Is Refractive Surgery Covered by Eye Insurance?

You've probably heard about refractive surgery — also known as laser eye surgery — and wonder if it's a way you could reduce your dependency on glasses or contact lenses. If you are a good candidate for refractive surgery, you might also want to know if vision insurance will cover some of your costs for refractive surgery. 

Let’s explore the basics of refractive surgery, including the benefits and potential risks, and show you how to approach this common eye procedure with your vision, health, and financial well-being in mind. 

What Is Refractive Surgery and How Does It Work?

Refractive surgery is commonly referred to as "LASIK" which stands for “laser-in-situ keratomileusis.” Refractive surgery has become a well-known vision correction surgery that can reduce or eliminate the need for eyeglasses or contacts. During refractive surgery, a special type of cutting laser is used to precisely change the shape of the cornea — the dome-shaped clear tissue at the front of your eye — to improve vision. 

In eyes with normal vision, the cornea bends light precisely onto the retina at the back of the eye, which the brain interprets as images. But with nearsightedness, farsightedness or astigmatism, the light is bent incorrectly, resulting in blurred vision. Glasses or contact lenses can correct vision but reshaping the cornea itself — with a procedure like refractive surgery — can also provide the necessary bending of light for optimal vision.

Refractive surgery was developed in the 1980s and approved by the FDA in 1998, gaining acceptance and popularity over time as the vision-correction surgery became more well-known and trusted. Approximately 9.5 million Americans have had refractive surgery as of 2018 — enough that nearly all of us know at least a few friends or relatives who have had refractive surgery. 

What to Know Before You Consider Refractive Surgery

Almost all surgeries carry some risk of complications and side effects, and refractive surgery is no exception. Compared to many medical procedures and surgeries, refractive surgery is generally considered a safe procedure with a low complication rate. Refractive surgery is one of the safest elective surgical procedures available today.

Refractive surgery has a 95% patient satisfaction rate, with research indicating that refractive surgery has a 99% success rate in achieving 20/40 vision or better.

Most refractive surgery patients are very pleased with the results of their vision-correction surgery. Even with the great track record of refractive surgery, the FDA advises that you consider the known limitations and possible complication of refractive surgery, which may include:

 - Vision loss (extremely rare)
 - Visual symptoms that do not resolve after 3–6 months of healing time,
    including halos, glare, or double vision.
 - Still needing to wear glasses or contacts, especially if your vision needed large
   corrections before surgery.
 - Dry eye syndrome
 - Diminished results with age in far-sighted patients

Your first step should be to talk to your ophthalmologist or trusted eye doctor who can help determine if refractive surgery may be a good option for you. Some people are not good candidates for refractive surgery, particularly if certain situations apply to them:

 - A prescription that has changed in the last year
 - Conditions that affect the body’s ability to heal wounds
 - Participating in contact sports
 - Jobs that prohibit corrective eye surgery
 - Eye history such as dry eyes, large pupils, thin corneas, or previous vision surgery

Your eye doctor can help determine if you have these or other conditions that would increase the chance of complications from refractive surgery. They will also perform a baseline evaluation that includes measurements of your vision and eye structures including the corneas. Before this exam you will need to stop wearing contact lenses for several weeks as they can temporarily change the shape of your cornea, leading to inaccurate measurements prior to vision surgery. 

During this meeting you’ll have the opportunity to ask your eye doctor questions and they will discuss the benefits and risks of the surgery. Carefully consider your own personal pros and cons before you decide. 

What to Expect With Refractive Surgery: During and After Surgery 

If your eye doctor has indicated you are a good candidate for refractive surgery and you’re ready to go forward, it’s time to prepare for the experience. You’ll have a set of instructions to prepare you in the weeks and days before surgery — make sure you follow these as listed. 

The actual surgery can take approximately 30 minutes. You’ll be reclining on a medical chair, with your eyes open and numbing drops applied to minimize sensation and discomfort. During the procedure, you will be looking into a light — not the laser — to keep your eye in one position for the surgery. Afterwards, you will feel some discomfort, and you will be provided with antibiotic drops as well as an eye shield to protect your eyes as the tiny incisions heal. 

Make sure to follow all your surgeon’s guidelines for the hours, days, and weeks after your refractive surgery so that your eyes can completely heal. As your eyes heal you may experience vision effects, such as halos or blurry vision. For nearly all patients these vision conditions will diminish over time, but one of the risks of refractive surgery is the long-term vision effect, especially dry eyes and halos or distortion at night. 

For most patients, it can take 3 to 6 months for your vision to stabilize to its new corrected state. This is normal — make sure you let your doctor know if you have concerns or follow-up questions about your procedure.

For more details, the FDA has a great set of resources on refractive surgery, including a guide on what to expect during and after your procedure.

What Are Refractive Surgery Costs and Is Refractive Surgery Covered by Insurance?

Refractive surgery is a fully elective procedure, which means that you will pay at least some of the cost out of pocket. However, many vision insurance plans offer discounts for refractive surgery which can help with your budgeting and planning for the surgery. 

The good news is that the relative cost of refractive surgery has come down over time. In 2008, the average refractive surgery procedure (for both eyes) was $4,000, which would be $5,600 in today’s market considering inflation. Current costs for refractive surgery are approximately $4,400 — that’s about 25% less than in 2008! 

Another way to save money on refractive surgery is to use FSA or HSA funds. Because these account funds are pre-tax-free, using your FSA or HSA means you could be paying less directly out of pocket. 

Vision insurance plans frequently offer their members discounts on refractive surgery procedures at clinics that they work with and may also offer additional bonus savings based on the vision plan chosen. These discount amounts vary but are often 20%–25% of the cash cost for the procedure. 

Beyond the potential discounts on refractive surgery, vision insurance offers many benefits that can make it a great choice for your vision health, including a free or discounted eye exam each year. Many vision insurance plans — including VSP’s vision plans — have low premiums that can save you hundreds of dollars each year, especially if you wear corrective lenses. 

Conclusion

Refractive surgery is an option for many people who would like to reduce their dependence on glasses or contact lenses. The technology has continued to improve since its approval in 1998, with success rates of 96% or more. Because refractive surgery is a surgical procedure, there are risks which each person should carefully consider and objectively evaluate with the help of their eye doctor. 

The cost of refractive surgery varies by surgeon, location and technology used but averages $4,400 prior to discounts. Having vision insurance can reduce the cost of refractive surgery, as can using FSA or HSA account funds.

Want to know more about saving money on refractive surgery while taking care of your vision health? VSP vision insurance has everything for complete vision health, including vision correction allowances, preventive health screenings, annual eye exams, refractive surgery discounts and more. Get started today and build your own vision plan that’s right for you and your family.

By choosing a vision insurance plan from VSP, you’ll get access to reliable vision care, plus the potential for discounts on refractive surgery. With access to a huge network of eye doctors all over the country, you’ll be confident knowing you have the resources for your best eye health. 

 

Information received through VSP Vision Care's social media channels is for informational purposes only and does not constitute medical advice, medical recommendations, diagnosis, or treatment.  Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.  

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