Some people have excellent outcomes with Crystalens (especially the new HD). For example, I can see pretty well at all distances, from one foot to infinity. Other people get very little accommodation, so still need glasses for some activities. Many people are in between, where they can see at more distances than they could with a monofocal lens, but not at all distances (or not as much as they had hoped).
Insurance only pays to restore basic vision after cataracts, which a monofocal lens does just fine. They figure it's fine if you have to wear glasses for some activities. The ability to see at more distances without glasses is considered "cosmetic", which is why you have to pay the difference if you want a premium lens like Crystalens.
It is like LASIK, not cosmetic but elective. I have hundreds of Crystalens patient and they do well. The results really depend on the surgeon and patient. Not all patients are candidates for Crystalens.
Dr. O.