Does Insurance Cover LASIK Procedures?

Glasses and contact lenses can reveal a sharper, brighter world once they bring your vision into focus. Although they help you to see your world more perfectly, they also come with some inconveniences. As your eyes change, so will your vision, and you'll have to return to the doctor for an annual examination for a prescription to buy another pair.

Some people decide to undergo LASIK to break the endless cycle of buying new prescription lenses for their eyes. Although the surgery has surged in popularity in recent years, some patients seek ways to pay for this procedure through insurance, financing or other means. Are you curious about LASIK?

What Is LASIK Surgery?

According to the American Academy of Ophthalmology, LASIK (laser-assisted in situ keratomileusis) is a type of refractive surgery that corrects vision-related issues. The FDA approved this procedure in 2002, and it’s now one of the top elective surgeries in the nation. A scientist came up with the idea for LASIK in 1981 during a Thanksgiving dinner. He proved that excimer lasers could reshape the eye. Today, surgeons use this laser to treat refractive errors when your eye doesn’t bend light correctly. Our eyes work similarly to a camera’s lens. Light rays travel through the cornea and lens to help form clear images of their environment. These two structures refract light, so it lands on the retina, which turns the light into signals. These signals travel to your brain, and are translated them into clear images. Some people's corneas or lenses don't bend light correctly, which causes their vision to become fuzzy or blurry. Optometrists generally use glasses or contacts to correct their vision, but LASIK offers a permanent solution for these issues.

LASIK is similar to other vision correction procedures like radial keratotomy (RK) and photorefractive keratectomy (PRK). Most medical professionals consider these procedures. They are generally safe for people with healthy eyes who no longer want to wear glasses or contacts. Most insurers won't cover this operation, but you can receive discounts.

What Does LASIK Eye Surgery Involve?

The goal of LASIK is to improve vision-related disorders in patients. This procedure may reduce your dependency on eyeglasses and contact lenses. When LASIK is successful, you may not need these items altogether.

Here is an overview of the three refractive issues that ophthalmologists may correct during LASIK surgery. They are:

Nearsightedness (myopia) – This condition occurs when the eyeball is slightly longer than normal, or the cornea curves too sharply. Myopia results in light rays focusing on the front of the retina, while distant objects aren't sharp. You may see objects that are close to you, but not ones that are too far away.

Farsightedness – This condition occurs when a person can see faraway objects, but nearby objects are blurry. Hyperopia occurs when the eyeball is shorter than a normal one, or the cornea has a flattened shape. It causes light to focus behind the retina instead of its surface. The disorder results in fuzzy, near vision, and it can sometimes disrupt distant eyesight.

Astigmatism – When you have a curved, flattened, or uneven cornea or flattened, it may result in a condition called astigmatism. This disorder results in blurry near and distant vision.

Most ophthalmologists order glasses or contact lenses to bend or refract light rays to the correct position on the patient’s retina. Now, surgeons can reshape the dome-shaped transparent tissue called the cornea at the front of the eye. This procedure provides the right refraction to correct eyesight.

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Am I a Good Candidate for the LASIK Procedure?

Your doctor will assess whether you’re a good candidate for LASIK surgery before they agree to perform it. This professional will gather your patient history by asking you questions about your eye health. He or she will find out whether you have any conditions that could cause poor outcomes or medical complications following surgery. These health conditions include:

Keratoconus – This eye disease results in progressive deterioration and thinning of your cornea. If you have a family history of this disease, a surgeon will discourage you from pursuing this elective surgery.

Eye infections – An ophthalmic surgeon will not perform LASIK surgery if you have conditions such as Keratitis, uveitis, herpes simplex and other medical illnesses that affect the eye area.

Eye injuries and lid disorders – These may result in poor outcomes.

Dry eyes – Patients with dry eyes can have their condition get worse if they have this procedure.

Large pupils – LASIK surgery may be inappropriate for people who have large eyes, even in dim light. Having surgery can result in halos, glare, starbursts, and ghost images.

Cataracts - Since there is damage to the lens, other procedures such as cataract removal or refractive lens exchange, may be better options.

Cornea abrasions and disease - LASIK can aggravate these conditions.

Advanced glaucoma – This procedure can worsen eye pressure issues.

Older patients – There is currently no age limit for this procedure; however, according to the American Academy of Ophthalmology, people age 60 and older may have a decreased tear production. It is challenging since LASIK surgery can result in decreased tear production.

Doctors can recommend that you not have refractive surgery if you have other medical conditions that can impact your ability to heal or complicate your outcomes. These include:

Diseases that affect immunity - These include HIV, arthritis, lupus, Celiac disease and other autoimmune issues.

Diabetes – This disease can affect your ability to heal well from incisions or surgical procedures.

Depression and chronic pain – These problems can cause complications or extend healing time.

Vision instability – These include vision changes due to pregnancy, age or hormonal fluctuations


How Much Does LASIK Surgery Cost?

The out-of-pocket charge for LASIK surgery can vary between $1,000 and $3,000 per eye. The price not only includes the procedure; it also covers the care that patients receive before and after the operation.

Last year, media organization All About Vision commissioned a study about the average national price of LASIK. They surveyed surgeons who routinely perform LASIK and other vision correction procedures (PRK, SMILE, and refractive lens exchange). The average cost for LASIK in 2019 was $2,246 per eye. This price usually includes preoperative and postoperative care, such as vision examinations and consultations. Surgeons may also schedule a follow-up procedure with you if the surgery did not result in eyesight within 20/40.

