Is LASIK Surgery Covered by Medicare?
Considering LASIK? Learn about Medicare's vision coverage policies, including typical limitations and alternative payment methods for the procedure.
LASIK surgery, a common procedure performed to correct vision, is often considered by individuals seeking to reduce their reliance on glasses or contact lenses. Medicare is the federal health insurance program for people 65 or older, younger people with certain disabilities, and people with End-Stage Renal Disease. Original Medicare, which includes Part A and Part B, generally does not cover the cost of LASIK surgery. This procedure is typically viewed as an elective service rather than a medically necessary treatment for an illness or injury.
Medicare Vision Coverage Rules
Original Medicare, specifically Part B, covers certain medically necessary eye care services and supplies. This coverage extends to diagnostic tests and treatments for various eye diseases and conditions. For example, Medicare Part B typically covers services related to cataracts, glaucoma, and macular degeneration. Coverage also includes vision correction following cataract surgery if an intraocular lens is implanted. This distinction highlights Medicare’s focus on addressing medical conditions that impair health.
Why LASIK is Excluded
LASIK is considered a type of refractive surgery. Its primary purpose is to correct common vision problems like nearsightedness, farsightedness, and astigmatism, allowing individuals to see clearly without corrective lenses. Medicare classifies LASIK as an elective procedure rather than a medical necessity. Medicare’s policy is to cover treatments for illnesses or injuries, not procedures performed for convenience or cosmetic improvement. Since LASIK is typically undertaken to improve vision for daily living rather than to treat a specific eye disease, it falls outside the scope of what Medicare deems medically necessary.
Medicare Advantage Considerations
Medicare Advantage Plans, also known as Part C, are offered by private insurance companies approved by Medicare. These plans must provide all the benefits of Original Medicare and often include additional benefits such as dental, hearing, and routine vision care. Despite these expanded offerings, Medicare Advantage plans rarely cover elective LASIK surgery. While some Medicare Advantage plans may offer benefits for routine eye exams or a portion of the cost of glasses or contacts, coverage for LASIK remains uncommon.
Financing LASIK
Since Medicare typically does not cover LASIK, individuals often explore alternative methods to pay for the procedure. Flexible Spending Accounts (FSAs) allow employees to set aside pre-tax money for qualified medical expenses, including LASIK. These funds must generally be used within the plan year, though some plans offer a grace period or limited carryover.
Health Savings Accounts (HSAs) offer another tax-advantaged option for those with high-deductible health plans. Contributions to an HSA are pre-tax, grow tax-free, and can be withdrawn tax-free for qualified medical expenses, including LASIK. Unlike FSAs, HSA funds roll over year to year, allowing individuals to save over time.
Many LASIK providers offer payment plans or work with third-party medical financing companies like CareCredit or Alphaeon. These options often include deferred interest periods or extended payment terms. Additionally, the cost of LASIK can be considered a medical expense for tax deduction purposes. Taxpayers can deduct qualified medical expenses if they itemize deductions.