LASIK Surgery: Does Medicare Cover It?
- LASIK eye surgery can correct vision problems, such as nearsightedness, farsightedness, and astigmatism.
- Because it is an elective procedure, it’s generally not covered by original Medicare.
- Some Medicare Advantage (Part C) plans may cover some or all of the costs of LASIK surgery.
LASIK eye surgery is an outpatient procedure done to correct vision issues such as nearsightedness, farsightedness, and astigmatism.
If you have original Medicare and your doctor has recommended LASIK for you, you may be wondering whether your insurance will pay for it.
Medicare covers only surgeries that are considered medically necessary. Since LASIK is an elective procedure, original Medicare doesn’t cover it.
However, if you have Medicare Advantage, you may have some coverage under your plan.
Read on to learn more about Medicare coverage for LASIK and how to get the most coverage possible.
However, there are exceptions for medically necessary services. These include: cataract surgery and treatments for eye diseases, such as:
LASIK surgery isn’t usually done to prevent blindness and isn’t categorized as medically necessary. It is an elective procedure done to improve vision, which can alternatively be corrected with eyeglasses or contact lenses.
For that reason, it’s not covered by Medicare.
What if I have a Medigap plan?
Since Medigap covers only services approved by Medicare, it doesn’t cover the cost of LASIK surgery.
Will Medicare Advantage cover LASIK?
Medicare Advantage (Part C) plans often include vision coverage. Some plans will cover all or some of the cost of LASIK.
Since plans and their coverage vary, you shouldn’t assume that your Part C plan will pay for this procedure. In the next sections, we’ll discuss how to confirm whether your plan offers this coverage.
If you’re considering LASIK, you may be able to take certain steps to get coverage:
- First, talk with your eye doctor. They probably have patients on Medicare who have had LASIK surgery done. If so, they may be able to provide insight into Part C plans in your area that cover the cost — or a percentage of the cost — for this procedure.
- If you’re new to Medicare, currently have original Medicare or a Medicare Part C plan that doesn’t cover LASIK, you can use Medicare’s plan finder tool to compare plans in your area that are a better fit.
- You can contact your local Medicare State Health Insurance Assistance Program to get information about plans in your area that provide this benefit.
- If you want to switch from original Medicare to a Medicare Advantage plan that covers LASIK, you may do so during open enrollment, which runs annually from October 15 to December 7. During open enrollment, you can also switch from one Part C plan to another.
- If you currently have Part C and wish to change plans, you can also do so during the annual Medicare Advantage open enrollment period, which runs from January 1 to March 31.
The costs for LASIK vary from doctor to doctor and from state to state. Factors that may play a role include:
- your vision
- the type of laser and technology used
- the doctor’s level of expertise
The consultation with your doctor to determine whether you’re a good candidate for LASIK may include multiple tests and eye measurements. This exam alone may cost several hundred dollars in some instances.
You’ll also need follow-up visits after the procedure to see how your eyes are healing.
Ask your doctor what the costs for all of these visits are upfront and if they’re folded into the total cost of LASIK surgery. The LASIK procedure itself usually averages around $4,200.
Temporary eyeglasses, sunglasses, or contact lenses may also be required, resulting in additional out-of-pocket costs.
All these costs add up and may mean LASIK isn’t an affordable option for you without help. If so, talk with your doctor. They may offer a low- or no-interest financing plan that can help you pay for LASIK over 1 or 2 years.
There are also vision insurance plans for older adults that you may wish to buy. These plans can provide extra coverage to your current Medicare insurance.
Not every vision insurance plan covers the cost of LASIK surgery. As with any insurance plan you’re considering, make sure to find out exactly what’s covered before you purchase the plan.
LASIK is typically done to eliminate the need for eyeglasses or contact lenses. If LASIK is too expensive, you may be better off staying with your current prescription lenses or trying a different type that works better for you.
When considering the costs, keep in mind that LASIK will save you the money you would’ve spent on eyeglasses or contact lenses and cleansing solutions.
This can represent a savings of several thousand dollars over time, making LASIK an affordable option when considering the long-term costs.
What should never be an option is LASIK that’s advertised as very inexpensive or downright cheap. Your eyes and vision are precious and shouldn’t be gambled with. If an offer sounds too good to be true, it probably is.
LASIK is an outpatient procedure that’s done to reshape the corneas, usually in both eyes, to improve your vision. It typically takes around 30 minutes for both eyes.
LASIK doesn’t require general anesthesia. Some patients are given medication to help them relax during the procedure.
Here’s an overview of what typically happens during the LASIK procedure:
- Before the procedure, your doctor will place numbing drops in each eye.
- Your eyes will be held open with an instrument, and you’ll be instructed to focus on a beam of light.
- A suction ring will be placed on your eye.
- Your doctor will use a small blade or cutting laser to cut a thin corneal flap in the front of your eye, which can be folded back to expose the cornea.
- The cornea is reshaped through the removal of microscopic corneal tissue cells.
- The flap is then laid back over the cornea.
- The procedure is repeated on your other eye.
It may take between 2 to 3 months to heal completely and see your final results.
According to Mayo Clinic, 8 out of 10 people report having 20/20 or near-20/20 vision and no longer needing eyeglasses or contact lenses after LASIK.
While rare, there are risks that may occur with the LASIK procedure. Some of these risks include:
- dry eyes
- glare, halos, or double vision
- problems healing
- vision loss or changes
- regression back to previous vision prescription
- LASIK is an outpatient surgical procedure that’s done to improve vision.
- Many people report that they no longer need to wear eyeglasses or contact lenses after having LASIK surgery.
- Since it’s an elective procedure, original Medicare doesn’t cover LASIK.
- Some Medicare Part C plans cover some or all of the cost of LASIK.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.