Flex Plans Can Bring Many Benefits To You
A helpful mechanism that makes surgery more affordable to many individuals is the FLEX plan, which is essentially a government-allowed, tax-free medical account that is administered as a benefit through many employers.
The employee simply specifies the year before the plan goes into effect how much money they would like deducted on a monthly, tax-free basis from their paycheck to cover the cost of a medical procedure or product. The employee can undergo surgery at any point during the year, paying for the procedure with the tax-free funds, essentially saving up to 40% of the LASIK price of the procedure, depending on their tax bracket.
Is Lasik A Medical Or Vision Benefit
Most patients are surprised to find out that medical insurance actually differs from vision insurance. They are even more surprised to learn that LASIK can be covered by either their medical insurance, vision insurance, or both.
Provides coverage for medical conditions, symptoms and treatments, in some cases provides partial or full coverage for laser vision correction.
Covers routine vision exams, glasses and contacts. Some vision plans provide partial coverage, while others provide member-only pricing for laser vision correction.
Insurance Companies Offering Health Plan That Cover Lasik Eye Surgery
- Insurer Aditya Birla Health Insurance
- Network Hospitals 5700+
- Covers Lasik Eye Surgery under all their Health Plans
You May Like: How To Get Health Insurance In Nc
Will My Insurance Cover Other Eye
Medically necessary eye-related procedures, like surgeries, may be covered by a health plan and under the care of an opthalmologist. Many vision insurance plans also cover various eye-related services and corrective devices, including eye exams, eyeglasses and contact lenses. Vision insurance is not always included in base health insurance plans and you may need to add it at an additional cost or purchase a vision plan separately.
A few health plans include vision coverage for adults. Health insurance is highly individualized, and you need a health plan that serves your coverage needs and budget. SmartFinancial can help match you with the perfect policy based on your answers to a few quick questions. Just enter your zip code below or call 855.214.2291 to receive your free health insurance quotes.
About the Author
Does Insurance Cover Lasik For Astigmatism
Unfortunately, most health plans consider laser surgery an elective treatment. Elective procedures are usually not covered by traditional insurance plans. However, some vision insurance companies are starting to offer discounts on LASIK.
Some vision insurance policies that offer discounts include:
- Vision Service Plan
If you get one of these plans, you’ll probably have to use an in-network eye doctor for your LASIK treatment. They usually have contracts with specific LASIK clinics. This is helpful because the surgeons in these networks have been vetted and approved by the insurance company to provide comprehensive LASIK treatment to correct astigmatism.
Don’t Miss: Does Dollar General Offer Health Insurance
How Successful Is Lasik For Astigmatism
LASIK has very high success rates for correcting astigmatism. According to the American Refractive Surgical Council:
“The latest research reports 99 percent of patients achieve better than 20/40 vision and more than 90 percent achieve 20/20 or better. In addition, LASIK has an unprecedented 96 percent patient satisfaction rate the highest of any elective procedure”
Should You Get Surgery
The decision of whether or not to get laser eye surgery is up to you.
Very few health funds provide full benefits for the procedure’s upfront costs.
Most people are looking at a health fund that will only pay a small percentage of the total cost.
There are costs associated with having glasses and contact lenses as well, so you might be able to offset the cost by thinking about it as a replacement.
The treatment can make life easier in the long term for those who need it.
It can be an expensive procedure, and requires careful consideration.
This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.
Speak with us
In What Situations Does Lasik Eye Surgery Help
LASIK Eye Surgery helps people within the age group of 18-40 years. In fact, this age group is considered apt for LASIK treatment. However, people above 40 years can also undergo the surgery depending on health conditions. As soon as you complete one year of wearing glasses, you can undergo eye laser surgery insurance coverage. Further, changes in technology have also led to changes in the criteria for eligibility for the surgery.
How Much Is Lasik With Insurance
Some of the most common questions we receive about LASIK surgery focus on the cost of the procedure, and the payment options available to cover laser eye surgery. What is the cost of LASIK, and does insurance cover it?
Most insurance companies consider LASIK an elective or cosmetic procedure, which means that it wont be covered by most policies. There may be some exceptions where insurance companies will cover the cost of LASIK, and there are diverse payment or financing options available if your insurance policy doesnt cover laser eye surgery.
You May Like: What Company Has The Best Health Insurance Coverage
How Much Is Covered
This generally depends on your insurer and policy. Some health funds cover the full cost of these procedures, while others only offer partial coverage. The amount youll be able to claim for treatment differs depending on the policy you have chosen. Its best to compare your health insurance plan options to find the right one for you and your requirements.
