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Does Medicaid Cover LASIK?

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Financing Your LASIK Procedure

One of the most common questions when an individual is considering LASIK is, “What is LASIK going to cost?” This is usually followed by what types of insurance coverage exist for the procedure, including Medicaid.

Medicaid is a joint federal and state program that provides healthcare coverage for eligible individuals and families. The specific benefits and coverage options available through Medicaid can vary from state to state. Medicaid typically covers essential medical services, such as doctor visits, hospital care, and prescription medications, but coverage for elective or cosmetic procedures, including laser eye surgery, is usually limited.

Laser eye surgery is often considered an elective or cosmetic procedure because it is typically used to correct vision problems like nearsightedness, farsightedness, or astigmatism. These vision issues are not typically considered medical emergencies. That being said, according to the Medicare website, there are some cases when LASIK surgery can be certified as medically necessary. Medicare is federal health insurance for anyone 65 and older as well as some people younger than 65 with certain disabilities or conditions.

If you have dual eligibility with Medicaid and Medicare, you may have some coverage for a portion of the procedure cost as well as the deductibles, coinsurance, and copayments. These are the instances in which Medicare and Medicaid could be used to pay for LASIK eye surgery to correct refractive errors:

  • When the refractive errors are the result of injury.
  • When the errors are the result of a previous surgery.
  • When the refractive errors are severe.
  • If the patient cannot wear glasses or contact lenses because of physical limitation.*

If you have any questions about Medicaid coverage for LASIK, we strongly recommend speaking to your insurance agent or an insurance professional who can help you navigate your coverage. In the meantime, we are happy to talk to you about other LASIK financing options that exist to help you pay for your surgery.

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*Source: Medicare.org “Does Medicaid Help Pay for Laser Eye Surgery?”