The Cost of Eye Surgery – Know Your Options

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We understand that when preparing for an eye surgery, cost is a very important factor to consider. To support our patients and empower them with the knowledge they need, we’re breaking down payment options when it comes to eye surgeries – including how to best utilize your health insurance benefits and Flexible Spending Account (FSA) funds.

Insurance – Learning Your Plan

Health insurance can be complicated, and many people do not know the vast benefits available to them through their public or private insurance. At the end of the day, specific coverage for eye exams and procedures is unique plan to plan, and ultimately is dependent on each insurance carriers’ policies. Typically though, medical coverage through health insurance may cover the cost of diagnosis and treatment. Medical eye problems and diseases – such as cataracts, age-related macular degeneration, glaucoma, diabetic retinopathy, dry eye, retinal issues, or corneal injuries – are often covered under health insurance policies.

Choosing an eye care provider that accepts your insurance also impacts your coverage. An ophthalmologist is a medical doctor and specialist in diagnosing and treating eye disorders and diseases, so their services are typically covered as such with medical insurance plans. There are also supplemental vision plans that could be available to you through your employer. These supplemental plans can be used to help reduce vison-related expenses such as contacts and glasses. Again, confirm with your eye care provider that they accept this type of vision insurance, as it is often treated differently than standard medical health insurance.

Utilizing FSAs

If you are planning for a surgery and have confirmed what your eye insurance covers, you can also use your Flexible Spending Account (FSA) to help pay for services not covered by insurance. FSAs are tax-advantaged accounts also known as Health Savings Accounts (HSAs.) They are special accounts that you can put money into pre-tax and then use that money to pay for eligible out-of-pocket health-related expenses. Fortunately, eye care – including vision correction – is considered an FSA-eligible expense. So, if you have an FSA or HSA, check with your insurance plan administrator to ensure eligibility before incurring any expenses.

One important thing to know about these pre-tax accounts is that in general the funds you contribute to them must be used within the plan year. There can be exceptions that vary by plan, but it is typical for any unused money left in the account to be taken away. That is what you will often hear the saying “use it, or lose it” when it comes to flexible-spending accounts. The typical use-by date is December 31st, however again this can vary by plan.

If you are preparing for an eye surgery, or considering one that you may have been delaying, now is the time to talk to your ophthalmologist and determine your plan for treatment. Our team can support you each step of the way and offer guidance on your insurance plan coverages and how you can best use your FSA or HSA. Give us a call today so we can help you use your funds in the most appropriate ways…so you don’t lose them!