Does Insurance Cover Eye Surgery?


Quick Answer

Health insurance normally covers eye surgery that it deems medically necessary. This includes cataract surgery. Health insurance normally does not cover LASIK and other refractive surgeries because they consider these to be elective or cosmetic procedures.

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Full Answer

Medicare and most other health insurance plans cover the implantation of a standard intraocular lens during cataract surgery. If a patient opts for a premium lens, which may allow him to see at various distances without the need for corrective lenses, he must pay the difference between the cost of the premium lens and the standard lens.

While most health insurance does not pay for elective and cosmetic eye surgeries, there are some circumstances under which insurance companies may pay for refractive or laser eye surgeries. Insurance companies may pay for surgery that corrects refractive errors caused by injury or surgery. They may also pay for such procedures when the patient has physical issues that prevent him from wearing eyeglasses or contact lenses.

In addition, some insurance companies may cover LASIK surgery for those involved in occupations in which wearing eyeglasses may prove dangerous or limiting. Those in the military, police officers, fire fighters and professional sports figures may qualify. Documentation is required, and there must be substantial evidence that such a procedure is warranted before the insurance company considers and approves it.

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