Eye Care, Insurance, LASIK, Surgery

If you’re considering LASIK (Laser-Assisted In Situ Keratomileusis) to correct your vision, one of the first questions you might have is whether your health insurance will cover the cost. While LASIK can offer permanent vision correction, it may require a higher up-front investment than contacts and glasses. Understanding how insurance works with LASIK can help you make an informed decision.

Why Insurance Typically Doesn’t Cover LASIK

Most health insurance plans consider LASIK an elective rather than a medically necessary procedure. Since LASIK corrects refractive errors (like nearsightedness, farsightedness, or astigmatism) that can be managed with glasses or contacts, insurers argue it’s not essential for maintaining overall health.

Although LASIK is rarely a medical necessity, it significantly improves the quality of life for most candidates. Imagine waking up to clear vision, swimming without contacts or glasses, and traveling without your contact lenses, solution, and case: it’s no wonder that over 98% of patients1 are satisfied with their LASIK results. Check out our previous blog to learn how LASIK leads to greater patient happiness, health, and financial wellness compared to contacts.

Exceptions: When LASIK Might Be Covered

While LASIK is generally not covered by insurance, there are some exceptions. Coverage may be possible in specific cases, such as:

  1. Laser Vision Correction for Military Members: The United States Armed Forces consider clear vision without the “crutches” of contacts and glasses a significant readiness benefit. Readiness describes a military member or unit’s ability to perform its mission efficiently and effectively on a moment’s notice, whether at home or down range. Therefore, laser eye surgery is a covered medical benefit for military members. My mission as an Air Force ophthalmologist was to augment the readiness of the warfighter through laser eye surgery. For thousands of America’s best and bravest, I am forever grateful to have improved their readiness and quality of life.
  2. Vision Impairment Beyond Corrective Lenses: If you have a severe refractive error that can’t be adequately corrected with glasses or contacts, your insurance might cover LASIK. This is rare but worth investigating if you’re in this category.
  3. Certain Medical Conditions: Some insurance policies might provide coverage if LASIK or another laser eye surgery is deemed medically necessary for conditions such as anisometropia (a significant difference in prescription between the two eyes) or other corneal diseases that diminish quality of life.
  4. Accidental Injuries: If your vision impairment results from an accident, such as eye trauma, and laser eye surgery is the recommended treatment, some insurers may provide partial or complete coverage.
  5. Employer-Sponsored Vision Plans: Some employers offer vision plans, health savings accounts (HSAs), and flexible spending accounts (FSAs) that allow you to use pre-tax dollars for LASIK. While these plans don’t cover LASIK outright, they can reduce your out-of-pocket costs by using pre-tax contributions.

Alternatives to Full Coverage: Discounts and Financing

While laser eye surgery such as LASIK, SMILE, and PRK are usually not covered by insurance, there are still a few money-saving strategies you can use to make your surgery more affordable:

  1. Insurance Discounts: Some health insurance plans have partnerships with LASIK providers to offer discounted rates to their members. While this isn’t the same as coverage, it can still result in significant savings.
  2. LASIK Financing Plans: Many LASIK centers offer financing options that allow you to pay for the procedure over time, often with little or no interest for a promotional period. This can make the procedure more affordable without insurance coverage. At the time of this blog posting, Corsini Laser Eye Center offers 24 months of interest-free financing through our partnership with Alphaeon. Call our office to see if you qualify for financing.
  3. HSA or FSA Funds: If you have an HSA or FSA, these funds can cover LASIK costs. The benefit of using these accounts is that they allow you to pay for medical expenses with pre-tax dollars, reducing the effective price of the surgery by a significant amount.

What to Do Next: Steps to Determine Your Coverage

  1. Review Your Insurance Policy: Check your policy documents or call your insurance provider to determine if any part of LASIK is covered under your plan.
  2. Ask About Discount Programs: Even if full coverage isn’t available, your insurance provider might offer a discount program or recommend preferred providers with negotiated lower rates.
  3. Explore Employer Benefits: Investigate any employer-sponsored health benefits, such as vision insurance, HSAs, or FSAs, that can help offset LASIK costs.
  4. Consult with LASIK Providers: Some LASIK centers offer free consultations and can help navigate insurance options and financing plans. Corsini Laser Eye Center always provides free consultations, and we will spend as much time as you like discussing your surgical and financial options.

A Word of Caution

Beware that lower costs do not mean better outcomes. In fact, the adage, “you get what you pay for” generally rings true for laser eye surgery. Centers with outdated technology may offer surgery at discounted rates or use bait-and-switch marketing techniques to get you through the door. You only get two eyes. Entrust them to a surgeon who shares your values and prioritizes patient outcomes and experience above all else.

Conclusion

While LASIK is usually considered an elective procedure and not covered by most health insurance plans, there are still ways to make it more affordable. Understanding your insurance policy, exploring discounts, and utilizing HSAs or FSAs can help reduce costs. Before deciding, consult your insurance provider and a LASIK specialist to explore all available options and ensure you make the best choice for your health and budget.

Thanks for reading!

Jonathan Corsini, MD

References:

  1. Sandoval HP, Donnenfeld ED, Kohnen T, Lindstrom RL, Potvin R, Tremblay DM, Solomon KD. Modern laser in situ keratomileusis outcomes. J Cataract Refract Surg. 2016 Aug;42(8):1224-34. doi: 10.1016/j.jcrs.2016.07.012. PMID: 27531300.