Medicare does not cover LASIK or other refractive eye surgery

Original Medicare (Parts A and B) does not pay for LASIK, PRK, or other procedures that correct refractive errors like nearsightedness, farsightedness, or astigmatism. Medicare considers these surgeries elective and cosmetic rather than medically necessary, even though they can reduce your need for glasses or contacts.

This applies whether you have Original Medicare or a Medicare Advantage plan (Part C). Some Advantage plans may offer vision benefits that cover eye exams or glasses, but they typically do not cover refractive surgery either. The best way to know what your specific plan covers is to call the plan directly or check your plan documents.

Key Takeaways

  • Original Medicare and most Medicare Advantage plans do not cover LASIK or similar refractive eye surgeries.
  • Medicare may cover cataract surgery or corneal procedures if they treat a medical condition rather than correct vision for its own sake.
  • Some employers offer vision insurance or flexible spending accounts (FSAs) that can help pay for LASIK out of pocket.
  • LASIK costs typically range from $1,500 to $3,000 per eye, depending on the provider and your vision needs.
  • If you have a Medicare Advantage plan with vision benefits, contact the plan to ask whether any refractive procedures are covered under those benefits.

When Medicare might cover eye surgery

Medicare does cover eye surgery in specific medical situations. If you have cataracts that cloud your vision, Medicare covers cataract surgery and an intraocular lens implant. If you have a corneal condition, injury, or disease that requires surgical repair, Medicare may cover that procedure as well.

The difference is that these surgeries treat a medical problem, not just a refractive error. If your eye doctor documents that the surgery is medically necessary to restore or maintain your vision, Medicare is more likely to cover it. Ask your eye doctor whether your condition qualifies as medically necessary before scheduling any procedure.

What you can do if you want LASIK

If you want LASIK and Medicare will not cover it, you have several options. You can pay out of pocket — costs vary widely by provider and location, but typically range from $1,500 to $3,000 per eye. Some surgeons offer payment plans or discounts for paying in full upfront.

If you have a flexible spending account (FSA) through a current or former employer, you may be able to use those funds for LASIK. You cannot use Medicare Savings Account funds or Health Savings Account funds tied to Medicare, but if you have an FSA from working years, check with your plan administrator about whether LASIK is a covered expense.

Some Medicare Advantage plans include vision benefits that cover eye exams, glasses, or contact lenses. While these benefits rarely cover LASIK itself, they may reduce your other vision costs. Call your plan to ask what vision services are included.

How to find out what your specific plan covers

The easiest way to know whether your plan covers any refractive surgery is to call the plan's customer service number. This number is on your insurance card. Tell them you are asking about coverage for LASIK or refractive eye surgery, and ask whether any vision benefits you have include those procedures.

You can also check your plan's summary of benefits and coverage document, which is available on the plan's website or by mail. Look for the section on vision care or eye services. If the document does not mention LASIK or refractive surgery, it is almost certainly not covered.

Frequently Asked Questions

Can I use my Medicare Savings Account to pay for LASIK?

No. Medicare Savings Accounts (also called Medigap policies) are supplemental insurance that helps pay for costs that Original Medicare does not cover — like copayments and coinsurance. They do not cover services that Medicare itself excludes, including LASIK.

What if my eye doctor says LASIK is medically necessary for my condition?

If your doctor documents that the procedure treats a medical condition rather than straightforward correcting your vision, Medicare may cover it. Ask your doctor to submit the request to Medicare with medical documentation. Medicare will review it and decide whether it meets the standard for medical necessity. This is different from routine LASIK for refractive error.

Does LASIK become covered when I turn a certain age?

No. Age does not change Medicare's coverage rules for LASIK. The procedure remains classified as elective and cosmetic at any age.

Are there any Medicare Advantage plans that cover LASIK?

Most Medicare Advantage plans do not cover LASIK. Some plans may offer vision benefits that cover exams or glasses, but LASIK is rarely included. Contact your plan directly to ask, or check your plan's coverage documents for the vision benefits section.