Insurance coverage for laser eye surgery


Of course, this operation can restore 20/20 vision to wearers of glasses and contact lenses, but the price can vary by several thousand per eye.

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For people who use glasses and contact lenses to see, you may have considered laser eye surgery to give you near 20/20 vision.

Cataract and refraction surgeon Dr Peter Sumich says the technology has come a long way in the past 20 years, with doctors now able to ensure “dramatically improved” safety and results.

Despite this, he says it is important for someone to have the appropriate wait levels before having the operation.

Dr Sumich says you can “almost always guarantee” that the operation will restore a person’s social or lifestyle vision as long as they don’t need glasses or contact lenses, but there are limits to processing.

“Most people don’t want to have to wear their glasses or contact lenses when going out to parties, barbecues or swimming at the beach and you can almost always guarantee that,” he says.

“You can’t always guarantee a patient that their vision will be as perfect as with contact lenses,” he said. “This is because you can obviously change your contacts every six months if necessary.

From cost to questions you should ask during your consultation and whether or not the surgery qualifies for private health insurance reimbursement, here’s everything you need to know.

Does Medicare Cover The Cost Of Laser Eye Surgery?

Unlike some medical procedures, laser eye surgery is not covered by Medicare. This is because it is classified as an elective cosmetic procedure and is not necessary in the management of a medical condition. Despite this, some private Gold level health insurance policies can help pay for some of your surgery.

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Which private health insurance funds offer discounts for laser eye surgery?

While there are some private health plans that cover all or part of an operation, these discounts are normally only found in top tier Gold health insurance plans. It is also the level that offers the most comprehensive levels of coverage against a wider range of medical conditions.

The funds will also specify exactly which procedures they cover (such as LASIK, PRK, and ICL), so it’s important to check the specifics of your private health coverage before committing to an operation.

Found in Extras coverage, some policies may also require long waiting periods or require you to go to a fund recognized by your provider. Some health insurance policies that allow members to claim include:

Bupa Gold Ultimate Health Coverage Plan – 100% coverage of a pre-existing condition, by a provider recognized by the fund. A 36 month waiting period applies.

Medibank Gold Ultra Health Plan – $ 3,500 after a member has served a 36-month waiting period.

AHM Lifestyle Supplements – Members can claim $ 600 per eye after serving a two-year waiting period.

AHM Super Extras – Members can claim $ 900 per eye after serving a two-year waiting period.

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How does laser eye surgery work?

Although the exact process will depend on the procedure chosen by your surgeon, the basics of surgery involve using a laser to reduce the thickness and reshape the surface of the eye.

In doing so, the procedure can correct nearsightedness, farsightedness, and astigmatism.

For this reason, the operation is not suitable for people who have a thin cornea or who lack tissue around the cornea.

“If you are a person who already has a thin cornea and little tissue, or if your eyes are weak to begin with and you remove some of the eye tissue, you could weaken the surface of the eye and make it too weak, or it could become deformed. We call it corneal ectasia, ”says Dr. Sumich.

“However, we have become very good at picking up those who are likely to have this problem and we are not offering them surgery.”

While patients over the age of 50 can also have laser eye surgery, Dr Sumich says they may be a good candidate for reading lens implants as well.

“If you’re over 50, lens implants are increasingly becoming the way to go and many of the same qualifiers apply,” he says. “However, there is something for almost all age groups to be able to optimize their vision where they can become a lifestyle independent of glasses.”

How do I find a laser eye surgeon?

Dr Sumich says the most important thing when finding someone to perform your laser eye surgery is to make sure it is a qualified eye surgeon who is a member of the Royal Australian College. of Ophthalmology.

This means that their education and experience have been verified by the College and meet regulatory requirements as judged by the Australian Health Practitioner Regulation Agency (AHPRA).

Making sure your surgeon has “substantial training” in refractive surgery is another key factor.

“You want to make sure the person is a subspecialist or has had additional training in refractive surgery,” says Dr. Sumich.

“Then you will probably ask the person their experience, their approach, the cost, if they have more complications than the next person and their success rates. “

While it may seem too blunt to ask your surgeon these questions, Dr. Sumich says it’s important to remember that “good surgeons aren’t put off by you asking them the expected questions.”

How much does laser eye surgery cost?

In Australia, the cost of the procedure can vary widely, with Dr. Sumich claiming it ranges from $ 900 to $ 4,000 per eye. Despite this, the factors that contribute to the cost are not based on “eye error” (such as astigmatism or patients who require a higher prescription) but are more related to the type of technology they are using. and their broader boutique or service offering.

“Centers that get the latest technology right out of the box will have a different cost than those that hang on to their equipment,” says Dr. Sumich.

“There are brand differentiations as well, which doesn’t matter as much to the consumer, but some people prefer to work with a certain type of technology. This is why there is no one-off cost.

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