Does My Insurance Cover LASIK Eye Surgery?

LASIK eye surgery offers many people an opportunity to reduce or eliminate their reliance on glasses or contact lenses.

Understanding Insurance Coverage for LASIK

LASIK is typically considered an elective procedure by most standard health insurance providers and is therefore often not covered. This classification stems from the perspective that LASIK is a convenience for vision correction, as glasses and contact lenses can also correct refractive errors like nearsightedness, farsightedness, and astigmatism. Procedures deemed medically necessary, which prevent disease or restore function, are generally prioritized for coverage.

There are rare instances where LASIK might be considered medically necessary, potentially allowing for some health insurance coverage. This could occur in cases of severe anisometropia, where there is a significant difference in prescription between the eyes that cannot be adequately corrected by glasses or contacts. Other situations might include severe contact lens intolerance, extreme dry eye conditions, or specific occupational requirements, such as for military personnel or first responders, where corrective eyewear is impractical or unsafe.

Standalone vision insurance plans, separate from general health insurance, typically offer discounts rather than full coverage for LASIK. These plans often provide negotiated discounts, which can range from 10% to 50% or offer flat dollar amounts, such as $800 to $1,000 off the procedure, especially when performed by in-network surgeons. Some employers may also offer specific benefits or access to discount programs for elective procedures like LASIK as part of their employee benefits package.

How to Determine Your Specific Policy’s Coverage

Before contacting your provider, locate your policy number and group number, as these will be necessary for identification. Having specific questions prepared can also streamline the inquiry process.

You can then contact your health insurance company by calling the member services number listed on your insurance card or by utilizing their online portals or chat functions. When speaking with a representative, inquire whether LASIK is covered under your plan, and if there are any specific criteria for coverage, particularly concerning medical necessity. Ask about any vision benefits that might apply, including negotiated discounts or allowances for in-network providers.

It is also beneficial to ask what is included in the quoted cost of LASIK, such as pre-operative examinations, the procedure itself, and post-operative care, including potential enhancements. If your employer provides your insurance, consulting with your human resources department can clarify available benefits, including any employer-sponsored discount programs.

Other Ways to Pay for LASIK

Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) offer tax-advantaged ways to pay for qualified medical expenses, including LASIK. LASIK is recognized as an eligible medical expense under IRS Publication 502.

Contributions to FSAs are made with pre-tax dollars, which can reduce your taxable income. These funds typically must be used within the plan year or a short grace period. HSAs are available to individuals with high-deductible health plans, allowing tax-deductible contributions and tax-free withdrawals for qualified medical expenses.

Many LASIK providers offer payment plans and financing options to make the procedure more accessible. These may include in-house payment plans or partnerships with third-party medical financing companies such as CareCredit or Alphaeon Credit. These plans can feature interest-free promotional periods, often ranging from 12 to 24 months, or extended payment terms with varying interest rates, potentially up to 22.99%. Monthly payments can sometimes be less than $200.

Additionally, various discount programs and promotions can help reduce the out-of-pocket cost. LASIK centers frequently offer seasonal promotions, package deals, or specialized discounts for groups like military personnel or first responders. Many providers offer free consultations to assess candidacy and discuss pricing. While credit cards can be used for payment, it is advisable to consider their interest rates carefully. The cost of LASIK, including associated expenses like pre-operative exams and transportation, may also be tax-deductible if your total medical expenses exceed 7.5% of your Adjusted Gross Income and you itemize your deductions.