Does Insurance Cover LASIK Surgery?
Understand the nuances of insurance coverage for LASIK and explore effective financial pathways to achieve clearer vision.
LASIK (Laser-Assisted In Situ Keratomileusis) is an elective vision correction procedure many individuals consider to reduce or eliminate their reliance on glasses or contact lenses. This article clarifies how health and vision insurance typically approach LASIK, and explores alternative payment methods.
Health Insurance Coverage Criteria
General health insurance plans typically do not cover LASIK surgery. It is categorized as an elective or cosmetic procedure, not a medically necessary treatment. Health insurance covers services essential for maintaining health; for refractive errors, glasses or contact lenses are considered adequate alternatives.
There are rare exceptions where health insurance might offer coverage, but these are limited to specific medical conditions. For instance, if a patient has severe anisometropia or corneal irregularities caused by a disease, LASIK could be deemed medically necessary. Such exceptional cases require medical documentation and pre-approval from the insurance provider. Patients believing their situation might qualify should consult their health insurance policy and provider.
Vision Insurance Benefits
Vision insurance differs from general health insurance, focusing on routine eye care services and materials like eye exams, glasses, and contact lenses. Most vision insurance plans do not provide full coverage for LASIK surgery, viewing it as an elective procedure. Many vision insurance providers offer negotiated discounts through a network of participating LASIK surgeons.
Discounts vary, often as a percentage off (e.g., 15% to 20%) or a fixed dollar amount (e.g., up to $1,000). To utilize these benefits, individuals typically need to confirm their specific vision plan’s offerings by checking their benefits summary or contacting their vision insurance provider. Also, inquire about participating surgeons within the network to ensure you receive the discount.
Tax-Advantaged Accounts for Payment
Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) offer ways to pay for LASIK surgery using pre-tax dollars, which can lead to savings. LASIK is considered a qualified medical expense by the IRS for both types of accounts.
FSAs are generally subject to a “use-it-or-lose-it” rule, meaning funds typically must be spent within the plan year or a short grace period (up to 2.5 months) or a limited carryover amount (up to $660 for 2025). In contrast, HSA funds roll over year after year and remain with the account holder even if they change employers.
Eligibility for an HSA requires enrollment in a high-deductible health plan (HDHP), while FSAs are typically offered by employers regardless of the health plan type. For 2025, individuals can contribute up to $3,300 to an FSA, and up to $4,300 for individuals or $8,550 for families to an HSA.
Additional Financial Approaches
When traditional insurance coverage is unavailable, other financial avenues can help make LASIK surgery affordable. Many LASIK providers offer in-house payment plans or collaborate with third-party medical financing companies, such as CareCredit. These financing options often feature interest-free periods (typically 6 to 24 months) or low-interest loans, allowing patients to pay through manageable monthly installments.
Some employers may partner directly with LASIK centers, providing specific employee discounts. Inquire with your human resources department about such programs. Personal loans from banks or credit unions, or using personal credit cards, remain options, though less advisable due to high interest rates. Consider associated interest costs and repayment terms carefully.