Why isnt Lasik Surgery covered by insurance?

[Tmy]

I wear contacts. Lately Ive been thinking about Lasik eye surgery. Im wondering why its not covered by insurance???

Heres a medical proceadure that can fix my disability. With Lasik we could wipe out most vision problems. Why no insurance coverage??? Birth control pills are covered but corrective eye surgery is not!

Is it becuase of the eye glass industry? Lasik is a danger to optomotrists, Lens Crafters, and Eye care insurance plans.

makes you think that the whole "doctors dont want to cure cancer cause its profitable" theory aint all that far off.

[Cleon]

I was wondering about that myself recently.

Insurance is all about numbers. I think the hesitation is simply one of cost; Lasik costs about $2000, on average (despite ads for "$500 per eye," less than 3% are performed for under $1000 per eye (http://www.allaboutvision.com/visionsurgery/cost.htm)). How often do you replace your glasses? Me, I do it maybe once every 4-5 years, and my vision plan only covers about $100 of a new pair.

So from an insurance perspective, they can shell out several Gs for Lasik, or they can pay out $100 or so every five years. Assuming you stay with the same job/insurance for 30 years (and we know that's a rarity these days), that means their grand total would be $600 (30 years / 5 years between new glasses = 6 new pairs of glasses * $100). Even if you have the King of Vision Plans that pays for up to $300 for your glasses, that's a life-long grand total of $1800--still less than your average lasik surgery.

So I think the reason vision plans don't cover lasik surgery is that it's simply more expensive than just covering lenses, and because it's more a surgery of convenience rather than medically necessary, there's no real push to get them to cover it. No conspiracy needed.

[HarryKeogh]

some plans do cover it. some generous employers even have plans with lasik centers to offer their employees cheap deals.

most don't because they consider it cosmetic. the way they see it: there's a cheaper alternative with less risk (glasses).

though you should sell your children to get Lasik if you have to. It's the best thing ever.

[Number Six]

I'm amazed at how important Lasik is to people. When I first heard of it I assumed it did more than it did because of the reaction by the public. As I understand it people go through their daily lives post-Lasik seeing as well as they did before but they do so without glasses or contacts.

So yeah, the vision you have without correction is improved, but as you go through your day and try to read the road signs or read your computer or recognizes faces in the distance or whatever, it's all the exact same as it was pre-surgery, except now you're doing it without correction instead of with correction. I can see how that'd be a nice convenience but the reaction I've heard from many is so much stronger than that.

When they can come up with a procedure that will make people see better than they ever have before even with correction then I'll be impressed.

As far as insurance covering it, I don't know...I'm sure in the wacky world of insurance there are less worth things covered and more worthy things not covered.

[SixSixSix]

I wear contacts. Lately Ive been thinking about Lasik eye surgery. Im wondering why its not covered by insurance???

I would assume that it is because it is non-essential surgery, much like cosmetic surgery, breast implants, and so forth.


Heres a medical proceadure that can fix my disability. With Lasik we could wipe out most vision problems. Why no insurance coverage??? Birth control pills are covered but corrective eye surgery is not!

Not sure what the equivalence is you're drawing between birth control pills and laser surgery. Both are non-essential, I suppose, though it is somewhat debatable about birth control pills. Abstinence has never been a particularly effective means of birth control. And condoms are not covered by insurance, for example. (At least not in Australia).


Is it becuase of the eye glass industry? Lasik is a danger to optomotrists, Lens Crafters, and Eye care insurance plans.

Now you're into conspiracy theory territory.


makes you think that the whole "doctors dont want to cure cancer cause its profitable" theory aint all that far off.
It's a huge step from, "Lasik isn't covered by health insurance" to "doctors are conspiring to hold back the cure for cancer". And one utterly unjustified by weak assertions that the optometrist industry are in cahoots with health insurance funds.

