6월, 2024의 게시물 표시

**노인성 백내장 수술, 의료보험 적용되면 실제 부담 비용은 얼마?**

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며칠 전, 78세 어머니께서 “눈이 뿌옇게 흐려져서 신문 글자가 안 보인다”고 말씀하셨어요. 처음엔 단순 노안인가 했는데, 안과에서 진단받아보니 양쪽 눈 모두 백내장 이 꽤 진행된 상태였습니다. 의사 선생님은 “수술이 필요하다”고 하셨고, 저는 가장 먼저 ‘비용’이 떠올랐죠. “요즘 물가도 비싼데, 백내장 수술에 얼마나 들까?”, “의료보험 되면 부담이 덜할까?” 이 질문에 답을 찾기 위해 직접 발로 뛰고, 통계청 자료와 건강보험심사평가원 데이터를 뒤져봤습니다. 의료보험 적용 범위 생각보다 넓지만, '전부'는 아니다 백내장 수술이 의료보험에 적용된다는 건 많은 분들이 알고 계세요. 하지만 적용되는 항목과 비용 부담의 구체적인 차이 는 생각보다 복잡합니다. 건강보험심사평가원이 2023년 발표한 자료에 따르면, 노인성 백내장 수술의 건강보험 적용률은 약 85%에 달합니다. 이 말은 수술 전체 비용 중 85% 정도가 보험으로 처리된다는 뜻이 아니에요. 오해하기 쉬운 부분이죠. 실제로 보험 적용은 기본 진료비, 검사비, 수술료, 그리고 기본 인공수정체 에 한정됩니다. 2024년 기준으로 건강보험이 적용되는 기본형 인공수정체는 한쪽 눈당 약 10만 원에서 15만 원 정도의 본인 부담금이 발생해요. 여기서 중요한 건 ‘기본형’이라는 단어입니다. 병원에서 권하는 고급형, 다초점, 난시교정용 인공수정체는 전액 본인 부담 입니다. 제 어머니 경우를 예로 들어볼게요. 의사 선생님이 “기본형으로 하면 보험 적용되지만, 노안까지 교정되는 다초점 렌즈는 100만 원 이상 추가 비용이 듭니다”라고 설명하셨어요. 이 말을 듣고 저는 표를 정리해봤습니다. 항목 건강보험 적용 여부 본인 부담금 (한쪽 눈 기준) 초진 및 검사비 적용 약 3-5만 원 수술료 (의사 수가) 적용 약 10-20만 원 기본형 인공수정체 적용 약 10-15만 원 다초점 인공수정체 비적용 약 80-150만 원 난시교정용 인공수정체 ...

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