Does My Health Insurance Cover Lasik
Most insurance programs, including Medicare, use the term medical necessity to determine coverage. If a medical procedure is required in order to preserve health, it is typically considered a medical necessity and therefore approved for payment.
Routine surgeries to preserve vision rarely fall under these protections, meaning that people who want to use LASIK benefits to eliminate glasses may not be able to use their Medicare benefits to do so.
When you purchase insurance, you are given information about what is and what is not included. You can look through that information and determine whether or not LASIK seems to apply in your specific situation. Weve also put together a page answering the question Could you receive a health insurance rebate for your treatment?
If you are working with a private insurance company, you can ask your doctor to submit a preauthorization form to your insurance company, detailing why LASIK is right for you.
Your doctor can attach your medical records to that request to give authorities the data they need to make a smart decision. You should hear back about whether or not you will be responsible for the cost.
You can also contact Medicare to find out about financial responsibilities, especially if you are using Medicare combined with private insurance.
Does Insurance Cover Lasik Eye Surgery
Does insurance cover LASIK eye surgery? Thats a question many people have when considering laser vision correction.
LASIK eye surgery is a form of laser vision correction that can treat common vision problems by re-shaping the cornea. It can correct myopia , hyperopia , and astigmatism . The results of LASIK are life changing as it can reduce or even eliminate dependency on glasses and contacts, thereby giving patients more freedom in their everyday lives.
At LASIK Experts, weve been performing laser vision correction procedures like LASIK for decades. Our talented team includes some of the most experienced LASIK surgeons in Philadelphia and New Jersey. With more than 40 years of combined experienced, our surgeons have completed over 80,000 LASIK and PRK procedures.
Below, we review what you need to know about whether insurance covers LASIK and the financing options offered by LASIK Experts that can help put you on the path to clear vision as soon as possible.
Lasik Surgery May Be Discounted By Your Vision Insurance Provider
If you wear prescription glasses or contact lenses, you may have wondered what life would be like with 20/20 vision. While glasses and contact lenses can help achieve this, they can be cumbersome. LASIK or laser-assisted in-situ keratomileusis eye surgery is a minimally invasive surgery that can help correct a wide range of vision problems. Some of the conditions that LASIK eye surgery can improve include near-sightedness, far-sightedness, and astigmatism. Although LASIK can be expensive, vision insurance may be able to help you cover some of the costs.
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Who Is Eligible For Receiving Laser Eye Surgery On Their Health Insurance
Health insurance for eye laser surgery is available to treat the rare instances when an ophthalmologist deems the visual impairment medically necessary. Such examples are few and far between, but include instances where a medical condition or accident has directly impacted your vision.
These are the main examples where health insurance will cover refractive laser surgery:
- Eye issues that result from an injury
- Imperfections from a prior surgery
- Severe sight loss
- Visual impairment, when the patient suffers from a disability which prevents him or her from wearing glasses or contact lenses
As with all types of laser eye surgery and lens replacement surgery, not everyone will be eligible for treatment. An eye specialist will be able to check your visual health, and recommend the options suitable for you. In general, though, youll need to tick these boxes:
- Aged over 21 years old
- No vision change of less than 0.5 dioptres in the past three years
- Not pregnant
- No signs of age-related long-sightedness
Lasik Insurance Coverage & Flexible Spending Accounts
With Insurance backed FSA LASIK programs, you may be able to afford the entire LASIK procedure using only your Flex Spending Account insurance coverage. Because we contract savings of 40% to 50% off the national average for Traditional LASIK with our doctors, often our set pricing is low enough to be covered entirely by your insurance eligible pre-tax spending account. Depending on your tax bracket, you may save up to 30% or more in taxes. Due to new federal regulations on healthcare, in 2015 the maximum you will be allowed to put in your flex spending account is $2550.
Our members often pay less than that with money left over for other flex-eligible services and procedures. Call one of our Care Managers so that you can find out the exact cost for your procedure before going in for your free exam and discuss the most effective way to use your flex spending account or health savings account to pay for insurance covered LASIK. Remember that 20-30% of people who want LASIK cannot have it done. Before you set aside FSA insurance money for LASIK you should go in for a free LASIK exam to make sure that you are a potential LASIK candidate.
