Tired of blurry vision and wondering if private health insurance can help with the cost of laser eye surgery? We discuss your options below.
SUMMARY
- You can get partial or total cover for laser eye surgery with private health insurance (depending on your provider and level of cover)
- Laser eye surgery cover is typically available with extras cover, or combined hospital & extras cover
- Medicare does not cover laser eye surgery as it’s not deemed medically necessary
- Waiting periods apply to receive the surgery
Transforming your eyesight with laser eye surgery can be a life-changer, saying goodbye to the daily grind of glasses or contact lenses. Without private health insurance, however, this vision correction surgery isn’t cheap. And unfortunately, Medicare doesn’t foot the bill as it’s not deemed medically necessary in most cases.
So, if you want laser eye surgery but don’t want to pay the whole bill out-of-pocket, private health insurance is your best option. Keep reading, and we’ll break down what kind of insurance coverage is available, and how to find the right provider for your needs.
How Does Health Insurance Help With Laser Eye Surgery Costs?
Extras Cover
When it comes to extras insurance, only a select few policies have your back for laser eye surgery. It’s not a must-have for insurance companies, so you’ll typically find it in their top-tier plans. In specific cases, like with Medibank, you may need to bundle up a hospital and extras policy to get that sweet coverage.
Hospital Cover
Don’t count on standard hospital insurance to cover your laser eye surgery; it’s usually off the list since it’s not seen as ‘medically essential.’ But some basic bronze policies do cover some eye-related issues—like tear duct issues, eye infections, or even a retinal detachment. For coverage of more serious procedures like cataract surgery, you’ll need a gold-level policy.
Which Health Funds Cover Laser Eye Surgery?
Health Fund: AHM
- Cover Type: Lifestyle Extras and Super Extra
- Procedures: LASIK, PRK, and ICL
- Waiting Period: 24 months
- Covered: $1,200
Health Fund: BUPA
- Cover Type: Ultimate hospital and Ultimate extra cover for existing policyholders
- Procedures: LASIK, PRK, and SMILE
- Waiting Period: 36 months for new members
- Covered: The full cost of surgery (if you’ve been a member for 3 years)
Health Fund: Medibank Private
- Cover Type: Gold Ultra Health Cover
- Procedures: LASIK and PRK
- Waiting Period: 36 months
- Covered: Up to $3500
Health Fund: Premier Extras
- Cover Type: Top Extras
- Procedures: LASIK and PRK
- Waiting Period: 12 months
- Covered: $1500
How Much Coverage Can You Expect From Your Health Fund?
Policy Limitations
The financial help you can expect from your health fund varies depending on your specific policy. Only a rare few will cover the full cost of the surgery, and that’s usually under the condition that your doctor’s charges don’t exceed a certain limit.
Every policy comes with its own set of restrictions. Some health funds, for instance, have a lifetime limit on how much they’ll cover, while others set annual or per-person limits.
Long story short: don’t expect your health fund to foot the entire bill for your eye surgery.
What’s the Price Tag on Laser Eye Surgery?
Cost Per Eye and Total Expenses
The typical cost for laser eye surgery falls between $1,500 and $4,000 per eye. This varies based on your chosen surgeon and other specific circumstances. Planning on fixing up both eyes? You’re likely looking at a total cost ranging from $3,000 to $8,000 or even more.
Most clinics charge per eye, and some health funds also use this basis for calculating their benefits.
Additional Costs
The sticker price isn’t just for the operation itself. There may also be consultation fees leading up to the surgery, although sometimes these are bundled into the overall cost.
If you see a health fund offering a lifetime limit of $1,000 to $3,000, you’ll notice right away that this won’t come close to covering the full expense of the surgery.
However, many clinics do offer payment plans for those who find the upfront cost to be too steep.
Understanding the Costs of Laser Eye Surgery Without Insurance
If you’re considering laser eye surgery without the help of health insurance, you’ll be responsible for the full cost of the procedure. The price can vary significantly based on the type of surgery you undergo and the provider you choose. Here’s a rundown of the expected costs for common types of eye surgeries.
