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 |  | With Health Insurance: $100+ copays & 10%-50% coinsurance |  | Without Health Insurance: $13,000-$27,000+ |
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A corneal transplant is a type of surgery in which a damaged cornea, the clear lens at the front of the eye, is replaced with a donor cornea. This procedure can restore vision, curb pain and improve the appearance of a damaged or diseased cornea.
Typical costs: | - A corneal transplant typically is covered by health insurance. For insured patients, out-of-pocket costs typically consist of a specialist copay, possibly a hospital copay of $100 or more, and coinsurance of 10%-50% for the procedure, which could reach the yearly out-of-pocket maximum. According to the Kaiser Family Foundation[1] , the average hospital copay for outpatient surgery is $132 and for inpatient surgery is $232.The average coinsurance rate is 17%-18%.
- For patients who are not covered by health insurance, the average cost of surgery can range from $13,000 to $27,000 or more. According to the Agency for Healthcare Research and Quality[2] , a corneal transplant typically costs $13,119 when done as an ambulatory procedure and $27,705 when performed as an inpatient surgery.
- A research report[3] by the actuarial and consulting firm Milliman found that in 2011 the typical cost for a corneal transplant was $24,400, which included $7,900 for surgeon's fees and $16,500 for hospital transplant admission.
- According to the Illinois Eye Bank[4] , patients typically aren't charged for the eye tissue used in the transplant, which will be received from a deceased donor.
Related articles: Eye Exam, Eyeglasses, Contact Lenses
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What should be included: | - To prepare[5] for the surgery, a patient will undergo eye exams, have his or her eye measurements taken, and receive treatment for any unrelated eye problems. Because transplanted tissues come from deceased donors, the wait typically isn't long, as it might be in other transplants.
- On the day of surgery, a patient's routine[6] will typically include being given a sedative and local anesthetic to numb the eye. The patient remains awake during the procedure.
- In some instances, a partial-thickness (lamellar) transplant may be used. This replaces only the innermost layer of the cornea rather than all layers.
- Following surgery, the patient will be given a protective eye shield and a gauze patch to wear for one to three days.
Additional costs: | - According to the National Institutes of Health[7] , in one out of three patients, the body rejects the corneal transplant in the first five years, requiring additional medical intervention or surgery.
- According to the Mayo Clinic, patients can expect frequent eye exams ($114 per visit without insurance, or a copay of $5-$50 for those covered by insurance) -- first weekly, then monthly -- to check for complications in the year after the surgery. Still, how often a patient must visit the eye doctor will depend on the individual situation.
- Glasses or contact lenses may be needed to improve vision after surgery.
Discounts: | - Many hospitals offer discounts of 30% or more to uninsured/cash-paying patients. At St. Joseph Hospital[8] in Orange, CA, for example, patients without health insurance may qualify for a 45% discount off billed charges. The hospital also offers an additional 10% discount if payment is made within 10 days of the patient receiving the bill.
- Under the federal government's Hill-Burton program[9] low-income patients may qualify for free or low-cost services.
Shopping for a corneal transplant: | - The U.S. Department of Health and Human Services offers a hospital comparison tool[10] that lists hospitals near a chosen zip code, how far away they are and whether they offer emergency service.
- The Oregon Health and Science University offers a brochure[11] about corneal transplants, while the AHRQ offers a general guide[12] for patients undergoing surgery.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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External Resources: | - kff.org/health-costs/report/employer-health-benefits-2012-annual-survey
- www.hcup-us.ahrq.gov/reports/statbriefs/sb86.jsp
- publications.milliman.com/research/health-rr/pdfs/2011-us-organ-tissue.pdf
- www.illinoiseyebank.org/education/faqs.htm
- www.mayoclinic.com/health/cornea-transplant/MY00491/DSECTION=how-you-prepare
- www.mayoclinic.com/health/cornea-transplant/MY00491/DSECTION=what-you-can-expect
- www.nlm.nih.gov/medlineplus/ency/article/003008.htm
- www.sjo.org/For-Patients/Your-Hospital-Bill/Self-Pay-Discount-Program.aspx
- www.hrsa.gov/gethealthcare/affordable/hillburton
- www.medicare.gov/hospitalcompare/(S(efntd2saaeir2l5pgarwuvvg))/search.aspx?AspxAut...
- www.ohsu.edu/xd/health/services/casey-eye/clinical-services/specialty-services/cor...
- www.ahrq.gov/patients-consumers/diagnosis-treatment/surgery/questions/surgery.pdf
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