Medicare Does Not Cover LASIK

Medicare does not pay for LASIK or other refractive eye surgery. This includes LASIK, PRK, SMILE, and similar procedures that reshape the cornea to correct nearsightedness, farsightedness, or astigmatism. Medicare classifies these surgeries as elective or cosmetic, meaning they are not medically necessary to treat disease or injury.

The only exception is if you need corneal reshaping to correct vision after cataract surgery or another eye condition — but this is rare and requires your doctor to document that the procedure treats a medical problem, not just improves your sight. Even then, coverage is not may provide.

If you want LASIK, you will pay the full cost yourself. The procedure typically costs between $2,000 and $4,000 per eye at most clinics, though prices vary by location and surgeon experience.

Key Takeaways

  • Medicare does not cover LASIK, PRK, or other refractive surgery because these procedures are classified as elective rather than medically necessary.
  • You will pay the entire cost of LASIK out of pocket, usually $2,000 to $4,000 per eye depending on your location and provider.
  • Some Medicare Advantage plans may offer vision benefits that cover a portion of LASIK, so checking your plan documents is worth doing.
  • If you have a secondary insurance plan or vision discount plan, it may reduce your LASIK cost, though most do not cover the full amount.
  • Cataract surgery is covered by Medicare, and if you need vision correction after that surgery, ask your eye doctor whether Medicare might cover the correction.

What Medicare Part A and Part B Cover for Vision

Medicare Part A (hospital insurance) and Part B (medical insurance) cover eye care related to disease or injury, but not routine vision correction. Part B covers eye exams to diagnose and treat diseases like glaucoma, macular degeneration, and diabetic retinopathy. It also covers cataract surgery, which is considered medically necessary.

What Medicare does not cover: eyeglasses, contact lenses, routine eye exams for refraction (measuring your prescription), or any surgery whose only purpose is to improve your vision without treating disease. LASIK falls into this last category.

If you have Medicare Part B, you do get one routine eye exam every 12 months to check for disease, at no cost to you. This is different from a refraction exam, which tests your prescription and is not covered.

Medicare Advantage Plans and Vision Coverage

Some Medicare Advantage plans (Part C) include vision benefits that go beyond what Original Medicare covers. These plans are run by private insurance companies and can add coverage for eyeglasses, contact lenses, and sometimes routine eye exams. A small number of Advantage plans also offer discounts on LASIK or other elective eye surgery.

The catch is that coverage varies widely from plan to plan and year to year. One Advantage plan in your area might cover $200 toward LASIK; another might cover nothing. You need to check your specific plan's documents or call the plan directly to ask whether LASIK is covered and what percentage they pay.

If you are shopping for a Medicare Advantage plan and LASIK is important to you, ask the plan whether they offer any LASIK benefit before you enroll. Some plans advertise vision benefits but exclude elective surgery; others include it. The only way to know is to ask.

Paying for LASIK Out of Pocket

Since Medicare does not cover LASIK, you have a few options to reduce the cost. Many LASIK clinics offer payment plans that let you spread the cost over 12 to 24 months with little or no interest. Some clinics also offer discounts if you pay in full upfront.

If you have a secondary insurance plan (sometimes called Medigap or supplemental insurance), check whether it covers vision. Most Medigap plans do not, but it is worth asking your insurance company. If you belong to a vision discount plan through your employer or a membership organization, that plan might offer a discount on LASIK — typically 10 to 20 percent off the clinic's standard price.

Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) can also be used to pay for LASIK if you have one through your employer or a spouse's employer. You can withdraw money tax-free to pay for the procedure. If you are on Medicare, you cannot open a new HSA, but you can use an existing one if you have it.

When Cataract Surgery Leads to Vision Correction

If you have cataracts and need surgery, Medicare covers the procedure. After cataract surgery, some people need additional vision correction — either glasses, contact lenses, or in rare cases, a corneal reshaping procedure. This is where the line between covered and uncovered can blur.

If your eye doctor determines that you need a procedure to correct vision problems that resulted from the cataract surgery itself (not just your baseline prescription), Medicare may cover it. For example, if the surgery left you with astigmatism that needs correction, your doctor might be able to document this as treatment for a surgical complication rather than elective vision improvement.

This is not automatic. Your doctor has to submit the request with documentation showing that the procedure treats a medical problem caused by the cataract surgery. Even then, Medicare's local office may deny it. If you are in this situation, ask your eye surgeon to submit the request and explain what happened during your cataract surgery that now requires correction.

Other Eye Surgeries Medicare Does Cover

Medicare covers several eye surgeries that are not LASIK. Cataract surgery is fully covered. Corneal transplants are covered when medically necessary. Surgery to treat retinal detachment, macular holes, and other retinal diseases is covered. Eyelid surgery is covered if it corrects a medical problem (like drooping eyelids that block vision) rather than improving appearance.

Glaucoma surgery is covered. Diabetic retinopathy treatment, including laser surgery, is covered. If you have any of these conditions, talk to your eye doctor about what Medicare will pay for. The key difference is that these surgeries treat disease or injury, whereas LASIK treats refractive error — a difference in how your eye focuses light, not a disease.

Frequently Asked Questions

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

No. A Medicare Savings Account is a state program that helps pay your Medicare premiums and cost-sharing; it does not cover services that Medicare itself does not cover. Since Medicare does not cover LASIK, your MSA cannot pay for it either. A Health Savings Account or Flexible Spending Account through an employer can be used for LASIK, but these are different from a Medicare Savings Account.

What if my doctor says LASIK is medically necessary for me?

Even if your doctor recommends LASIK, Medicare will not cover it unless the procedure treats a specific disease or complication — not just improves your vision. If your doctor believes your case is an exception, they can submit a request to Medicare with documentation. Medicare's local office will review it, but most requests for LASIK are denied. Ask your doctor whether they think your situation qualifies before you pursue this route.

Does Medigap insurance cover LASIK?

Most Medigap plans do not cover LASIK because they only cover what Original Medicare covers, plus some cost-sharing. Since Medicare does not cover LASIK, Medigap will not either. Check your specific plan documents or call your Medigap insurer to confirm, but this is the standard rule.

If I get LASIK before I turn 65 and enroll in Medicare, will Medicare cover follow-up care?

Medicare will cover follow-up care for complications or disease related to your LASIK surgery — for example, if you develop dry eye or an infection. But Medicare will not cover repeat LASIK or enhancement procedures if your vision changes over time. You would pay for those out of pocket.

Are there any Medicare programs that help pay for vision correction?

Original Medicare does not have a program for vision correction. Some Medicare Advantage plans include vision benefits, but these vary by plan. Your best option is to check your current plan's documents or call your plan to ask what vision services are covered. If you do not have an Advantage plan and want vision coverage, you can switch during the annual enrollment period.