The problem with conspiracies is that no other form of human endeavour is that perfectly coordinated. All health insurance companies are controlled by all optometrists? One would assume it to be far more likely that if there were a profit to be made here, a single "defector" health insurance agency that decided to cover it would suddenly have a competitive advantage - unless you want to suggest that the other companies would go after the rogue with black helicopters.

Why has this not happened? Beats me. Some companies in Australia are covering homeopathy, acupuncture, and other nonsense now (Kiless and I recently changed our health insurance because of this - to a company that doesn't cover that sort of bollocks). I would imagine that the answer is simpler - laser surgery is fairly new, and health insurers haven't yet got trusted data that they can use to come up with an appropriate premium.

Never ascribe to malice what incompetence can explain.

[Tmy]

Why wouldnt I think theres a conspiracy. You dont think Lens Crafters has some sort of plan to deal with the popularity of Lasik?

Glasses are a crutch. Youd think Id be able to have surgery to fix that so I wouldnt need a crutch.

[SixSixSix]

Err... no, I don't.

[Tmy]

Its the nature of business. See a threat and deal with it. Im sure theres been a whole lot of hand wringing at the Lets Crafters of the world.

Why if there was a push to make lasik mandatory under insurance,,, who do you think would lobby against it??

[Cleon]

Why wouldnt I think theres a conspiracy. You dont think Lens Crafters has some sort of plan to deal with the popularity of Lasik?

Probably. Is there any evidence that this plan involves massive payoffs to insurance companies? There'd be a paper trail, at least.

I also don't think Lenscrafters is in any immediate danger. There are a lot of people out there without vision plans, there are people who don't qualify for Lasik, there are people who like wearing glasses, and there are people--like me--who are scare s***less by the idea of having to stare into a laser beam.


Glasses are a crutch. Youd think Id be able to have surgery to fix that so I wouldnt need a crutch.

It's not a significant disability; with the exception of amusement park rides, I can't think of any activity where my dependence on glasses requires extra effort.

[WildCat]

The purpose of any kind of insurance is to protect against the unknown. This is why it isn't included in coverage for near-sighted people, because you can't insure against a known cost. You would simply be pre-paying through higher premiums. But health insurance companies have been blurring this line (for example "covering" the cost of routine checkups) so Tmy's confusion id understandable.

[Tmy]

The problem is if you lose/break your glasses. Then your screwed. After all vision is extremly important.

I heard that the army offers lasik so that soilders dont have to depend ob glasses. Is that true?

[Rob Lister]

Lasik doesn't last forever. It lasts only as long as would any eyewear perscription. It's basically just 'etching' contact lenses onto your eyeball. When your vision changes, so too will the last 'etching' be less than sufficient.

For older folks like me, the current technology cannot (cheaply) address both my near and far vision problems. I can fix either, but not both. For an extra extra-large dime I can fix both but only for a few years.

It just isn't worth it to me. I may get it for my kids though.

[Kiless]

Certainly doesn't improve spelling.... :)

The fact that it doesn't last is important. And it's only effective after a certain age (I heard it was around age 35?) and... how many of us have managed after breaking their glasses? I've noticed an improvement in the resiliance of eyeglasses since the 1980s and many of the places advertise a get one, get one free deal - does that happen in the USA?

[luchog]

It's not a significant disability; with the exception of amusement park rides, I can't think of any activity where my dependence on glasses requires extra effort.
Well, it did keep me out of the Special Forces when I joined the Army.

[HarryKeogh]

Lasik doesn't last forever. It lasts only as long as would any eyewear perscription. It's basically just 'etching' contact lenses onto your eyeball. When your vision changes, so too will the last 'etching' be less than sufficient.

this is incorrect. I had lasik done 6 years ago and my vision is still 20/15.

below is the answer given in most LASIK website FAQ sections

Q: Are the results achieved from LASIK permanent?
A: The effects of LASIK are permanent. The effects of LASIK do not wear off. But it is important to realize that a person's eye can still change internally. That is why many surgeons recommend having the procedure done after the major eye changes have occurred in one's life. For instance, LASIK is not recommended on children because their eyes change a great deal. They would need the vision fine-tuned in a few years. If the procedure is performed after the age of 18, the chance of long-term stable correction is more likely. Even the eyes of patients over the age of 18 can still be changing.



so to say it lasts as long as your eyeglass prescription is incorrect.

your description of the procedure isn't quite right either. Corneal tissue is removed. Nothing is etched onto the eyeball.

