Medicare covers various healthcare services including medically necessary surgeries. It does not cover elective surgeries, such as LASIK.
LASIK eye surgery is a procedure that may improve a person’s vision if they are near-sighted, far-sighted, or have astigmatism.
Medicare considers this surgery an elective procedure and does not cover the cost under Original Medicare. However, some Medicare Advantage plans may cover LASIK eye surgery.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare covers eye surgery only when a doctor declares it medically necessary. LASIK is generally considered an elective surgery, as most people can use glasses or contact lenses to correct their vision. This means that Original Medicare (Part A and Part B) does not offer coverage for this procedure.
In addition, Original Medicare does not cover routine eye care, although coverage may be available for medically necessary eye exams or surgery related to another medical condition.
For example, Medicare may cover certain eye care services related to diabetes, glucose, or if a doctor states a person needs cataract surgery.
Learn more about Original Medicare.
A Medicare Advantage (Part C) plan must provide the same level of coverage as Original Medicare. Most Medicare Advantage plans also offer additional benefits, including routine vision care, such as:
- annual eye examinations
- corrective glasses
- contact lenses
However, Medicare Advantage plans do not always cover LASIK surgery. Individuals may need to contact their plan provider to determine the exact coverage details.
Learn more about Medicare Advantage plans.
Laser-assisted in situ keratomileusis (LASIK) is a surgical procedure
Generally, an ophthalmologist performs laser surgery on an outpatient basis. An ophthalmologist is a specialist eye doctor who can examine, diagnose, and treat the eye, and also perform eye surgeries.
The
- possible vision loss or severe visual symptoms
- severe dry eye syndrome
- for some, the results may diminish over time
Read more about LASIK surgery.
LASIK surgery costs depend on several factors, including where the surgery is done, the surgeon’s experience, and the technology used for the procedure.
According to LASIK.com, the average cost in the United States in 2024 will be $1,500 to $5,000 per eye.
However, if a person needs a medically necessary procedure, such as cataract surgery Medicare Part B would cover the cost if it is done on an out-patient basis. Medicare Advantage plans generally also provide coverage for cataract surgery.
Although Medicare does not generally cover eyeglasses and contact lenses, it does provide coverage for one set following cataract surgery. The beneficiary must pay 20% of the Medicare-approved amount.
If the individual requires a more advanced lens implant, they may have to cover some costs.
A person considering LASIK surgery may receive help covering costs. This assistance may include pricing and incentives from private companies, coverage from a person’s employment health plan, and Flexible savings accounts (FSAs).
- Special pricing and incentives: These incentives may include no-interest financing, limited-time special prices, or discounts for pairs or groups of people that clinics offer.
- Financing: Some finance companies specialize in elective surgical procedures, including LASIK. These companies offer fixed rates and long-term payment plans. Clinics providing LASIK surgery may give out information about financing plans.
- Employer discounts: An employer may arrange employee discounts for LASIK surgery. Some large employers may have subsidized health plans that will cover some or all of LASIK’s cost.
- Flexible spending arrangements (FSAs): These plans are arranged with a person’s employer, with deductions from paychecks, to help pay for out-of-pocket medical expenses. The FSA may cover the cost of LASIK surgery.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Original Medicare does not cover the cost of LASIK or other elective surgeries. However, it covers costs associated with cataract surgery or for treatment of an eye condition such as glaucoma.
Typically, Medicare Advantage plans offer additional benefits above that of original Medicare, such as vision and dental care, although they may not cover LASIK.
If a person chooses to get LASIK surgery and does not have coverage from a Medicare Advantage plan, they may find private financing options or discounts.