Which Health Funds Cover Laser Eye Surgery?Are you considering laser eye surgery to improve your vision? Many Australians are curious about whether their health fund covers this procedure or not, because if it doesn’t, you may have to pay out of pocket.At IVISION LASER, we offer laser eye surgery in Adelaide, including SMILE ® Pro, LASIK, and PRK, and we’re here to help you through the whole process. Understanding which health funds cover our procedures can help you make an informed decision about your eye care, but with an overwhelming amount of options out there, it’s not always the easiest thing in the world.So, is laser eye surgery covered by BUPA or Medibank? What other health funds are out there? We’ve investigated which health funds offer coverage for laser eye surgery in Australia to help you explore your options. Keep reading to find out more.If you’re considering LASIK the best place to start is to check out our free online suitability test.Health FundCoverageWaiting PeriodDetailsBupa1https://www.bupa.com.au/health-insurance/cover/gold-ultimate-health-coverPartial / Full36 monthsSome plans provide 100% cover for the cost of laser eye surgery if performed by a fund-recognised provider (eligibility terms apply).Medibank2https://www.medibank.com.au/health-insurance/cover/gold-ultra-health/Partial36 monthsOffers coverage through its Gold Ultra Health policy, with a lifetime limit of $3,500.Australian Health Management (AHM)3https://ahm.com.au/health-insurance/extras-cover/lifestyle-extrasPartial24 monthsPartially covers laser eye surgery under their Lifestyle Extra Cover or Super Extras cover. Limit per financial year starts from $600 per eye, with additional lifetime limits.Defence Health4https://www.defencehealth.com.au/getmedia/f52e9c86-51a8-489d-8418-a9235353d4c4/TopExtras.pdfPartial12 monthsIncluded in the Top Extras covers up to a limit of $1000 per person every 2 years.For more details, or to better understand the terms and conditions of these coverage options, you should reach out to your provider.What do I do if my health fund isn’t listed here?If your health fund isn’t listed here, don’t worry. This list may not cover all available options, and there are many health funds in Australia that offer different types of coverage.Your health fund might still provide coverage for laser eye surgery, even if it isn’t mentioned in our list. It’s always a good idea to contact your provider directly to ask about your specific situation.When you reach out, ask detailed questions about what is covered under your plan, including any waiting periods, out-of-pocket costs, and whether you need to meet any specific criteria to qualify for coverage. This will give you a clear understanding of what financial support you can expect.Additionally, health funds often update their policies and coverage options. By contacting your health fund, you can get the most up-to-date information. If you find that your current health fund does not cover laser eye surgery, you might consider looking into other health funds that do, or explore different types of coverage plans that better meet your needs.Why is there a waiting period before my health fund will pay for laser eye surgery?Health funds often impose a waiting period before they will pay for laser eye surgery. This waiting period is the time you must wait after joining a health fund before you can claim benefits for certain procedures.5https://pubmed.ncbi.nlm.nih.gov/37956990/Waiting periods serve several purposes for health funds, but primarily it is to prevent the practice of joining a health fund to cover an expensive surgery and then leaving soon after.If choosing a health fund with your future laser eye surgery in mind, make sure to ask about the length of the waiting period and any other conditions that may apply. This information will help you plan your surgery and avoid any surprises when it comes to coverage several years down the line.Is laser eye surgery covered by Medicare?No, Medicare does not typically cover laser eye surgery, as it is considered a cosmetic procedure.Why doesn’t Medicare pay for laser eye surgery?Medicare focuses on providing coverage for treatments that are essential for maintaining health, such as surgeries for cataracts, which can significantly impair vision and daily functioning if left untreated. Because laser eye surgery is seen as enhancing convenience and appearance rather than addressing a critical health issue, it is not included in Medicare’s list of covered procedures.For individuals seeking laser eye surgery, it is important to explore other funding options, such as the aforementioned private health funds or paying out of pocket. Knowing the criteria for what Medicare covers can help you make informed decisions about your eye care and potential costs.Are There Other Funding Options for Laser Eye Surgery?For those in Australia whose health funds do not cover laser eye surgery, it’s not the end of the world. There are options available to help you achieve your dreams of clear vision.1. Self-FundingIf your health fund doesn’t cover laser eye surgery or you don’t have health insurance, you can choose to pay for the procedure entirely out of pocket. This option is known as self-funding. Many people choose to self-fund their laser eye surgery to avoid waiting periods or restrictions imposed by health funds.How much does laser eye