Cataract Surgery. Will the NHS or my insurance company pay?

Recently cataract surgery has been restricted by some primary care trusts in Manchester and Cheshire. The aim is to restrict surgery to patients who really need the operation but the thresholds, sometimes just based on vision chart measurements not quality of life have been set at a level which in some cases is a worse level of vision than would be necessary to be legal for driving.When considering whether to have cataract surgery discuss with your optician what can be managed by optimising your glasses.

If you are struggling with vision related tasks such as reading and driving and adjusting the glasses prescription is not likely to be helpful then you should discuss this at your hospital visit and make clear that the cataract is impairing your quality of life.
If the NHS won’t pay for your cataract operation will your private provider? One of the benefits of private healthcare was the expectation that you could have your consultation and surgery with the consultant of your choice with whom you had developed a relationship and trust. However although most private insurers do not place the same restrictions on cataract surgery some are trying to reduce how much they spend. This may involve a contract with a certain private hospital or individual providers who may have negotiated a lower fee.
The private insurer may therefore ask you to have your cataract surgery done by a hospital and surgeon you have had no previous contact with. This may leave you in the difficult position of losing the choice which you thought you had or face a surcharge from your consultant to cover the shortfall from the payment by your insurance company. Before accepting this type of limitation from your insurer do check the wording of your policy and discuss any concerns about your choice with your insurance company.

Appointment times can be worked flexibly around your needs and may be accommodated on evenings and weekends.
You can also be seen at a private hospital close and convenient for you.


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