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Other Ways To Pay For Lasik
Many U.S. employees have an FSA, HSA or HRA to cover health expenses with income-tax-free accounts. The cost of laser eye surgery is an eligible expense for all these accounts. In addition, some people may deduct the cost of major medical expenses. Check with your tax preparer to see if you qualify. If you know you want LASIK but are concerned about up-front cost, assess your contributions during your employers open-enrollment window and consider increasing your savings so you can afford the procedure next year. At Tidewater Eye Centers in Virginia Beach, we understand the frustration with wearing glasses and contacts and the desire to have LASIK. Thats why we offer a variety of flexible payment plans and financing options to help make laser eye surgery more affordable for you. To learn more about LASIK and ways to pay, contact us at 757-483-0400 or tidewatereye.com.
The doctors at Tidewater Eye Centers have either authored or reviewed the content on this site.
Union Or Labor Health Insurance
Comprehensive labor union health plans sometimes pay for a portion of the costs of refractive surgery. Some speciality unions, such as the one for operating engineers, consider corrected vision necessary for employment and pay $1,000 towards the cost of the procedure. So, always, check with your employer health plan before you go shopping for care.
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What Are My Other Options
LASIK is typically done to eliminate the need for eyeglasses or contact lenses. If LASIK is too expensive, you may be better off staying with your current prescription lenses or trying a different type that works better for you.
When considering the costs, keep in mind that LASIK will save you the money you wouldve spent on eyeglasses or contact lenses and cleansing solutions.
This can represent a savings of several thousand dollars over time, making LASIK an affordable option when considering the long-term costs.
What should never be an option is LASIK thats advertised as very inexpensive or downright cheap. Your eyes and vision are precious and shouldnt be gambled with. If an offer sounds too good to be true, it probably is.
What Are My Best Steps For Getting Coverage
If youre considering LASIK, you may be able to take certain steps to get coverage:
The costs for LASIK vary from doctor to doctor and from state to state. Factors that may play a role include:
- your vision
- the type of laser and technology used
- the doctors level of expertise
Youll also need follow-up visits after the procedure to see how your eyes are healing.
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Lasik From An Insurance Perspective
During a LASIK procedure, you will be awake but sedated. You will look closely at a bright light, and a small incision will be made in your cornea. That incision will allow a bit of your cornea to flip up, so eye tissue beneath the cornea can be removed. This reshaping process is designed to help light move efficiently through your eye, so that light is focused on the proper part of the retina in the back of the eye.
Insurance companies can be wary of offering coverage for an expensive form of care when there is another, less expensive, form of care that does much the same thing. Glasses and contact lenses, when applied properly, can help to correct vision loss problems. Since those solutions are in place, surgery might not seem like a medical necessity, even if it provides significant lifestyle and long-term financial benefits to the patient.
Since LASIK is not always considered a medically necessary procedure, according to the American Refractive Surgery Council, it is rare for insurance companies to cover the cost of care. These companies are likely to consider LASIK a cosmetic procedure you might use to eliminate the use of glasses and contacts not a vital and last-chance hope of regaining your vision. Just as your insurance company might require you to pay for lip filler or breast enhancement surgery, you might also be expected to pay for your LASIK surgery.
Medicare And Medicaid Lasik Coverage
LASIK is not covered by Medicare or Medicaid, as it is considered an elective procedure. However, there are some cases where LASIK is classified as medically necessary and insurance coverage may be possible.
For instance, the insurance duo may cover refractive error LASIK in the following situations:
Refractive errors are deemed severe by a licensed professional.
Refractive errors were caused by an injury or previous surgical procedure.
Physical limitation prevents the patient from wearing glasses or contact lenses.
So, if youve had vision surgery before and the surgery created problems for your vision that can only be fixed with LASIK, the cost would likely be covered in the same way another medically necessary procedure would be covered. However, the eye surgeon and location where LASIK is performed must accept Medicare and/or Medicaid cases.
Its important to note that Medicaid is funded and regulated by the state, which means coverage and other important details can vary depending on where you live. Make sure to check the Medicaid website for your particular state or reach out to a local representative for more information.
