WHY ISN’T LASIK COVERED BY MOST INSURANCE PLANS?

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WHY ISN’T LASIK COVERED BY MOST INSURANCE PLANS?

September 29, 2020

Do you ever wonder why LASIK vision correction surgery still isn’t covered by insurance plans? This simple outpatient procedure can return sight to those who have spent their lives relying on glasses or contact lenses. Because laser eye surgery is an elective procedure, most health insurance companies consider it cosmetic and not medically necessary. However, there are certain conditions under which medical plans might in rare circumstances cover refractive or laser eye surgery:

  • Eye surgery for refractive errors that are a result of an injury
  • Eye surgery for refractive errors that are a result of surgery
  • Eye surgery for severe refractive errors; however, there is no standard level of impairment at which insurance will cover correction. Insurance coverage under these circumstances is generally very inconsistent and individuals should check with their provider.
  • Eye surgery when a patient is not only unable to wear glasses due to physical limitation (such as an allergy or deformity), but cannot wear contacts due to physical limitation (lens intolerance)

Vision insurance may be of some help. However, vision benefits are slightly different than standard medical or health insurance. Vision insurance plans are designed to reduce a patient’s costs related to routine preventative eye care. While most of the benefits relate to eye exams and prescription eyewear, some plans offer additional savings. Some of the larger vision insurance carriers offer specific laser vision correction benefits including:

  • Discounts on laser vision correction procedures
  • Higher discounts of up to 50% on procedures performed by in-network surgeons
  • Frame benefits for non-prescription sunglasses after vision correction surgery

“There are some insurance plans that now include LASIK vision correction surgery,” says Trish Whiteside, Practice Administrator. It’s important to keep checking with your insurance provider to determine if you are enrolled in a plan that provides coverage. You may have to pay the costs up front as an out-of-pocket expense front and file a claim post surgery.

Some patients choose to apply tax-free funds from their flexible spending account (FSA) or health savings account (HSA) to pay for their LASIK procedure. Check with your human resources department to learn more about a FSA or HAS plan. Many people don't realize LASIK eye surgery is FSA and HSA eligible because they probably see it as elective, rather than necessary. But LASIK doesn't just slightly improve vision; it corrects nearsightedness, farsightedness, and even astigmatism in patients, possibly eliminating their need for glasses or contacts. In other words, it can dramatically improve their lives while reducing eye care costs.

Dr. Stewart Shofner has performed over 40,000 LASIK/PRK procedures on middle Tennessean’s eyes. Shofner Vision Center offers affordable vision care using the latest technologies and also offers special discounts to all military, law enforcement, firefighters and first responders. Eliminate the hassle of wearing glasses or the daily routine and expense of contact lenses and schedule a free LASIK consultation online at Shofner Vision Center or call (615) 340-4733.

WHY ISN’T LASIK COVERED BY MOST INSURANCE PLANS?

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