Ontario patients with cataracts have many options to consider regarding surgery. Cataract surgery is the most commonly performed surgery in Canada, during which your cataract is removed and an artificial intraocular lens is implanted. Technological advances have revolutionized cataract surgery allowing for improved safety, the costs of which are funded by the Ontario Health Insurance Plan (OHIP).
Several newer innovations in cataract surgery are not covered by OHIP and are optional choices for all patients in Ontario. These uninsured services are not medically necessary and are designed to reduce dependence on glasses/contact lenses, and/or to potentially enhance the quality of your vision.
What is covered by OHIP?
Eye measurements are needed to select the appropriate lens implant used during surgery. OHIP covers the cost of testing using ultrasound. There are other preoperative measurement techniques that are optional and are not insured. These may permit a more customized vision correction with lens implants and reduce your dependence on glasses at the focus point of your choice (distance or near). Preoperative testing takes place in your surgeon’s office, where payment for the optional uninsured services is made.
OHIP covers the cost of surgeon fees and the standard lens implant for cataract surgery. There are special feature implants, additional procedures, specialized diagnostics, and certain lasers that are non-insured services that patients can choose at the surgical facility or hospital for an additional cost.
Optional special feature lens implants may:
- treat astigmatism
- reduce your need for glasses
- attempt to improve the quality of your vision
All uninsured cataract services in Ontario are optional. Your ophthalmologist should discuss with you any fees for un-insured services and answer any questions you may have.
The cost for uninsured services can vary between surgeons and hospitals/surgical facilities. Payment for non-insured cataract services are paid for directly by the patient to the surgeon’s clinic or hospital.
Every patient has a right to know their options and to make well informed decisions about which options, if any, they wish to choose and the costs involved.
Can I pay to get faster surgery?
No. Wait times can vary significantly for cataract surgery. Independent of where your surgery takes place, Ontario surgeons are legally prohibited from offering faster surgery for a fee, otherwise known as queue jumping. Any payment out of pocket should only be for uninsured testing, procedures, or lens implants — not to have surgery done sooner.
Why are the wait times so long?
More than 10 years ago, the provincial government promised to develop and deliver a wait time strategy which would reduce wait times for treatment in specific “priority areas” – namely cataract surgical procedures. Unfortunately, the wait time continues to worsen. You can help by taking action and sending a letter to your MPP, letting them know your concerns.
Frequently Asked Questions
The following brochure contains frequently asked questions and answers regarding cataract surgery in Ontario. (brochure link)