Insurance Status of Chrystalens/AIOL

My doctor has been watching the development of Crystalens, and
accommodative lenses in general, for the last year as a possible
treatment option for my rapidly advancing cataracts in both eyes.

As you probably know, Crystalens is not a Medicare-accepted treatment,
so private insurance companies are unlikely to cover it at all.
Considering the costs associated with the procedure, I will probably
be forced to accept the traditional synthetic replacement lenses, one
at a time, as it becomes "medically necessary."

This bothers me a great deal. I'm still in my thirties, both eyes are
in the -9 to -10 range, have astigmatism, and a scleral buckle in one
eye. This product seemed a perfect miracle, except for the
insurance/cost aspect.

I was looking at the Crystalens site when a statement struck me rather
cold: "If you've already had cataract surgery, you're not a candidate
for the Crystalens procedure." The reason is not given as to why this
is so, but I will assume it is because the muscles that accommodate
the natural lens are severed and then wither away to useless nubs. Is
this correct?

If so, then being forced to accept an approved non-accommodating
replacement lens is being forced to permanently sacrifice a perfectly
operative structure of the body, without any possibility of recovering
utility.

How does this stand legally? At what point does your desire to be made
as whole as possible give way to the insurance companies' desire to
save money? I wonder if a person could challenge the current
situation based upon the notion that accepting a relatively
debilitating procedure is not in the best interest of their health,
considering the options.

What are your thoughts? How do we effect a change in the status of
this procedure?


BLReed

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The insurance companies will insure anything but it means the premium will
be higher. You need to tell your employer and employee bargaining group
that you want this covered; they can check what the increase premium cost
will be. You will then need to convince your fellow employees to accept
that increased cost as part of the next pay raise/ benefit review and
instead of increased pay or pension or other benefits.

Dr Judy