Medicare does not cover LASIK or other elective laser eye surgery. Original Medicare (Parts A and B) only pays for procedures deemed medically necessary, and vision correction surgery like LASIK falls squarely into the elective category. That means the full cost comes out of your pocket. However, Medicare does cover certain laser eye procedures when they’re performed to treat a disease or medical condition rather than to replace glasses or contacts.
Why Medicare Excludes LASIK
Original Medicare draws a hard line between medically necessary procedures and elective ones. LASIK and PRK reshape the cornea to correct nearsightedness, farsightedness, or astigmatism, essentially doing the same job as glasses or contacts. Because corrective lenses already address the problem, Medicare treats laser vision correction as a personal choice rather than a medical need.
This applies to both Part A (hospital coverage) and Part B (outpatient coverage). Neither part provides any reimbursement for elective refractive surgery, regardless of how strong your prescription is or how long you’ve worn glasses.
Laser Procedures Medicare Does Cover
Not all laser eye surgery is elective. Medicare covers laser procedures when they treat an underlying eye disease or correct a complication from a covered surgery. The key distinction is the reason for the procedure: treating a medical condition qualifies, while improving your uncorrected vision does not.
YAG Laser Capsulotomy After Cataract Surgery
The most common covered laser eye procedure for Medicare beneficiaries is a YAG laser capsulotomy. After cataract surgery, the thin membrane behind the artificial lens can become cloudy over time, a condition called posterior capsule opacification. This causes blurred vision, glare, and reduced contrast, essentially making it feel like the cataract is coming back. A YAG laser capsulotomy uses a focused laser to create an opening in the clouded membrane, restoring clear vision in a quick outpatient procedure.
Medicare generally covers this procedure when it’s performed at least 90 days after cataract extraction and the patient has documented visual impairment, typically visual acuity of 20/30 or worse, symptoms of glare, or decreased contrast sensitivity. Coverage within the first 90 days is possible but requires specific clinical justification, such as a capsular plaque that couldn’t be safely removed during the original cataract operation or displacement of the implanted lens.
Other Medically Necessary Laser Treatments
Medicare also covers laser procedures for conditions like diabetic retinopathy, glaucoma, and retinal tears. The CMS policy on laser procedures states that when a laser has been approved by the FDA and is used in place of a conventional surgical technique to treat a disease, Medicare contractors can determine coverage on a case-by-case basis. The procedure must be performed by a practitioner trained in the surgical management of that specific condition.
For these covered procedures, you pay the standard Part B cost-sharing: the annual Part B deductible plus 20% coinsurance on the Medicare-approved amount. If you have a Medigap (Medicare Supplement) policy, it may cover some or all of that 20% coinsurance, but only for procedures Original Medicare already approves. Medigap does not add coverage for procedures Medicare excludes, so it won’t help with LASIK.
Medicare Advantage and Vision Benefits
Medicare Advantage (Part C) plans are required to cover everything Original Medicare covers, but many also offer extra benefits including routine vision care. These extras commonly include annual eye exams, prescription glasses, and contact lenses. That’s a meaningful upgrade over Original Medicare, which generally doesn’t cover routine eye care.
However, having vision benefits on a Medicare Advantage plan does not automatically mean LASIK is covered. Most Medicare Advantage plans still exclude elective refractive surgery. Some plans may offer discounts through partner vision networks, but actual coverage for LASIK is uncommon. If you’re considering it, contact your specific plan to ask about their coverage details before assuming anything.
Paying for LASIK Out of Pocket
If you want LASIK and Medicare won’t cover it, you’re looking at paying the full cost yourself. LASIK typically runs between $2,000 and $3,000 per eye, though prices vary by surgeon, technology, and location. A few options can help manage the expense.
- Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs): If you had an HSA before enrolling in Medicare, you can use remaining funds for LASIK since it qualifies as a medical expense. You can’t contribute new money to an HSA once you’re on Medicare, but existing balances are still yours to spend.
- Financing plans: Many LASIK providers offer interest-free or low-interest payment plans that spread the cost over 12 to 24 months.
- Provider discounts: Some LASIK centers offer reduced rates for seniors or run periodic promotions. It’s worth comparing prices across multiple providers in your area.
Cataract Surgery Is a Different Story
One point worth clarifying, since it causes frequent confusion: cataract surgery itself is covered by Medicare. Cataracts are a medical condition, not an elective concern, and the surgery to remove a clouded natural lens and replace it with an artificial one is considered medically necessary. Medicare Part B covers the procedure, the standard monofocal lens implant, one pair of prescription glasses or contacts after surgery, and any follow-up laser treatment needed for complications like capsule opacification.
What Medicare won’t cover is upgrading to a premium lens implant during cataract surgery. If you choose a multifocal or toric lens designed to reduce your need for glasses after the procedure, you’ll pay the difference between the standard lens cost and the premium lens cost out of pocket. The surgery itself and the basic implant remain covered.