Is Lasik Covered By Your Insurance Plan
Find Cheap Health Insurance Quotes in Your Area
Insurance plans usually don’t cover Lasik or corrective eye surgery because it’s a voluntary procedure. But that doesn’t mean you have to pay full price.
Your insurance company may offer discounts on Lasik as a policyholder perk. This is more common with vision insurance than with health insurance, but either option can save you thousands of dollars. Plus, you can use a flexible spending account or health savings account account for even more savings on Lasik surgery.
We recommend Cigna health insurance plans for the best benefits for Lasik eye surgery.
The cost of Lasik eye surgery averages $2,250 per eye when paying full price. Costs vary based on where you get the procedure and whether the procedure is traditional or custom.
You May Like: How Does Health Insurance Through Employer Work
Coverage For Lasik Is Rare
For the most part, health insurers will pay only for glasses or contacts. Insurance has taken the position that LASIK is cosmetic, said Dr. Charles R. Moore, the founder of International EyeCare in Houston, Texas.
Your healthcare provider will probably cover some, or all, of the cost of a pair of glasses. But if you want an expensive designer pair, or need bi-focal glasses, you will most likely pay a good portion of that expense out of pocket. Similarly, though many experts see pointing lasers into your eyes to improve your eyesight as a health-related procedure, high-end refractive surgery isnt typically viewed as medically necessary by insurers.
Keep in mind, though, that even without insurance to share the cost of surgery, there are financial benefits to LASIK, particularly if you buy high-end contact lenses, designer eyeglasses or special bi-focal lenses.
Ways To Pay For Lasik Eye Surgery
If you cant get a Lasik eye surgery covered through your insurance plan, there might be other ways to find savings. If you have a Flexible Spending Account through your employer, you could use it to pay for part of the cost of the procedure.
An FSA is an untaxed account that allows you to contribute money for health-related expenses within 1 calendar year. As of 2021, the yearly limit for contributions into an FSA is $2,750. Its likely that this amount will not be enough to cover the full cost of Lasik eye surgery, which generally costs between $4,000 to $5,000 for both eyes.6
However, there are 2 ways you could possibly contribute more than the $2,750 annual limit from your FSA towards the procedure:7
- 2 ½ month grace periodSometimes, employers may allow you an extra 2 ½ months after the yearly expiration date to use your FSA funds. This means you could combine the funds from the previous year with contributions made within the 2 ½ month period and use it toward a Lasik procedure.
- $500 rolloverYour employer may offer a rollover of up to $500 of unused FSA funds from a previous year into your current years spending. With a rollover, you could add up to $500 onto your annual FSA fund limit.
Employers can offer one of these FSA options, but not both. They may offer neither one. Be sure to check with your employer about available FSA options before you plan your Lasik procedure.
Read Also: What Does Ppo Means In Health Insurance
Hmo Plans Can Put You And Your Doctor Into An Unwanted Financial Pit
If you have an HMO policy, coverage is even less likely than a PPO plan since HMO payments to your doctor are usually based on a concept known as capitation. Capitation is when the HMO pays the doctor a lump sum of money per month to cover all of the care for a given patient, regardless of how much care the patient requires.
If the patient needs surgery or specialty care, the doctor or medical group providing treatment pays the cost. This is why it is typically so difficult to get surgery or a specialty referral in a capitated HMO setting, as the insurance company who owns the HMO policy financially pits the doctor and the patient against one another.
Flexible Spending Arrangements Or Health Savings Accounts
Some employers offer access to an FSA or HSA to allow employees to set aside tax-free money that can later be used for a qualified procedure such as LASIK. For 2022, the U.S. Internal Revenue Service currently caps contributions to health savings accounts at $3,650 for an individual HSA or up to $7,300 in a family HSA plan. The IRS limits the pre-tax contributions to an FSA for 2022 to $2,850 for the tax year. Importantly, there are new rules governing how account holders can use their 2021 account funds which potentially gives you access to even more money. Check with your benefits manager for details.
Don’t Miss: How To Enroll In Cigna Health Insurance
Insurance In The Netherlands
At CZ, one of the largest insurance companies in the Netherlands, you can submit an S2 application if treatment cannot be provided in the Netherlands, or not in time. Other companies, such as Interpolis and Zilveren Kruis, only state that the treatment should be non-urgent. Although an S2 application can be submitted for each type of therapy, each request is assessed separately and therefore there are no guarantees.
