Meuhedet cataract surgery – price, rights and what to check

Meuhedet members facing cataract surgery usually ask two questions: how much will it cost, and what does the fund cover. The answer depends on three main things: whether the surgery is done within the health basket, under Meuhedet's supplementary insurance or privately, which lens you choose, and whether laser is used. On this page we explain the differences between the routes, what is known about the costs, and which questions to ask the fund before you decide.

Three routes to cataract surgery

Meuhedet members, like members of all the health funds, usually have three options:

• The health basket: surgery in a public hospital, with a referral and a commitment from the fund.
• Supplementary insurance (Meuhedet Adif or Meuhedet Si'a): surgery with a surgeon in the fund's arrangement, with a co-payment and according to the terms of the plan.
• Private surgery: self-funded surgery, with a free choice of surgeon, institution and lens type.

No single route suits everyone. The decision depends on availability, the type of lens that suits you, how important choosing the surgeon is to you, and your budget.

What the health basket includes

Within the health basket, cataract surgery with a regular (monofocal) lens is performed in a public hospital with a referral and a commitment (Form 17) from the fund, so the cost to the patient is usually low. Premium lenses and laser technique are not part of the basic entitlement.

A monofocal lens focuses on one range of vision, usually distance, so many patients still use reading glasses after surgery. Anyone who wants a premium lens, such as a toric lens to correct astigmatism or a multifocal lens, should find out in advance whether they will pay for the extra and how much.

Meuhedet Adif and Meuhedet Si'a: surgery within the arrangement

Meuhedet Adif and Si'a usually provide coverage for surgery with surgeons in the fund's arrangement, subject to a co-payment and to the terms of the plan (for example, a waiting period). In practice, this means the surgeon is chosen from the fund's arrangement list, and the amount of the co-payment is set by the plan and by the institution.

In supplementary insurance such as Meuhedet Adif too, the terms for a toric lens or a premium lens are set in the plan's regulations, and it is advisable to check them with the fund. The same applies to surgery with laser technique.

Surgery with a surgeon or at an institution that is not in the arrangement is usually funded entirely by the patient. So if you are considering private surgery, check with Meuhedet in advance whether there is any entitlement in your case, and do not assume you will get a refund.

How much private cataract surgery costs

Private cataract surgery with a standard lens usually costs NIS 10,000–13,000 per eye, all-in: the surgeon's fee (about NIS 7,500), the operating room (about NIS 3,500) and a standard lens (about NIS 500). A premium lens (multifocal or EDOF) or a toric lens adds about NIS 2,500–5,000 per eye, and the use of laser (femtosecond) adds NIS 2,000–7,000 per eye.

Prices are a general estimate only; an exact quote is given after an examination. Get a personal price quote

The price is for one eye. If you need surgery in both eyes, calculate the cost for each eye separately. More information on the timing between the eyes is on the page Cataract surgery in the second eye, and a full breakdown of private surgery prices is on the page Private cataract surgery price.

What affects the final price

• The route: the health basket, supplementary insurance within the arrangement, or private surgery.
• The lens type: a standard lens is included in the price of private surgery, while a toric or premium lens adds to the cost. A comparison of lens types is on the page Types of lenses in cataract surgery, and details on toric lenses are on the page How much does a toric lens cost.
• The surgical technique: laser-assisted (femtosecond) surgery adds to the cost and is not part of the basic entitlement.
• The co-payment: in supplementary insurance it is set by the terms of the plan, and it usually goes up when you choose extras such as laser or a premium lens.

Health basket, supplementary insurance or private surgery: the real difference

The health basket is the cheapest route for the patient. On the other hand, the surgery is done in a public hospital, with a regular lens, and usually without the option of choosing a surgeon. Waiting times vary between hospitals and between regions of the country, so it is worth asking about them in advance.

Supplementary insurance usually lets you choose a surgeon from the arrangement list and have the surgery at an institution in the arrangement, in return for a co-payment. It is a middle path: more choice than the basket, at a lower cost than fully private surgery, but only within the limits of the arrangement and the terms of the plan.

Private surgery allows a free choice of surgeon, institution and lens type, and sometimes more flexibility with the date. On the other hand, it is usually funded entirely by the patient. If you choose this route, get a detailed quote in advance that includes the surgeon, the operating room, the lens and any extras.

In every route, what matters more than the price is that the decision on the lens type is made after a full examination, and that you understand in advance what the payment includes and what it does not. Questions such as how many follow-up visits there are after surgery, who is available for questions in the first days, and what happens if further treatment is needed are worth asking in every route.

How to choose a lens and a route

The lens is chosen in consultation with the ophthalmologist, after tests and measurements of the eye. The considerations include your need for distance, intermediate and near vision, whether you have astigmatism, and the general condition of the eye. Not every lens suits every eye, so it is worth hearing the doctor's recommendation before comparing prices.

Once it is clear which lens suits you, you can compare the routes: is this lens available in the route you chose, what is the co-payment, and what would the difference be if you chose private surgery. Information on the tests before surgery is on the page Preparing for cataract surgery.

Questions to ask Meuhedet before surgery

1. Is the surgery covered for me within the health basket, and where can it be done?
2. Which supplementary insurance plan do I have (Adif or Si'a), and has the waiting period passed?
3. Which surgeons and institutions are in the arrangement, and what is the co-payment with each of them?
4. What are the terms for a toric or premium lens, and for surgery with laser technique?
5. If I choose private surgery outside the arrangement, is there any entitlement?

It is a good idea to ask for the answers in writing, because the terms change from time to time and between plans.

Summary

Meuhedet members can have cataract surgery within the health basket, under supplementary insurance with a surgeon in the arrangement, or privately. The main differences are in the choice of surgeon, the lens type and the cost. Private surgery with a standard lens usually costs NIS 10,000–13,000 per eye, and a premium lens or laser adds to this amount. Before you decide, check the terms with the fund and get a proper quote after an examination.