out of pocket in Melbourne?
For patients with private health insurance, the typical out-of-pocket gap is approximately AUD 500 to 1,500 per eye, depending on your health fund, level of cover, lens choice, and the anaesthetist's fee. For self-funded patients without private health insurance, all-inclusive costs for standard monofocal cataract surgery are approximately AUD 2,500 to 3,500 per eye.
Are premium lens implants covered by health insurance?
No. Premium lens implants such as extended depth of focus and trifocal lenses attract an additional out-of-pocket upgrade fee of approximately AUD 1,000 to 2,500 per eye, which is not covered by Medicare or private health insurance.
Does the anaesthetist charge a separate fee?
Yes. The anaesthetist is a separate specialist who bills independently of the surgeon and the hospital. Their gap fee varies and is not set by Northern Eye Consultants. We recommend asking your health fund about anaesthetist cover when you confirm your surgical benefits.
How do I find out my exact out-of-pocket costs before surgery?
Contact our patient services team with your health fund details and we can provide an estimate. A formal written quote covering all expected costs is provided at your pre-operative consultation before you make any decision to proceed with surgery.
Ready to find out your costs?
Contact our patient services team or ask your GP or optometrist for a referral to Northern Eye Consultants, Northpark Private Hospital, Bundoora.