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How to get Private Health Insurance for Laser Eye Surgery

Megan Fraser
Megan Fraser Updated: 15 March 2021
Types of Health Insurance

How to get Private Health Insurance for Laser Eye Surgery

So you need to correct your vision, but the health insurance benefits available remain a blur. It’s essential to understand what to expect regarding the operation and the associated costs. You may also want to compare the private health insurance plans available to you to find the right cover for your requirements.

eye

When it comes to laser eye surgery, there are limited options available to you. Insurers like HIF and AHM offer members limited cover under Hospital and/or Extras cover for vision-related procedures. Having a good understanding of your condition and the type of treatment you need will generally guide you to the right cover for your requirements.

Key Facts

  • This type of cover is available as part of your Hospital and/or Extras policy.
  • Most insurers offer cover up to a certain limit, usually between $1,200 and $3,500.
  • Generally, you’ll only be able to claim for medically necessary procedures.

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Does health insurance cover LASIK?

Yes, there are a few insurers who offer their members cover for this type of procedure. However, it’s important to note that this cover is limited and is
generally only included in higher level Hospital and Extras policies. The amount you’re covered for and the specific benefits you can claim for generally depends on the fund you’re with and your policy type.

How much is covered?

This generally depends on your insurer and policy. Some health funds cover the full cost of these procedures, while others only offer partial coverage. The amount you’ll be able to claim for treatment differs depending on the policy you have chosen. It’s best to compare your health insurance plan options to find the right one for you and your requirements.

What is laser eye surgery?

Laser eye surgery is a medical procedure completed by a trained physician to correct your vision. Typically, your doctor will use a beam of light to reshape the surface of your eye. This helps with short and long-sightedness and astigmatism, cataracts, some cases of glaucoma, age-related macular degeneration and diabetes-related eye diseases.

Types of laser eye surgery

The use of a laser for vision correction may seem commonplace, but there are some differences in the types of procedures available. Common surgeries include:

eye
LASIK (laser-assisted in situ keratomileuses): This procedure differs in how a surgeon accesses the cornea. The process requires the surgeon to create a flap in the eye’s epithelial layer through which the corneal tissue is altered. The flap is then closed.
eye
Surface laser treatments (PRK, TransPRK, ASLA and LASEK): In this procedure, the eye’s epithelial layer is removed, and the laser is used to reshape the underlying corneal tissue. The epithelial layer naturally regenerates after surgery.
eye
SMILE (small incision lenticule extraction): Your ophthalmologist will use a laser to change the shape of your cornea to improve the way light rays are focused on the retina to improve near-sightedness and astigmatism.

How much does LASIK cost?

Costs for these types of procedures generally range from $2,500 to $6,000. However, it’s important to note that this varies. Typically, quotes reflect the treatment cost per eye, so make sure you factor this into your plans. Costs usually depend on the level of surgical correction required, the technology used for the procedure and the surgeon’s experience.

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  • Reduce out-of-pocket expenses
  • Keep your family healthy
  • Easy and convenient
  • Free to use

Want to talk to a specialist? Call 1300 743 254

Which health funds cover the cost of laser eye surgery?

Benefits for these procedures vary between private health insurers and further differ depending on your chosen plan.

Health fundProcedurePolicy typeHow it works
medibank
Medibank
Laser Eye SurgeryGold Ultra Cover
  • Pay upfront and claim back later. Ultra cover customers get back half for LASIK/PRK only.
Bupa
Bupa
Laser Eye SurgeryHospital & Extras: Gold Ultimate
  • Ultimate Hospital and Ultimate Extras customers are fully covered for this.
defence
Defence Health
Laser refractive surgeryPremier Hospital Gold Cover
  • Please contact Defence Health directly to confirm your benefits eligibility.
HIF
HIF
Eye Surgery (non-cosmetic only)Gold Hospital Cover
  • Gold Hospital covers 100% of all inpatient, medically necessary treatments.
AHM
AHM
Corrective Laser Eye SurgeryLifestyle Extras and Super Extras
  • Per eye, Lifestyle Extras pay $600 with a lifetime limit of $1200 and Super Extras pay $900 with a lifetime limit of $1800 class=”lid-list lid-list–check”

Source: Privatehealth.gov.au, March 2021 (Estimates for a single adult with no dependents in NSW)

Does Medicare cover LASIK?

No, Medicare considers LASIK as elective surgery and do not offer any benefits for this type of treatment. Original Medicare typically does not offer any cover for vision care. So, you won’t be able to claim for vision exams, corrective glasses or frames or contact lenses. However, Medicare Advantage may offer members limited cover for eyecare.

eye surgery

Frequently asked questions and answers

  • What are the risks and complications of eye surgery?

    Though the likelihood is low, as with any surgery, there are risks and complications. Post-op, temporary complications and side effects include over-or under-correction of a refractive error resulting in focus problems, loss of visual sharpness, dry eyes or problems with the corneal flap.
  • Do you need health insurance for laser eye surgery?

    No, you do not need health insurance for this type of procedure. However, some private health insurance providers offer some cover as part of their Hospital or Extras plans. Such benefits can help to reduce your out-of-pocket expenses for the surgery.
  • How do you claim for these procedures?

    It’s best to check your policy for the details of eye surgery benefits, associated waiting periods and claim procedures. Some private health insurers may require that you pay for your surgery upfront and claim after, while others will pay your chosen clinic directly once an invoice is received.
  • Does Bupa cover laser eye surgery?

    Yes, Bupa is one of the private health insurers that do cover such procedures in full. The benefit is however only available to Ultimate Hospital and Ultimate Extras customers.
  • Can you get a rebate for this type of surgery?

    Some private health insurers do offer their customers a rebate. This is dependent on the benefits of your chosen plan and subject to specific waiting periods. It’s best to check with your health insurance provider to check if you qualify for a rebate.

Health Insurance Quotes

  • Reduce out-of-pocket expenses
  • Keep your family healthy
  • Easy and convenient
  • Free to use

Want to talk to a specialist? Call 1300 743 254

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