Does Insurance Cover Lasik? Open Your Eyes to the True Costs

Surgery for vision correction has progressed a great deal over the past few decades. Laser surgery, such as Lasik, has become common, giving consumers additional options if they do not want to use glasses or contacts. However, does insurance cover Lasik eye surgery? With the complexity of the American health care system, the answer is not a simple yes or no.

What Complicates This Answer?

Asking "does insurance cover Lasik" brings up many different aspects of health insurance. Any direct coverage would be under vision insurance, not medical insurance. Also, HSA and FSA spending accounts exist for situations like this, and though they are not insurance, they are a part of the health plan for many people. Since plans vary greatly, coverage for Lasik varies greatly as well.


False advertising is also a problem. Some clinics advertise Lasik for prices under a thousand dollars. The true cost may be more than this due to other doctor visits or supplies that may be required. While some health plans may offer some coverage for these, one would not say that they are covered by insurance. So, let us look into how the many aspects of the American healthcare system relate to laser eye surgery. Only then can we answer, "Does insurance cover Lasik?"

What Complicates This Answer?

Asking "does insurance cover Lasik" brings up many different aspects of health insurance. Any direct coverage would be under vision insurance, not medical insurance. Also, HSA and FSA spending accounts exist for situations like this, and though they are not insurance, they are a part of the health plan for many people. Since plans vary greatly, coverage for Lasik varies greatly as well.


False advertising is also a problem. Some clinics advertise Lasik for prices under a thousand dollars. The true cost may be more than this due to other doctor visits or supplies that may be required. While some health plans may offer some coverage for these, one would not say that they are covered by insurance. So, let us look into how the many aspects of the American healthcare system relate to laser eye surgery. Only then can we answer, "Does insurance cover Lasik?"

What Is Lasik?

In Lasik, an eye surgeon alters the shape of the cornea, the clear tissue in the front part of the eye. This is done by cutting a thin flap into the front of the cornea and changing its shape with a laser. Essentially, this uses the cornea of the eye like a contact lens, and can correct nearsightedness and other visual problems. After the cornea has been reshaped, the flap is replaced and heals quickly. This only takes around 10 minutes per eye and patients report excellent satisfaction overall.


Although this seems easy and fast, there is a significant amount of work to be done both before and after the procedure. Before Lasik is performed, the doctor must be certain that the patient is a good candidate. The cornea must be sufficiently thick to accommodate the level of vision correction, and the patient should be screened for any eye conditions, such as chronic dry eyes. A laser map is often taken of the cornea, tracking how light travels through the eye. Contact lenses cannot be worn and antibiotics may be given to prevent infection after the surgery.

What Is Required After Lasik?

What Is the Cost for Lasik?

Although some advertisements claim that Lasik can be performed for under one thousand dollars, these often do not include all the costs associated with the pre-operative and post-operative care and are considered a bait-and-switch by many. The average cost for Lasik was $2199 in 2018. Some clinics may offer free pre-operative examinations for those interested in Lasik, which can lower the price. However, some other clinics raise prices if patients have astigmatism or more correction is required. Consumers should be wary of this and other possible price increases before having the procedure.

Does Insurance Cover Lasik Costs?

Most medical insurance plans do not cover Lasik. Unfortunately, most vision insurance plans consider Lasik to be a cosmetic procedure and do not cover it as well. Most vision insurances focus on preventative care for the eyes and cover a certain amount for glasses and contact lenses. However, this varies by insurance. Some vision insurances offer discounts or a value-added plan on laser eye surgery procedures and further discounts if an in-network doctor performs the surgery. Also, some patients can use their vision insurance to cover the sunglasses required after Lasik.


Vision insurance may also offer some coverage for follow-up visits or medications required after Lasik. This too will vary by the insurance plan and consumers should inquire with their particular insurance company. Does insurance cover Lasik? No, but it may offer discounts and other ways to decrease the overall cost. Also, there are elements to health plans that can also help reduce the out-of-pocket cost.

How Do HSA and FSA Plans Help Pay for Lasik?

Although they are not insurance, HSA and FSA accounts are other ways for consumers to pay for health expenses that are not covered by insurances. Lasik is one of these expenses.

Health Savings Accounts (HSA)

Can Anyone Open a HSA?

Flexible Spending Accounts (FSA)

Potential Additional Costs

Although Lasik has a high rate of satisfaction, complications can occur. One of the most common is dry eye, which can be common after this procedure. Though not a serious complication, it may require examinations and treatment. Inflammatory conditions can occur around the corneal flap, which can require additional surgery if anti-inflammatory eye drops do not resolve the condition. Fortunately, this only occurs in around 2% of cases. Other complications with the flap can occur, but at a rate of less than 0.5%.


Although the rate of serious complications is low, the FDA has performed studies on Lasik complications and has warned consumers to carefully choose their doctor. Since Lasik is such a popular procedure, with around 700,000 procedures per year, even a low rate of complications will result in a significant number of patients with problems. Also, some worry that low-cost Lasik centers may not perform adequate screening, leading to more complications. Consumers should carefully research their doctor before having this procedure.

Conclusion

So, does insurance cover Lasik? No, but the healthcare system has ways to cover this gap in coverage. HSA and FSAs allow patients to put tax-free money into savings accounts for situations like Lasik. Some vision insurances also offer discounts on Lasik and other laser corrective procedures, especially when performed at in-network doctors.


Of course, cost is not the only concern. Advertisements offer Lasik procedures for under a thousand dollars, but they may be bait-and-switch situations with a much higher true cost once all other required care and examinations are added. Serious complications, though rare, still result in a significant number of patients with problems after this procedure. So, prospective consumers must research their doctor and contact their health insurance to find out if the costs and risks make Lasik the right procedure for them.

Featured Photo by Helloquence on Unsplash

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