*Quotes are based on single individual with less than $93,000 income and living in Sydney.
How does health insurance cover laser eye surgery?
Extras
Only a handful of extras insurance policies cover laser eye surgery. There's no requirement for funds to offer cover – which means it's usually only available with very comprehensive policies. In some cases, like Medibank, you'll need to take out a combined hospital and extras policy to be covered.
Hospital
Hospital insurance doesn't usually cover laser eye surgery because it's generally not considered 'medically necessary'. However, all bronze policies cover other eye-related treatments including tear duct conditions, eye infections, retinal detachment and trauma to the eye. You'll need a gold policy if you want health insurance for cataract surgery.
What's the difference between laser eye surgery and other eye surgery?
Laser eye surgery. These are all different ways of reshaping the lens to correct vision and remove the need to wear glasses. These procedures vary in cost and aren't always covered by either hospital or extras cover.
Other eye surgery. This encompasses a wide variety of medically necessary surgical procedures such as glaucoma. It's covered by hospital insurance. Some insurers pay for any major eye procedure recommended by an ophthalmologist, others will only cover specific treatments or parts of the eye.
Medicare, Australia's public health system, only covers essential procedures like cataract removal surgery. It does not cover optionals like corrective laser eye surgery.
What does Medicare cover you for?
What isn't covered?
Costs of treatment as a public patient in a public hospital
Partial costs of being treated as a private patient in a public hospital
Essential eye procedures required for the patient to maintain their sight
Corrective surgery
Unessential elective or optional procedures done for cosmetic purposes
Procedures carried out to prevent a patient from needing to wear glasses or contact lenses
Treatments undertaken as a private patient in a private hospital.
Treatments undertaken at private ophthalmology (eye-related) surgery centres.
Costs associated with eye surgery such as anaesthesia and operating theatre fees.
Extras Cover
Corrective laser eye surgery.
Additional treatments such as eye therapy.
Subsidies for glasses and contact lenses.
How much does laser eye surgery cost without insurance?
Without health insurance, you'll need to pay the full cost of laser eye surgery yourself. The final bill will depend on the type of surgery you have, and will vary based on which provider you ultimately choose. Here is a summary of some of the price ranges of common surgery types.
Procedure
Typical price (per eye)
Details
LASIK
$1,500 - $3,400
In LASIK (laser-assisted in situ keratomileusis), a surgeon uses lasers to create a flap in the cornea and reshape the underlying tissue before replacing the flap.
PRK
$1,500-$3,400
For PRK (photorefractive keratectomy), a surgeon uses a topical solution to remove the top layer of corneal cells, and a laser to reshape the exposed corneal tissue below.
SMILE
$3,300 - $3,700
In SMILE (small incision lenticular extraction), a surgeon make a small incision in the cornea with a laser and then removes a small disc of underlying corneal tissue.
LASEK
$2,400 - $3,400
LASEK (laser-assisted sub-epithelial keratomileusis) has a laser create an ultra-thin layer of the barrier that protects the cornea, which is moved to the side so the surgeon can reshape the corneal tissue below. The barrier is then re-positioned back on the cornea.
ICL
$4,700 - $6,200
An ICL (implantable contact lenses) is a custom lens, similar to a contact lens, that is created by a surgeon and implanted directly into the eye.
What should I look for when comparing laser eye insurance policies?
When comparing health insurance policies for laser eye surgery, keep the following in mind:
Waiting periods. This is the minimum amount of time you must wait between taking out a policy and claiming benefits with it. For laser eye surgery, this is often 24 months, while in-hospital major eye surgery is typically two months.
Excess. This is a fee you must pay when claiming benefits. Not all health insurance policies include excesses, but some do. You may be able to opt for a higher excess and lower premiums, or a lower excess and higher premiums. It's good to make sure that your excess is not so high as to prevent you from making any claims.
Limits. All private health funds have annual limits, which are the maximum amount you can claim in benefits per year. Limit for laser eye surgery range from around $500 to $3500.
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Gary Ross Hunter is an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, The Guardian and news.com.au. Gary holds a Kaplan Tier 2 General Advice General Insurance certification which meets the requirements of ASIC Regulatory Guide 146 (RG146).
While COVID-19 vaccinations are free in Australia, other vaccines with out-of-pocket costs can be covered by private health insurance with some extras policies.
If you're wondering what pharmaceutical costs are covered by private health insurance, we've got a guide to health cover for non-PBS pharmaceuticals here.
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