surgery cost without insurance in Australia?The cost of laser eye surgery in Australia can vary depending on several factors, including the type of procedure, the clinic you choose, and the experience of the surgeon. On average, the cost typically ranges from $2,500 to $3,500 per eye. Some advanced procedures or treatments at highly specialised clinics might cost more.It’s important to note that these costs usually include pre-surgery consultations, the surgery itself, and post-surgery follow-up appointments. However, you should always confirm what is included in the quoted price to avoid any unexpected expenses.2. Payment Plans and Financing OptionsMany clinics offer payment plans and financing options to make laser eye surgery more affordable. These plans allow you to spread the cost of the surgery over several months or even years. Some clinics partner with financing companies that specialise in medical loans, offering low or zero-interest plans for eligible patients.Before committing to a payment plan, ensure you understand the terms and conditions, including any interest rates, fees, and the total amount payable over the life of the loan. This option can make the cost of surgery more manageable by breaking it down into smaller, more affordable payments.3. Medical LoansIn addition to payment plans offered directly by clinics, you might consider taking out a medical loan. Medical loans are specifically designed to cover healthcare costs, including elective procedures like laser eye surgery.Several financial institutions in Australia offer medical loans with competitive interest rates and flexible repayment terms. When considering a medical loan, compare different lenders to find the best rates and terms for your financial situation. Be sure to read the fine print and understand any associated fees, interest rates, and repayment schedules.Medical loans can be a practical solution for funding your laser eye surgery if you prefer not to use credit cards or if payment plans are not available at your chosen clinic.Frequently Asked Questions about Laser Eye Surgery Coverage1. Is laser eye surgery a cosmetic or elective procedure?Laser eye surgery is considered a ‘cosmetic procedure’ by some health funds. Others categorise it as an ‘elective procedure’ due to the benefits it can bring to the patient’s life, beyond the superficial difference of not requiring glasses or contacts any more.2. But what’s the difference?A cosmetic procedure is one that improves a person’s appearance. Laser eye surgery may be viewed as cosmetic because one reason for getting it could be to remove the need for glasses.On the other hand, an elective procedure is one chosen by the patient to improve their quality of life in major or minor ways. To have clear vision without the need for glasses can be considered a life-changing experience for people with poor eyesight, and often is described that way in patient testimonials for laser eye surgery.Laser eye surgery can fall into both categories, depending on the individual’s perspective and vision needs.3. Why is laser eye surgery considered a cosmetic procedure by some health funds?Some health funds view laser eye surgery as a cosmetic procedure because it enhances the appearance of the eyes by eliminating the need for glasses. This means that the surgery is seen as a way to improve one’s looks rather than a necessary medical treatment.Health funds often categorise procedures as either ‘medically necessary’ or ‘cosmetic’. Medically necessary procedures are those needed to treat or manage a health condition, while cosmetic procedures are typically done to improve appearance. Since laser eye surgery can make you look better by freeing you from glasses, it is often put into the cosmetic category.This perspective can impact whether or not the procedure is covered by insurance. If a health fund sees the surgery as cosmetic, they may decide not to cover it because they reserve their coverage for medically necessary treatments. This can be frustrating for people who need laser eye surgery to improve their quality of life, even if it also has cosmetic benefits.Additionally, some health funds might categorise the procedure as ‘elective’, meaning it is chosen by the patient rather than required for health reasons. Unfortunately, elective procedures are also less likely to be covered by some policies, as they are not deemed essential. Understanding how your health fund categorises laser eye surgery is an important determining factor in whether you can receive financial support for the procedure.The price tag of laser eye surgery can put some people off, even if it could have a significant effect on their quality of life. Fortunately, some health funds – including Medibank, AHM, Bupa, and Defense Health – provide full or partial coverage of the procedure. There are also various financial options available to help manage or reduce the out-of-pocket cost, even if you don’t currently have a policy that will fund it.If you’re interested in getting laser eye surgery, we’re here to offer our expertise and help you consider your options. At IVISION LASER, we provide a comprehensive range of vision correction procedures, including ZEISS SMILE ® Pro, all-laser LASIK, SmartSurfACE (TransPRK), and more.To take your first step towards clear vision today, book an appointment with us or take our self-suitability test.