Does Medicaid cover Lasik surgery? We’ve tackled this question to provide ready and far-reaching answers to vision care needs.
Lasik surgery is a popular procedure for correcting refractive errors. These conditions include astigmatism, nearsightedness (myopia), and farsightedness (hyperopia).
Will Medicaid Pay for Lasik Eye Surgery?
As a program that covers various healthcare costs, Medicaid coverage for Lasik eye surgery is being discussed.
Vision correction needs, cost factors, and occupational corrections are reasons people inquire about vision care under Medicaid.
The Need for Lasik Eye Surgery
Anyone with vision problems will need such corrected using the proper procedure.
As earlier stated, some eye conditions will require undergoing surgical procedures. Lasik surgery is a popular way to correct eye conditions like astigmatism, presbyopia, farsightedness, and nearsightedness.
While programs like Medicaid are designed to help low-income families access quality care, not everyone qualifies, as there are set requirements.
Also, because Medicaid is a program run by Federal and state governments, there’s likely to be variation in what’s covered.
To benefit from government programs like Medicaid, you’ll need to find out if the Lasik eye surgery procedure is being covered.
If so, to what extent and what are the requirements for enrollment in the program? Medicaid coverage typically varies by state. So, you’ll do well to know what’s being covered.
Answering the Question
At the beginning of this article, a question was posed; does Medicaid cover Lasik eye surgery? The answer is mostly no!
First, as an elective procedure, Lasik surgery is mainly considered as not being necessary. This might not be easy to process for anyone with vision care needs.
While that is true, it’s a reality you’ll need to live with. Another likely reason why Medicaid doesn’t cover Lasik eye surgery is due to the costs involved.
By its design, Medicaid only caters to the primary healthcare needs of low-income households. This means more expensive healthcare needs aren’t covered.
So, what type(s) of vision care needs are covered by Medicaid?
It depends on the State you live in. For most states, Medicaid will cover eye care needs considered necessary, such as diseases, injuries, and some forms of eye exams.
Medicaid coverage may also be extended to providing a pair of eyeglasses or contact lenses. Regarding eye surgeries, only a few types may be covered under Medicaid.
Medicaid Part A & B
To further understand the extent of Medicaid coverage for vision care, you’ll need to look at both Parts A & B.
Under Medicaid’s Part A, coverage is given for inpatient services like hospice care, hospital stays, home health care, and skilled nursing facility stays.
Part B coverage for Medicare mainly focuses on outpatient services such as X-rays, doctor visits, lab tests, and prescription drugs. For vision care, surgical procedures aimed at correcting vision aren’t covered.
While that is true, there may be exceptions.
Such exceptions are seen in situations where certain conditions are deemed medically necessary.
So, what vision care needs are considered essential under Medicaid? They include glaucoma, macular degeneration, diabetic retinopathy, and cataract surgery.
Here, it’s clear that Lasik eye surgery isn’t covered under Medicaid in most states. However, vision care surgery is only performed when the condition is considered medically necessary, as shown above.
Medicaid Alternatives for Lasik Eye Surgeries
With Medicaid coverage for Lasik eye surgeries ruled out, what other options exist to correct your vision through
Lasik surgery? You may have to check to see if your state provides expanded Medicare provisions. Also, consider making inquiries at your local community clinics.
Private health insurance is another alternative for Lasik surgical procedures. Vision insurance from employers and paying out of pocket are additional alternatives.
You can also apply for a medical loan or seek other financing options.
i. Expanded Medicare Provisions may Cover Lasik Eye Surgery.
As briefly stated, some states have expanded Medicare programs to provide more services, including vision care.
While that’s true, there’s no guarantee that such an expanded program will cover Lasik eye surgery. First, you must determine if your state has an expanded Medicaid program.
ii. Inquire from your Local Community Clinic
There’s likely to be helpful information about Medicaid coverage for Lasik eye surgery at your local community clinic. This is a great way to go about finding Medicaid alternatives.
iii. Private Health Insurance
Private health insurance is another way to find a Lasik eye surgery procedure. Here, it would be best if you were enrolled and chose a suitable plan.
As a policyholder, you’ll be required to pay regular premiums. There are also deductibles and in-network & out-of-network providers to choose from.
iv. Vision Care Insurance from Employers
In the absence of Medicaid coverage for Lasik eye surgeries, an alternative will be to explore vision care insurance opportunities offered by employers. Now, not every employer provides vision care insurance.
For those that do, inquire if it covers Lasik eye surgery.
v. Pay Out of Pocket
One of several alternatives you have to pay for Lasik eye surgery is paying out-of-pocket. Here, you’ll bear the total costs of the procedure, which can be pretty expensive.
The price for this procedure might be around $2,000. This is the average amount you’re likely to pay.
vi. Medical Loan
A medical loan is one of the ways to fund your vision care surgical needs.
It’s mostly the last option for persons unable to fund the procedure out of pocket. Now, there are specific loans offered for Lasik eye surgery. You’ll need to research these to apply.
vii. Financing Options
To help patients afford the cost of treatment, surgeons may recommend financing provisions.
By spreading out payment, vision care services become a lot more affordable. You’ll do well to ask your surgeon if there are such provisions. A lot can be achieved using this strategy.
Lasik Procedures Might Come with Risks
Like many medical procedures, there are risks attached to Lasik eye surgeries. Some people might experience vision loss or changes and dry eyes.
Other possible scenarios include vision loss, visual changes or alterations, double vision, glare, and regression. For many, these will sound scary, so it’s best to consult or discuss with a surgeon first.
As seen so far, Medicaid does not cover Lasik eye surgery. However, we’ve provided alternative approaches to getting the procedure done.