[fishbob]

When they can come up with a procedure that will make people see better than they ever have before even with correction then I'll be impressed.


You ought to be impressed.
I can see better now than I could during any of the 30+ years of 'correction'.

Also, I don't have to constantly wipe my glasses when it is raining.
Also I no longer have to deal with my glasses fogging up when I step outside into the cold (less of a problem down south, but a concern here for more than half the year).
I can also wear cool shades that I never could wear before.

Lasik is expensive. Insurance companies do not like expensive. Insurance companies do not care that I can see better than ever when it is expensive.

[chulbert]

Insurance is all about numbers. I think the hesitation is simply one of cost; Lasik costs about $2000, on average (despite ads for "$500 per eye," less than 3% are performed for under $1000 per eye (http://www.allaboutvision.com/visionsurgery/cost.htm)). How often do you replace your glasses? Me, I do it maybe once every 4-5 years, and my vision plan only covers about $100 of a new pair. I'm a little suspicious of your source. AllAboutVision.com is owned by Access Media Group, LLC, a for-profit "company specializing in the vision care market." I imagine they take a somewhat hostile position against a treatment that essentially eliminates an individual's need for vision care. Additionally, I would expect them to cite a source for their "3% figure" that is a wee bit more authoritative than a newspaper article.

[toddjh]

I know next to nothing about it (I've had 20/15 vision all my life :D), but I was under the impression that lasik was unreliable and had an uncomfortably large chance of screwing your vision up pretty badly. That would be a good reason for insurance companies to deny coverage. Am I confused?

Jeremy

[Miggins]

My husband wears glasses and we`ve looked into this- apart from being too expensive for him to try, we were a bit worried about the tiny type discaimer at the end (don`t blame us if you go blind......words to that effect)
Anyway, I think specks can look quite nice on men, gives them an intelligent air, even if they`re not. A lot of celebs have taken to wearing plain glass glasses at some point, to acheive that fashionable `geeky` look.
I`ve got pretty good vision I think, although years ago I went for an eye test and was told I should really wear glasses, even though I didn`t really need them, as one of my eyeballs is `lazy` (not the only part of me which is lazy)
This made me a bit suspicious- an optician telling me I needed glasses- hmmmm.
It reminded me of my sister, who goes to the dentist every month for a check up, brushes her teeth and flosses 3 times a day, and now has 4 false teeth , crowns, root canal problems, and allsorts of dentistry wizardry, whereas I, who brushes once every 2 days if I can be bothered and last went for a check at 15, have a lovely set of gnashers for an English person, with only one tooth missing at the back somewhere.
Hurrah for fear of dentists!
Incidentally (no pun intended) I think sanitary towels and tampons should surely be free on the NHS by now.

[Pope130]

Lasik is expensive. Insurance companies do not like expensive. Insurance companies do not care that I can see better than ever when it is expensive.

Depends on the insurance company. Mine covers Lasik, perhaps you should consider a different plan.
Also, while karatotomy will change the shape of the eyes lens, thus restoring focus at one distance, it will not retore flexibility to the lens. The most common vision problem in the general population is the inability to focus on near objects due to loss of flexibility of the lens (when you find your arms are too short to hold the paper). Reading glasses, or multifocals are used. Lasik, or other forms of karatotomy do not deal with this.
Normally Lasik is used to restore distance vision (with glasses for reading), although in some cases near vision is selected (with glasses for distance). Rarely one eye will be carved for distance and the other for near.
I wear glasses myself, could have Lasik for free, and plan to continue wearing glasses.

