Does Medicare Cover LASIK Surgery?

The decision to have LASIK surgery is an exciting one. Soon, you’ll be able to see clearly and be free of contacts or glasses! But you may have questions about how to pay for your surgery. At ICON Eyecare, we believe every patient should have the opportunity for great vision and vision care — even when insurance doesn’t apply.

What Is LASIK?

LASIK eye surgery is one of the most common elective eye surgeries in the U.S. More than 600,000 surgeries are performed each year. It’s a safe and effective laser surgery that can help correct refractive errors including astigmatism, myopia (nearsightedness), or hyperopia (farsightedness). LASIK stands for laser-assisted in situ keratomileusis.

Original Medicare Generally Does Not Cover LASIK

Original Medicare is the federal health insurance program for people 65 and older. It only covers medically necessary surgeries, which essentially means no other less-invasive corrective measure is available to help correct the condition. LASIK is considered an elective procedure, so Original Medicare generally will not cover the surgery unless it meets the criteria for being medically necessary.

LASIK Coverage Varies by Medicare Advantage Plan

Medicare Advantage plans, also called Part C or MA plans, are purchased through private insurance companies. These plans must provide the same coverage as Original Medicare Parts A and B at a minimum, but most plans include additional benefits like vision, dental, and prescription drug coverage. Some MA plans include coverage for LASIK surgery, although you may be responsible for copays and coinsurance. Importantly, your provider and facility must be in the plan’s network. Always speak to your insurance plan prior to your surgery to understand your benefits and out-of-pocket payment responsibilities.

LASIK Is Generally Not Covered by Other Federal Insurance Programs

Medicaid is the nation’s public health insurance program for people with low income. It is a joint program between the federal government and the states. TRICARE is the federal program that provides health insurance to active duty military, military retirees, and their families. As with Original Medicare, these programs will generally not cover LASIK unless it meets the criteria for being medically necessary.

What Are the Medically Necessary Criteria?

There are circumstances when LASIK may be considered medically necessary and therefore covered by programs like Original Medicare and Medicaid. These instances include:

• When the refractive errors are caused by an injury or previous surgery
• When vision is so blurry or impaired that corrective lenses are not sufficient
• When a physical limitation prevents the patient from wearing glasses or contact lenses

If LASIK is considered medically necessary, it must also be performed by a provider and in a facility that accepts that type of insurance.

Affordable Payment Options for the Vision You Deserve

Facing the cost of LASIK surgery without financial assistance can be concerning. At ICON Eyecare, we want to make elective procedures like LASIK affordable for almost any budget. These payment options can help you get the vision you deserve:

• Deferred interest and financing: We offer flexible payment plans and interest-free financing through Alphaeon Credit and CareCredit. You may qualify for 0% interest for up to 24 months with no money down with approved credit, as well as extended payment options for up to five years. Your surgical counselor can help answer any question and assist you with completing the application process at your consultation.
• Health savings accounts (HSAs) and flexible spending accounts (FSAs): With these types of accounts, you can use pretax dollars to pay for medical expenses not typically covered by insurance — including LASIK. You can use these funds to cover all or part of your procedure.

Trust the Expert Team at ICON Eyecare

The surgeons of ICON Eyecare have decades of combined experience and have helped thousands of patients see clearly with LASIK vision correction procedures. We’re committed to your safety and helping you achieve the best outcomes possible. Request an appointment with us today.