Why Insurance Won’t Cover LASIK
February 11, 2025
You want LASIK but are not excited about paying the $4,500 or so price-tag. Why won’t your insurance pay for it?
The purpose of insurance
The key to understanding why insurance won’t pay for LASIK is understanding the purpose of insurance.
Insurance historically protects you from financial catastrophe. Homeowners insurance allows you to rebuild if your home burns down. If you need a life-saving surgery, medical insurance protects you from the full brunt of expense. If you get into a bad car crash, auto insurance protects you from big expenses related to property damage and bodily injury claims.
LASIK in an elective luxury
Medical insurance will pay for expenses when there is inherent need including situations where there is life and limb-threatening injury or disease. Insurance manages risk by requiring insured participants to pay into a pool to sustain periodic payouts for the various allowed claims.
LASIK is an elective surgery, more like cosmetic breast augmentation and liposuction. Patients have these procedures because they want to, not because there is an underlying medical need for it. If medical insurance covered elective procedures, everyone’s already expensive medical insurance premiums, including yours, would soar significantly higher. There is no free lunch.
Expecting your medical insurance to pay for LASIK is tantamount to expecting Medicaid (government health coverage for those with low-income) to pay for designer eyeglass frames with the expensive lens treatments. Obviously, such expectations are not financially prudent for Medicaid nor sustainable. As an example, Medicaid in California (Medi-Cal) covers basic eyeglass frames which get sent to one of three state prison optical laboratories (CALPIA) where inmates fabricate the eyeglass lenses which helps to contain costs while also providing on-the-job training.
Isn’t having LASIK less expensive in the long run?
Not really. For some LASIK can save overall eye care cost. But in general, it does not make a compelling difference. Undergoing LASIK does not absolve the ongoing need for regular eye exams. This is because LASIK does not prevent your eye from aging. Nor does LASIK reduce the risk of eye disease like cataracts, glaucoma, and macular degeneration.
For those having LASIK, afterwards, there are still glasses and/or contacts afterwards that could further enhance vision. In many instances though, these glasses and/or contacts may not be worth getting. Some patients after LASIK actually need more pairs of glasses afterward, even though they may be less dependent on using glasses compared to before LASIK.
Trying to save on long term eye care costs by having LASIK is not a surefire bet. It is better reason to undergo LASIK is if you are looking to reasonably reduce your dependency on glasses and/or contact lenses.
Strategies to minimize LASIK cost
Seeking the lowest cost provider for laser vision correction is misguided. Quality and service are more important to bringing a desirable outcome. That said, cost is still a factor for most.
Laser vision correct qualifies as an expense for a flexible spending account (FSA). This allows you to allocate pre-tax dollars for eligible health expenses. Before setting up an FSA for LASIK, you should first schedule a laser vision consultation to confirm that you indeed are a suitable candidate for the procedure.
Patients covered by the largest vision benefit plan in the U.S., called Vision Service Plan, may have a specific plan that grants access to their VSP Laser VisionCare Program. This program contracts with selected laser vision correction centers to offer the procedure at contracted rates (which may offer a cost savings) in exchange for directing patients to them.
ReVision Optometry is a referral-based practice in San Diego providing contact lens services for patients with keratoconus. To schedule an appointment, request your appointment online, or call our office at 619.299.6064.