Does health insurance cover cataract surgery? 

It’s the most common elective procedure performed in Australia, but cataract surgery has a long waiting list in public hospitals. According to Australian Institute of Health and Welfare data, the average wait for cataracts in 2024-25 was more than 106 days (3 months). If you have private health insurance, you can have your cataracts done in a private hospital relatively quickly, by the doctor of your choice, and you might get your own room (if the hospital can accommodate this). But how do you know if your health insurance covers cataracts? 

What are cataracts? 

Cataracts are when the lens of your eye becomes cloudy, usually caused by ageing and exposure to UV light. The most effective treatment for cataracts is surgery to remove the affected lens(es) and replace them with an artificial clear lens, a procedure that takes around half an hour.  

Half of Australians over the age of 70 will experience cataracts.

Is cataract surgery covered by health insurance? 

Yes, cataract surgery is covered by private health insurance, depending on your level of cover.  

Full cover for cataract surgery is included in Gold tier Hospital Cover. Insurers may choose to offer it on Silver Plus policies. Restricted benefits for cataracts are offered on some Basic Hospital Cover policies, but you will face significant out-of-pocket costs. 

What are the tiers of Hospital Cover and what treatments do they include?

Don’t forget, there may be a waiting period for cataract surgery on health insurance. Usually, this will be 2 months if you have recently started your policy or have upgraded from a lower tier of policy where cataracts were not included. And if your cataracts are considered a pre-existing condition, you may have to serve a 12-month waiting period. Talk to your insurer to find out what waiting periods apply. 

How much does cataract surgery cost? 

If you have cataract surgery in a public hospital, the costs will be covered by Medicare. If you have private health insurance and choose to be treated in a private hospital, the typical out-of-pocket cost is $480.

If you want cataract surgery in a private hospital, talk to your insurer to find out whether you’re covered, and ask about the excess, out-of-pocket fees, waiting periods and conditions that may apply. 

What’s the best health insurance policy for cataracts? 

There’s a wide range of health insurance policies available that will cover you for cataracts – and a wide range of prices, too. We found the cheapest policy covering cataracts for one adult in Victoria with a $750 excess was a Silver Plus policy for $233.80 per month, with a $750 excess, and the most expensive was a Gold policy for $515.55 per month, with a $750 excess, as of July 2026.

To find the best health insurance policy for cataracts, use the healthslips.com.au calculator to search every policy on the market. You won’t have to enter any contact details to see your results, so you can be anonymous.

Look for a new policy, or compare your existing policy to other policies. 

healthslips.com.au does not provide general or personalised advice. Your particular circumstances are likely to impact the accuracy, completeness and relevance of the information or results. Take this into account before making a decision and talk to an expert for financial advice.     

Trudie McConnochie

Writer and Researcher

Knowledge is power – that’s the guiding principle behind everything Trudie writes, and it’s a philosophy she brings to her work at healthslips.com.au. By breaking down complex information into easy-to-understand blogs and stories, she aims to empower Australians to make the best choices and an informed decision around private health insurance.

Trudie understands firsthand some of the complexity of private health insurance having moved to Australia from New Zealand and having to navigate a vastly different public healthcare system and health insurance structure.

Trudie holds a Bachelor of Communication Studies (journalism major) from the Auckland University of Technology.

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