Does insurance cover LASIK? That’s a common question from individuals who want 20/20 vision without glasses. Whether you’re annoyed with foggy glasses, tired of putting in contacts every morning, or you need LASIK for practical reasons like a job requirement, this page will give you an overview of the procedure and help you understand LASIK insurance and other options for helping pay for LASIK.
In the future, working with a trustworthy and transparent insurance company will make it easy to understand what you are and are not covered for. With less time spent managing your plan, you can get the care you need, faster, and go back to the things you love most in life.
Laser in-situ keratomileusis, better known as LASIK, is a surgery that aims to improve the eyesight of the patient. LASIK is used to correct three common problems with eyesight.
Nearsightedness, which is when you have trouble seeing things at a distance. Contact lenses or glasses are often used to restore eyesight. Nearsightedness is also called myopia.
Farsightedness, which is when you have trouble seeing things up close. Reading glasses are often used to restore eyesight. Farsightedness is also referred to as hyperopia.
Astigmatism is when everything is blurry, regardless of distance. A combination of contact lenses, glasses, and reading glasses are often used to restore eyesight.
Eyesight quality is dictated in part by the relationship between the cornea and the retina. Light passes through the cornea at the front of the eye, and in individuals with perfect eyesight, the cornea bends/refracts light perfectly into the retina, which is closer to the back of the eye.
If things are blurry, that can mean the relationship between the two is imperfect.
With nearsightedness, light is focused on the front of the retina rather than directly on it.
With farsightedness, light is focused on the back of the retina rather than directly on it.
With astigmatism, light is focused in a uniformly imperfect manner.
LASIK works by using a laser to precisely make modifications to the shape of your cornea, which in turn changes how light is focused onto your retina and in turn fixes your vision problems.
For most individuals, it doesn’t take long to recover from LASIK surgery. Your vision will be affected immediately following the surgery, but many individuals start seeing clearly within 24 hours. For others, adjusting may take up to three to five days.
You should stay in contact with your doctor during this time to let them know about any side effects and ensure your recovery is going as it should be.
Dry eyes for up to several months
Higher-than-usual sensitivity to bright light
The potential for double vision and “halos”
Although rare, LASIK surgery also comes with the potential for long-term side effects:
Under or over-correction to your eyesight, resulting in worse vision than before, with the potential for long-term loss of eyesight
Problems with tissue regrowth or uneven tissue removal, which may lead to astigmatism
Quality of vision gradually deteriorates as your eye changes naturally due to age
Be sure to consult your doctor beforehand to fully understand the potential side effects of LASIK and how to best avoid them.
First and foremost, the ideal patient for LASIK usually already wears contact lenses or glasses consistently. LASIK does have risks associated with it, so if your vision problems are minor, you may want to consider another option, such as continuing to wear contact lenses or glasses.
LASIK is not recommended for individuals who:
Have severe cases of nearsightedness, or who have unique eye attributes, such as thinner corneas or larger pupils than usual
Have an existing eye disease that affects the cornea, or a hereditary history of eye diseases
Are experiencing changes in eyesight solely due to aging
Play contact sports, such as rugby or boxing, which may result in contact blows made to the face (and especially the eye)
Although looking into LASIK online is a good first step, anyone serious about the procedure should be sure to talk to their doctor. Your doctor will be able to perform tests and ask specific questions based on your health, in particular, to determine if LASIK is right for you.
In general, there are two types of medical procedures, often referred to as elective and medically necessary procedures.
Elective procedures are voluntary and not required to maintain the good health of the patient. An example of a procedure that is almost always elective is teeth whitening.
Medically necessary procedures are required insofar as they are necessary to maintain the good health of the patient. An example of a medically necessary procedure is surgery for a hernia.
Since contact lenses or glasses are almost always good enough to allow the patient to function in their day-to-day lives, LASIK is almost always considered an elective procedure and therefore not covered by insurance, regardless of whether you have a public or private insurance plan.
There are exceptions, though. For example, if a police officer is unable to tolerate contact lenses and is forced to wear glasses, that could make it impossible for them to do their job safely. In this case, the police officer may be able to receive insurance coverage for LASIK. Other individuals with medical problems, such as severe dry eyes or severe seasonal allergies, may also be able to petition their insurance companies in similar ways.
Retreatments are frequently needed for individuals who get LASIK surgery. It’s 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 doesn’t cover LASIK surgery, it’s 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.
Even with an insurance plan, LASIK will usually cost the full amount because it is considered an elective procedure. LASIK is an expensive surgical procedure that is usually billed on a “per eye” basis. Each eye generally costs between a couple hundred and a couple thousand dollars, depending on various factors such as the area you live in and where you opt to get the procedure done.
