Because it’s an elective procedure, LASIK eye surgery is generally not covered by Original Medicare. Some Medicare Advantage (Part C) plans may cover some or all of the costs.
LASIK eye surgery is an outpatient procedure to correct vision issues such as nearsightedness, farsightedness, and astigmatism.
If you have Original Medicare and your doctor has recommended LASIK, you may be wondering whether your insurance will pay for it.
Medicare only covers 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 about Medicare coverage for LASIK and how to get the most coverage possible.
Original Medicare, made up of Part A and Part B, doesn’t provide coverage for vision care in most instances. Parts A and B generally don’t cover:
- eye exams
- eyeglasses
- contact lenses
- surgical procedures to correct vision
However, there are exceptions for medically necessary services. These include cataract surgery and treatments for eye diseases, such as:
- age-related macular degeneration
- glaucoma
- diabetic retinopathy
LASIK surgery usually isn’t performed to prevent blindness and isn’t categorized as medically necessary. It’s an elective procedure 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 Medicare-approved services, 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, don’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 may have patients on Medicare who have had LASIK surgery. 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 or 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 Oct. 15 to Dec. 7. You can also switch from one Part C plan to another during open enrollment.
- 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 Jan. 1 to March 31.
The costs for LASIK vary from doctor to doctor and 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
Ask your doctor up front what the costs are for all of these visits and if they’re folded into the total cost of LASIK surgery. The LASIK procedure itself usually averages around $4,400.
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.
Temporary eyeglasses, sunglasses, or contact lenses may also be required, resulting in additional out-of-pocket costs.
All of these costs add up and may mean LASIK is outside of your budget. 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 an outpatient surgical procedure that can improve vision. Many people report no longer needing to wear eyeglasses or contact lenses after having LASIK surgery.
Since LASIK is an elective procedure, Original Medicare doesn’t cover it. However, some Medicare Part C plans cover some or all of the cost.