Procedure Costs Breakdown
- LASIK: $1,500 – $3,400 per eye
In LASIK procedures, a laser is used to create a small flap in the cornea. The surgeon then reshapes the underlying tissue and repositions the flap. - PRK: $1,500 – $3,400 per eye
PRK, or photorefractive keratectomy, involves removing the top layer of the cornea with a topical solution. A laser is then used to reshape the exposed tissue. - SMILE: $3,300 – $3,700 per eye
SMILE, short for small incision lenticule extraction, involves making a small cut in the cornea. The surgeon then removes a small disc of corneal tissue. - LASEK: $2,400 – $3,400 per eye
In LASEK (laser-assisted subepithelial keratomileusis), a laser creates an ultra-thin layer over the cornea. This is moved aside so the surgeon can reshape the corneal tissue below it, before repositioning the layer. - ICL: $4,700 – $6,200 per eye
ICL, or implantable contact lenses, involves inserting a custom lens—kind of like a permanent contact lens—directly into the eye.
Each of these options has its own pros and cons, so it’s essential to discuss them thoroughly with your ophthalmologist to determine the best approach for you.
Key Factors to Consider When Comparing Laser Eye Insurance Policies
Waiting Periods
One of the first things to consider is the waiting period associated with the policy. This is the minimum time frame between when you take out a policy and when you can start claiming benefits. For laser eye surgery, the typical waiting period is often around 24 months. Major eye surgeries that require hospitalisation usually have shorter waiting periods, generally around two months.
Excess Charges
Another important factor is the excess—essentially a fee you need to pay when you make a claim. Not every health insurance policy has an excess, but some do. You often have the choice of opting for a higher excess to bring down your premium or a lower excess with a slightly higher premium. Just make sure your excess isn’t so steep that it discourages you from making a claim.
Annual Limits
Lastly, it’s essential to look at the annual limits. These caps are set by private health funds and dictate the maximum amount you can claim in benefits within a year. When it comes to laser eye surgery, these limits can range from as low as $500 to as high as $3,500.
Being savvy about these key factors can help you find a policy that offers the best coverage for your needs, while also fitting within your budget.
What Is Laser Eye Surgery?
Laser eye surgery is essentially a tune-up for your eyes. The procedure uses a laser to reshape your eye’s surface. The goal? To correct or enhance various vision issues. We’re talking about:
- Myopia (Short-sightedness): When seeing distant objects clearly is a challenge.
- Hyperopia (Long-sightedness): When you’re great at spotting far-off details but struggle with the fine print.
- Astigmatism: A situation where the front of your eye is a bit misshapen, blurring your vision.
This surgery can also be a game-changer for certain eye diseases and even some age-related degeneration issues. As for the time commitment, it’s generally a quick visit, taking around 10-20 minutes per eye.
Eligibility Criteria
Before you hop onto the operating table, there’s some homework to do. You’ll need an assessment to check if this eye upgrade is right for you. In general, you should:
- Be at least 18 years old.
- Have a “normal” cornea—no weird shapes or excessive thinness.
- Not suffer from dry eyes that resemble the Sahara.
- Not having a medical condition that hampers healing.
- Have a stable eyeglass prescription.
- Be free of autoimmune diseases.
- Steer clear of risky eye activities like contact sports, depending on the type of surgery.
FAQs
Is laser eye surgery covered by Medicare?
No, Medicare doesn’t typically cover laser eye surgery since it’s considered a cosmetic procedure (i.e. you want to remove your need for glasses). However, if you have a certain eye disease and require medically necessary treatment, the cost of your surgery may be covered or subsidised.
If your doctor says you require medically necessary treatment, ask them if Medicare will subsidise your treatment and if any expenses you incur will be covered.
Where do you go for laser eye surgery?
You typically go to a private laser eye clinic for treatment. Your eye doctor may recommend or even refer you to one. Before booking in for treatment, you might like to contact a few clinics to compare your options and surgeons’ opinions.
Questions to ask before you have laser eye surgery
To help ensure you understand a little more about what you can expect from your surgery, both for treatment and costs, it’s a good idea to ask as many questions as you can. Some of these include.
What is enhancement surgery?
Enhancement laser surgery is a follow-up procedure to an initial laser vision correction surgery like LASIK, PRK, or SMILE. It aims to refine the results of your first surgery, correcting any residual refractive errors like myopia (short-sightedness), hyperopia (long-sightedness), or astigmatism.
Find the Best Health Fund for Your Optical Needs
Ready to see clearly without breaking the bank? Use CHI’s easy comparison tool to find the best health insurance provider for all your laser eye surgery. Don’t squint over the fine print—let us simplify the search for you!