However, some insurance companies and dental plans will have agreements with certain LASIK providers to get better rates for their members. In this case, your insurance plan saves you money not by providing direct coverage of the procedure, but instead by giving you a discount due to your insurance plan functioning as a “membership” of sorts.
Due to the convenience of having perfect eyesight, many individuals are looking for ways to help pay for LASIK surgery but are unable to afford the full cost upfront. Outside of insurance, there are seven common ways to pay for LASIK:
Personal financing. A combination of savings, gifts, and sources of credit can be used to afford the procedure.
Tax refunds. When your tax refund comes in, it may cover a significant portion of your LASIK procedure. Even if it doesn’t, it’ll likely take a big chunk out of the cost.
Insurance discounts. As mentioned, certain insurance companies will offer discounts on LASIK from certain providers, which can significantly help with associated costs.
Health Savings Account (HSA). An HSA is a tax-free savings account that can be used to pay for medical procedures. If LASIK is an approved procedure under your HSA, you can often pay for LASIK without spending a dime from your regular savings or checking accounts. HSAs are commonly offered in small business health insurance plans.
Installment plans. Certain LASIK providers may be able to work with you in setting up an installment plan for the procedure.
Healthcare financing. If your LASIK provider does not offer an installment plan, you may be able to outsource financing to a third party.
Vision insurance. Vision insurance is a special type of insurance plan that can help pay for elective vision procedures like LASIK.
You probably have a health insurance plan, but that plan is unlikely to cover everything associated with eyecare, including contact lenses, eye exams (the “physical examination” of vision), glasses, and LASIK. Vision insurance aims to fill the gap in health insurance plans by providing an affordable way to access important eyecare products and services.
Unlike standard insurance policies, vision insurance usually does not require you to hit a certain deductible before you get access to benefits. Instead, the vision insurance plan will usually cover a certain dollar amount in eyecare services every year. Certain plans also make use of a copay or coinsurance structure where you pay either a flat fee to access eye care products and services, or you split the bill with your insurance company at a fixed percentage.
Since vision insurance doesn’t cover as much as a normal health insurance plan does, it’s usually not as expensive as regular health insurance is. You can think of vision insurance as a supplementary insurance policy to your primary one, similar to gap insurance.
The exact cost of your vision insurance plan will be dictated by how much coverage you wish to receive. For example, if you want to get vision insurance to help with LASIK, your plan will probably be more expensive than someone who just wants to get discounts on eye exam services and contact lens purchases.
The majority of vision insurance plans cover elective procedures, and therefore LASIK. However, there are usually tiers of vision insurance plans from any vision insurance provider. Therefore, you should understand the exact services you’re covered for before you enroll in a new healthcare plan. Ask clearly, “Will vision insurance cover LASIK?”, and also be sure to get specifics of coverage regarding retreatments and complications.
The last thing you want to do is get vision insurance but still need to pay the full cost for LASIK because you didn’t do your homework.
Vision plans are usually highly customizable, and you can often get discounts on essentially any eyecare product or service you may need. By default, many vision insurance plans cover only the basics, such as eye exams and contact lenses, so LASIK may not be covered. In general, the more you spend on your vision insurance monthly premium, the more coverage you get.
Even with vision insurance and the other tips that have been recommended for helping pay for LASIK, you may still need additional funds to get the surgery. Healthcare financing—also sometimes referred to as a medical credit card—can potentially get you the upfront funds you need while you pay off the debt in monthly installments.
Medical credit cards are generally considered to be better than regular credit cards for LASIK because medical credit cards are often able to offer lower interest rates than regular credit cards.
CareCredit is a healthcare financing company that was founded in 1987. With a network of over 250,000 healthcare providers in their network, you’ll likely be able to find a LASIK provider near you. LASIK is covered by CareCredit, along with a variety of other eyecare products and services.
Alphaeon is similar to CareCredit. Both offer healthcare financing services that potentially cover LASIK. Be sure to compare rates from the two, and other popular healthcare financing companies, to get the lowest interest rates and pay as little as possible for your LASIK procedure.
Will insurance cover lasik eye surgery? The answer, unfortunately, is usually no, so don’t sweat it if you opt out of health insurance but end up wanting LASIK.
However, there are many other avenues to consider to help pay for LASIK, including vision insurance and healthcare financing companies. Before you begin, be sure to consult with your doctor to make sure LASIK is a safe and appropriate surgery for you in particular.