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Lasik and Insurance

Medical insurance may pay for some of the care related to Lasik, if not all.

Image of insurance policy being printed on a computer.  
Few medical insurance plans pay for Lasik.  

Limited Coverage

Few insurance plans cover vision correction surgery like conventional or wavefront custom Lasik, Bladeless Lasik, PRK, LASEK, Epi-Lasik, or RLE, however there are methods to maximize your existing insurance coverage.

Some managed care plans, especially vision and medical HMOs and PPOs, will contract with selected doctors or facilities to provide refractive surgery at a discounted rate. The HMO or PPO does not provide any money to the doctor, but you may receive the benefit of a lower negotiated cost. The problem with this scenario is that many times the negotiated rate is actually higher than the current market rate. Sometimes the plan's negotiated rate is higher than the current market rate from the same provider. Even if your HMO or PPO provides "coverage", it may not be very valuable. Be sure to check around.

Indemnity medical insurance plans - the ones that pay a percentage of the bill - usually do not provide coverage for refractive surgery. These types of plans normally exclude what they consider to be cosmetic or elective surgery. However, this is not always true. Some indemnity insurance plans will cover refractive surgery, so it is in your best interest to determine exactly what your plan will cover. If your insurance is through your employer, talk to your human resources people. If you have an independent insurance policy, talk to your agent or broker.

Exclusions and Limitations

All types of insurance plans have exclusions and limitations. Normally, anything that is considered cosmetic and most elective surgeries are either limited or excluded. There are conditions when refractive surgery may be considered a necessary medical procedure. We have a position statement that may be of assistance at Refractive Pathology. You will probably need to argue your point to your insurance company and you will need the cooperation of your doctor, but it may be possible to have coverage.

Flexible Spending Account

Some employers have medical flex plans that allow you to spend a certain amount for any medical care, including cosmetic and elective procedures. You need to check with your employer's human resources department. For details, read Flexible Spending Accounts.

Tax Deductible Medical Expense

Refractive surgery is a medical expense, and under certain circumstances it is deductible from federal income taxes. You need to check with your tax advisor if this may apply to you. You may want to read more information regarding deductibility of refractive surgery.

When making a decision about refractive surgery, make the decision as if you are writing the check yourself. You don't want your decision about the quality of the doctor to be influenced by a reduction of cost. A poor quality doctor is no bargain at any price. You also will probably pay closer attention and give greater consideration to whether or not refractive surgery is right for you if you will feel the full brunt of the cost.

Lasik Related Difficulties Covered

If you are experiencing difficulties related to refractive surgery, such as dry eyes, your medical insurance will probably pay for needed care, even if it would not have paid for the initial refractive surgery.

Battle Your Insurance Company

Read an excellent article by provides tips on how to effectively work through the process to get all available coverage from your insurance plan. See Fight Your Insurance

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

Personalized Answers

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

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A few of the communities where Lasik doctors are certified by USAEyes :