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Why Get Laser Vision Correction
One of the top reasons people choose LASIK eye surgery is because it is relatively quick and has minimal side effects. You can have the procedure done in about 30 minutes, and most of that time is setting up.² The other reason people choose LASIK eye surgery is because of how quickly you can notice results. Most report seeing very well the day following surgery and can resume normal activities within 48 hours.
Another reason people decide to get laser vision correction is to reduce their dependence on prescription glasses and contacts. Most people who have laser-assisted eye surgery get 20/25 vision or better³, which works well for most activities. Also, LASIK eye surgery is a relatively safe procedure. The laser shuts off if a patient begins moving their eye rapidly, which reduces the likelihood of error and injury.
LASIK surgery remains a very popular surgical option for individuals of every age. Approximately 700,000 Americans get LASIK surgery every year.
How Can I Get A Free Tailored Quote
So, for those of us who are lucky enough to have private medical insurance, laser eye surgery most likely will not be available. However, many clinics offer financing options that help you spread the costs of surgery if youd like to avoid paying everything upfront.
Compare clinics: See if there are any top-rated laser eye surgery clinics near you, and find out the right treatment for you.
Want a tailored quote? The cost of your laser eye or lens replacement surgery will depend on the clinic you choose, the experience of the surgeon, and the treatment you go for. That means the only way to get an accurate quote is to go to a free consultation, have free eye tests , and talk through your options with an eye expert.
Our simple tool helps thousands of readers a day get ready for a glasses-free life:
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How Much Does Lasik For Astigmatism Cost
The Vision Center reports that you can expect to pay between $1,000 and $3,000 per eye for LASIK. How much your surgery will cost depends on the surgeon, what technology is used and the specifics of your eye condition. On average, patients in the U.S. spend approximately $4,500 for LASIK surgery on both eyes.
âGenerally speaking, LASIK surgery to treat farsightedness and astigmatism is on the higher end of the spectrum, while LASIK surgery to treat nearsightedness is a little less,â licensed health insurance agent Christian Worstell tells WebMD Connect to Care.
Lasik Coverage For Blue Cross Blue Shield Insurance
If youre living with glasses or contact lenses for vision correction, you may be wondering, does my Blue Cross Blue Shield insurance cover LASIK? While we wish there were a simple answer to that question, there isnt.
Some health insurance policies, including BCBS, cover LASIK. Though its difficult to answer that question without knowing more details about your specific policy, coverage can vary even within a company depending on the particular plan.
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Using Your Health Care Benefits Wisely
When you enroll in a health care plan, you are given a great deal of information about what is and what is not covered. Sometimes, that information is given to you in printed form, and sometimes that information is available to you through an online portal. You can look over that information and see if your company specifically excludes all forms of LASIK or if there are loopholes in which your surgery might be covered.
For example, some plans offer coverage for LASIK for people who had another form of eye surgery and now have difficulty seeing clearly. If this is your background, you might be able to file for an exemption, and your handbook should provide you with details about how to go through that process. If your plan offers no such loophole language, you might stop considering use of your insurance and think of other ways to pay for the help you need.
Your insurance plan may not even cover eye health at all. This is not a benefit that is considered mandatory for all health plans. According to Healthcare.gov, only some plans that are included in the Health Insurance Marketplace cover adult eye health. Since many private plans follow rules set up by the marketplace, this means many private plans also offer no vision protection.
You can talk with your LASIK provider about payment plans, financing, and other special offers that can help to reduce your costs. These can be excellent ways to save money even if you cannot use your insurance.
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.
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Interested In Lasik Schedule An Appointment With A Qualified Provider
Hearing that most insurance companies dont provide any coverage for LASIK can be disheartening. That doesnt mean you need to give up on your dream of ditching your glasses for good. Some insurance companies may offer a discount program, or you can finance the cost of your surgery. These options make paying for the treatment more manageable.
No matter how you intend to pay for LASIK, a qualified surgeon is a must. At Brimhall Eye Center, we tailor your surgery to your unique eyes and lifestyle. Our surgeons use the highest-quality lasers to improve your vision and your quality of life. For more information and to schedule a consultation, contact Brimhall Eye Center today.