Robert Klaus

[jj]

Lasik doesn't last forever. It lasts only as long as would any eyewear perscription. It's basically just 'etching' contact lenses onto your eyeball. When your vision changes, so too will the last 'etching' be less than sufficient.


Can you do it twice? Doesn't it cause more dispersion every time you do it? I haven't gotten it because I've been warned that I will have more dispersion after I get it, and because of the other issue you mention below.

(And my night vision is very good, as is dispersion, despite the age, etc. You figure. I see better than most people when it gets darkish outside, both in terms of refraction and sensitivity. Don't ask me, I grew that way. Now don't ask me about tracking a target from distance via binocular vision, my depth perception (*&(*&(*'s.)


For older folks like me, the current technology cannot (cheaply) address both my near and far vision problems. I can fix either, but not both. For an extra extra-large dime I can fix both but only for a few years.


And that really is the problem in a nutshell. Do fogies get near correction or far correction? If we get one, then the other requires glasses. Once you have to carry around glasses, what's the benefits?

I admit to not having gotten bifocals yet, I prefer to have a good field of view at my terminal.


It just isn't worth it to me. I may get it for my kids though.

I worry about the possible need for repeated surgeries, and what effect (if any) that will have on corneal dispersion.

(N.B. I'm talking about corneal dispersion here, lens dispersion (aka cataracts) is not going to be affected, as far as I know, in any way. So you still want those UV blockers no matter what.

[fishbob]

Depends on the insurance company. Mine covers Lasik, perhaps you should consider a different plan.
Also, while karatotomy will change the shape of the eyes lens, thus restoring focus at one distance, it will not retore flexibility to the lens. The most common vision problem in the general population is the inability to focus on near objects due to loss of flexibility of the lens (when you find your arms are too short to hold the paper). Reading glasses, or multifocals are used. Lasik, or other forms of karatotomy do not deal with this.
Normally Lasik is used to restore distance vision (with glasses for reading), although in some cases near vision is selected (with glasses for distance). Rarely one eye will be carved for distance and the other for near.
I wear glasses myself, could have Lasik for free, and plan to continue wearing glasses.

Robert Klaus

Yeah. I was near-sighted as hell AND was becoming unable to focus on near objects. I got the one eye carved for distance and other for reading. Six years now without specs. Except for some cheapos from the grocery store for reading small print. $40 and I have 4 or 5 pairs of cheapo reading specs laying around where I might need them.

Carved sounds frightening. I prefer to think of it as re-shaped. With lasers. Actually, that sounds pretty frightening too.

[fishbob]

Can you do it twice? Doesn't it cause more dispersion every time you do it? I haven't gotten it because I've been warned that I will have more dispersion after I get it, and because of the other issue you mention below.

(And my night vision is very good, as is dispersion, despite the age, etc. You figure. I see better than most people when it gets darkish outside, both in terms of refraction and sensitivity. Don't ask me, I grew that way. Now don't ask me about tracking a target from distance via binocular vision, my depth perception (*&(*&(*'s.)

And that really is the problem in a nutshell. Do fogies get near correction or far correction? If we get one, then the other requires glasses. Once you have to carry around glasses, what's the benefits?

I admit to not having gotten bifocals yet, I prefer to have a good field of view at my terminal.

I worry about the possible need for repeated surgeries, and what effect (if any) that will have on corneal dispersion.

(N.B. I'm talking about corneal dispersion here, lens dispersion (aka cataracts) is not going to be affected, as far as I know, in any way. So you still want those UV blockers no matter what.

My night vision is not as good as before lasik. Temporarily, I had a starburst effect around bright lights at night. This went away over a few months. I don't need glasses for the computer terminal. Reading a newspaper causes a bit of squinting (my distance eye is no help with newspapers). Reading fine print requires reading glasses. Reading a book is easier with reading glasses. Cheap reading glasses.