Seventy-one percent charge a single price for all vision correction procedures performed with an excimer laser that reshapes the cornea. These physicians customarily include automated technologies, like the femtosecond lasers used in bladeless LASIK (which creates a flap in the cornea), in the comprehensive fee, instead of charging extra.

Almost 26% of surgeons use exact pricing for this procedure, meaning that they may charge more for technologies that use wavefront technology (which measures how light passes through the cornea) during customized procedures.

Are Bargain LASIK Procedures Worth the Price?

A few ophthalmologists advertise low-cost LASIK procedures to patients that sound like a good deal. But these surgeries often have hidden costs that patients will be responsible for in the future. There are several things that people should remember.

Low-cost LASIK procedures only correct mild nearsightedness. The cost of LASIK may be higher than advertised if you have astigmatism, farsightedness or severe myopia.

Additionally, these costs won’t cover all the medical care you’ll need. They will only provide a few follow-up visits and any post-op care at an extra cost. These cheap procedures don’t cover any corrective enhancement/retreatment surgeries you’ll need if the operation didn’t go as planned. They may charge you additional money for your first consultation.

Your physician may use older equipment for your operation. Newer equipment allows your doctor to perform your surgery with precision. Additionally, you won’t get a custom LASIK or bladeless (all-laser) LASIK surgery.

Before undergoing a bargain LASIK procedure, get a customized quote from the ophthalmologist. Read the fine print in your contract to learn what medical care you’ll receive and any hidden fees you’ll have to pay. Don’t go ahead with the procedure if it’s not going to cover the things you need.

Does Health Insurance Cover LASIK Surgery?

You’ll likely have to pay for most of your LASIK surgery procedure out-of-pocket. Health insurance plans rarely cover the cost of LASIK, because many providers consider it an elective procedure. Most vision plans will only pay for glasses or contacts and not LASIK or other refractive eye surgeries.

Many insurers are now providing partial coverage and discounts for LASIK because of its high popularity. Large union group insurance plans may pay for a portion of the costs. Schedule an appointment with your human resources office or union representative to find out if their plan covers this procedure. Large employers also offer subsidized health insurance plans that pay for part of the costs of LASIK. You can ask your company about any benefits for elective eye procedures.

Insurance providers will cover this surgery when patients meet specific criteria. Get free health insurance quotes and see which plans cover LASIKS. Be aware, however, that most vision plans only offer a discounted rate or partial coverage for laser eye surgery. If you have a consultation with a doctor’s office, they can also tell you if your current insurance will offer any coverage for the LASIK procedure. Health insurance plans may cover LASIK for patients with the following health conditions:

Refractive errors caused by an injury - They will consider eye surgery for vision disorders that result from an injury in an accident, a fall, etc.

Eye changes following surgery - Insurers will provide LASIK if an operation caused a refractive error.

Bad refractive errors - Insurance companies may cover eye surgery for extreme refractive errors; however, there is no standard of impairment that insurers will cover in these corrections. Individuals should check with their insurers since many have inconsistent standards regarding which operations they’ll reimburse.

Patients who have certain medical conditions - Insurers may approve LASIK for patients who can’t wear glasses or contacts because of physical limitations (such as allergies, intolerances or deformities).

Speak with your provider and find out if your insurance plan has benefits for refractive surgery.

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Can My Vision Insurance Help with LASIK Surgery?

Most vision insurance plans don’t cover refractive surgeries like LASIK, because they are elective procedures that aren’t medically necessary. These attitudes have slowly changed. A few vision insurance providers have decided to cover some but not the entire cost for this procedure. If your vision plan doesn’t cover any coverage for LASIK surgery, SmartFinancial can help you find one that offers these elective benefits. Our transparent insurance technology allows you to compare plans and rates from multiple insurance providers in your area.

Vision plans generally cover only part of the costs. There are other non-insurance ways to lower the cost of LASIK procedures such as financing plans, Flexible Spending Accounts (FSA), and Health Savings Accounts. Some vision providers offer an insurance discount on treatment and additional savings when members use an in-network surgeon.

Flexible Spending Accounts and Health Savings Accounts

Some patients use Flexible Spending Accounts (FSA) to pay for their LASIK surgery. This account allows people to save pre-tax income from your job and use it for out-of-pocket health care expenses. Any unspent money doesn’t roll over at the end of the year.

Health Savings Accounts (HSA) allow people to divert money, tax-free and use it for LASIK surgery. To be eligible for this account, you must be enrolled in a high-deductible health plan (HDHP) by your employer. All unspent money rollovers, so you can use it the following year.

The maximum annual employee contribution to an FSA is $2,750 in 2020. The tax-free annual contribution limit for HSA is $3,550 per individual and $7,100 for families. If you have enough time and money, you can wait two years to save up for LASIK surgery using your HSA. The maximum annual employee contribution to an FSA is $2,750; however, the average cost for LASIK surgery was $2,246 per eye in 2019.

LASIK for U.S. Military Members

Service members in the U.S. military may be able to obtain LASIK and other corrective eye surgeries free of charge. It will depend on your assigned rank and duties in each branch. Do you need a vision plan that can help cover the cost of a Lasik procedure? Buying insurance can be confusing, but SmartFinancial can help simplify the process. We have helped shoppers save money on insurance, one policy at a time.

You don’t have to spend hours comparing coverages and prices with different carriers. Our transparent technology platform matches people with the right insurance carrier and coverage. You’ll only have to complete a simple application or speak with one of our expert insurance concierges. We’ll provide you with multiple quotes from insurance companies in minutes. You’ll be able to pay online or in person. It’s just that easy.

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