In all cases, a treatment plan and a cost estimate will be requested. The doctor of the clinic where the treatment will take place can indicate how urgent the procedure is. A referral letter from a Dutch doctor strengthens the request. It should not matter whether the desired operation takes place in a regular hospital or at a private clinic.
You can find an example of a reply of an insurance company to an S2 application right here: Insurance letter Zilveren Kruis
In case you need help from a lawyer to help during the negotiations with the insurance company youre with, we recommend Mrs. Desiree Maes, also known as The Pink Lawyer.
Get Coverage For New Drugs
Many new drugs or services introduced in the market undergo trials to test additional benefits or uses. Consumers can try to get into one of the trials and get the service or product as part of the trial. However, although each trial is designed differently, many have a group of participants who receive a placebo, a fake treatment, so you are not guaranteed the drug or service. Your physician should be able to help you learn of any trials available as the Food and Drug Administration requires the listing of drug trials.
Recommended Reading: Can You Have A Baby Without Health Insurance
Are Retreatments Or Complications From Lasik Covered By Insurance
Retreatments are frequently needed for individuals who get LASIK surgery. Its common for doctors to offer retreatment free of charge within one year. You may also need retreatment down the line in five to ten years, which is generally not provided free of charge. In general, if your insurance doesnt cover LASIK surgery, its unlikely it will cover LASIK retreatments.
Although very rare, complications from LASIK can result in negative side effects, such as the scratching of your cornea. In this case, your insurance is likely to cover treating the complications, as complications from LASIK are frequently deemed medically necessary due to their severity.
Health Insurance And Refractive Or Laser Eye Surgery
Health insurance usually doesn’t cover the cost of refractive or laser eye surgery, but some companies will pay the bill if certain criteria are met. Some insurance companies offer a vision plan which may provide a discounted price or apparent partial coverage for laser eye surgery. Because laser eye surgery is an elective surgery, many health insurance companies consider it cosmetic and not medically necessary. Certain conditions under which medical insurance plans might in rare circumstances cover refractive or laser eye surgery include:
- Eye surgery for refractive errors that are a result of an injury
- Eye surgery for refractive errors that are a result of surgery
- Eye surgery for severe refractive errors however, there is no standard level of impairment at which insurance will cover correction. Insurance coverage under these circumstances is generally very inconsistent and individuals should check with their provider.
- Eye surgery when a patient is not only unable to wear glasses due to physical limitation , but cannot wear contacts due to physical limitation
Check with your insurance company to determine if you are enrolled in a plan that provides benefits. You may have to cover the costs as an out-of-pocket expense or with your flexible spending account or health savings account.
About Lasik Eye Surgery
Lasik eye surgery is performed for an improved vision of the individuals. It is used to correct the vision of the people having myopia, hyperopia, and astigmatism. The surgery is done with a complex procedure and it takes around 30 mins to complete the procedure using advanced technology. Initial step for this process includes medical inspection of the eye condition by the experts, and checking of the eligibility. It is considered to be one of the effective treatments for a better vision as it helps the people regain their perfect vision.
Which Health Insurance Covers Laser Eye Surgery
Whilst no private health insurer will pay for the full cost of your laser refractive or refractive lens surgery, some providers will offer some cashback on optical expenses, which may include a consultation with an eye specialist, or some cases of cataract surgery.
If you are one of the many people in the UK who receive medical insurance through your employer, its worth noting that many corporate eye care insurance policies specifically exclude laser eye surgery from their terms.
These 10 popular health insurance providers may part-fund your laser eye surgery:
Read Also: How To Enroll In Health Insurance
Why Cataract Surgery Is Important
Although you may not be scheduled for cataract surgery as soon as this condition is diagnosed, your eye doctor will follow the diseases progress and recommend surgery for you as soon as it is medically necessary. AARP reports that a recent study found that cataract surgery may increase your lifespan by improving your overall health, showing exactly how important this procedure can be.
TheJournal of the American Medical Association, Ophthalmology published a 20-year study involving 74,044 women, ages 65 and older, who developed cataracts which required surgery. In 41,735 women, there was a 60 percent lower risk of death after the cataracts were removed, although many of them had additional health problems compared to those who did not opt for cataract surgery.
The link, researchers believe, is with overall improved quality of life. Not only are post-surgery individuals able to see better, so they are less likely to suffer a serious accident, they experience reduced stress overall, which improves health in other ways. After cataract surgery, the women were able to exercise more and be more cautious when taking prescription medications. For them, driving and walking became safer. They were less likely to experience falls and other accidents.