Medicare does not pay for LASIK or other refractive surgery

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

Some Medicare Advantage plans (Part C) may offer limited coverage for refractive surgery, but this varies widely by plan and insurer. You would need to contact your specific plan to find out whether LASIK is covered and what your out-of-pocket costs would be.

Key Takeaways

  • Original Medicare does not cover LASIK, PRK, or similar refractive surgeries under any circumstances.
  • Some Medicare Advantage plans may cover part or all of the cost, but coverage differs by plan and by insurer.
  • If you want LASIK coverage, you can contact your Medicare Advantage plan directly to ask about their policy.
  • Vision insurance through a former employer or purchased separately may cover LASIK, even if Medicare does not.
  • LASIK costs typically range from $1,500 to $3,000 per eye when paid out of pocket, though prices vary by location and surgeon.

Why Medicare does not cover LASIK

Medicare's coverage rules focus on treating disease and injury, not on correcting vision through elective procedures. Glasses and contact lenses are considered the standard treatment for refractive errors, and Medicare will pay for routine eye exams and glasses or contacts if you are may be able to access for coverage. LASIK, by contrast, is classified as a cosmetic or elective procedure because it is not medically required to treat an eye disease or condition.

This distinction matters: Medicare will cover cataract surgery (which removes a clouded lens due to disease) but not LASIK (which reshapes the cornea to change how light focuses). Even though both procedures affect vision, only cataract surgery addresses a medical problem rather than a preference for not wearing glasses.

What Medicare Advantage plans may cover

Medicare Advantage plans are run by private insurers and can offer benefits that Original Medicare does not. Some plans include vision coverage that goes beyond what Original Medicare provides, and a small number of plans may cover refractive surgery like LASIK. However, coverage is not standard across plans, and most Medicare Advantage plans do not include LASIK coverage.

If you have a Medicare Advantage plan and are interested in LASIK, the only way to know whether it is covered is to contact your plan directly. You can find your plan's customer service number on your insurance card or on the plan's website. When you call, ask specifically whether LASIK or PRK is covered, what percentage of the cost the plan pays, and whether you need a referral from your primary care doctor or eye doctor.

Other vision coverage options

If you have vision insurance through a former employer or have purchased a standalone vision plan, that coverage may include LASIK. Employer-sponsored vision plans sometimes offer discounts on refractive surgery even when they do not cover the full cost. You can check your plan documents or contact your vision insurance provider to find out what is included.

Some LASIK surgery centers also offer financing plans or discounts for patients without insurance coverage. These are separate from Medicare and vision insurance — they are payment arrangements between you and the surgery center. If you are considering LASIK, it is worth asking the surgeon's office whether they offer payment plans or discounts for cash-paying patients.

What Medicare does cover for vision care

Although Medicare does not cover LASIK, it does cover certain vision-related services. Original Medicare Part B covers one routine eye exam every 24 months if you have diabetes, and it covers eye exams related to glaucoma screening. Medicare also covers glasses or contact lenses after cataract surgery, and it covers treatment for eye diseases like glaucoma, macular degeneration, and diabetic retinopathy.

If you need glasses or contact lenses for everyday vision correction (not after surgery), you will need to pay for them yourself unless you have a separate vision insurance plan. Many seniors find that purchasing an inexpensive vision plan through a private insurer costs less than paying out of pocket for glasses or contacts over time.

How to find out about your specific plan's coverage

The fastest way to learn whether your plan covers LASIK is to call the customer service number on your insurance card. Have your member ID number ready, and ask directly: "Does my plan cover LASIK surgery or other refractive surgery?" The representative can tell you whether coverage is available, what your out-of-pocket cost would be, and whether you need a referral.

You can also review your plan's Summary of Benefits and Coverage (SBC) document, which lists what is and is not covered. This document is available on your plan's website or by calling customer service and asking them to mail or email it to you. The SBC will show you the vision benefits section and whether refractive surgery is mentioned.

Frequently Asked Questions

Can I use my Health Savings Account (HSA) to pay for LASIK if Medicare does not cover it?

Yes. If you have an HSA through a high-deductible health plan, you can use those funds to pay for LASIK out of pocket. HSAs allow you to set aside pre-tax money for medical expenses, including procedures that insurance does not cover. Keep your receipt from the surgery center for your tax records.

Does Medicare cover the eye exam before LASIK surgery?

Medicare may cover a routine eye exam if you have diabetes or are being screened for glaucoma, but it will not cover an eye exam specifically to determine whether you are a candidate for LASIK. The pre-LASIK evaluation is considered part of the elective procedure and is not covered.

If I have both Original Medicare and a Medigap plan, will either cover LASIK?

No. Medigap plans (also called supplemental insurance) fill in gaps in Original Medicare's coverage, but they do not cover services that Original Medicare excludes. Since Original Medicare does not cover LASIK, Medigap will not either. A separate vision insurance plan would be your option.

What if my vision problem is caused by an eye disease — does Medicare cover LASIK then?

No. Even if your refractive error is related to an eye condition, LASIK is still considered elective. Medicare will cover treatment for the underlying disease (such as corneal scarring or keratoconus) but not LASIK as a correction method. Your eye doctor can discuss what treatment options Medicare does cover.