Corrective Laser Eye Surgery

Health insurance for major eye surgery

Compare health insurance that will cover cataracts and laser eye surgery.

More and more insurers are covering major eye procedures like cataract and corrective laser eye surgery. You don't even need a top-level policy for medically-necessary procedures like certain cataract treatments.

Some insurers even offer a range of rebates and other discounts toward laser eye surgery through their extras policies.

How much does insurance for major eye surgery cost?

You'll find major eye surgery in hospital cover. Below are a few policies from finder.com.au partners that cover this treatment, prices quoted are for a single policy in NSW:

Fund Policy Excess Cost per month Apply
White Deluxe $500 $138.95 Go to Site
Premium $500 $148.33 Go to Site
Mid Plus $500 $144.43 Go to Site
health.com.au-logo Core $500 $139.75 More info

What if you have multiple major eye surgery options?

In the case of major eye surgery, you will sometimes be faced with a choice as to how you would like the procedure to be carried out, and your decision will have health insurance implications. For example, you may be given the choice of:

  • Femtosecond laser cataract surgery, which is quicker and safer although may require a high level of extras cover.
  • Manual cataract surgery. Which is cheaper and therefore may be your only option if you have basic extras cover.

Should this happen, it’s a good idea to check with your health fund and your doctor before agreeing to any procedure to ensure that you understand all the insurance implications of your decision.

Looking to compare laser eye surgery clinics and costs? Check out our guide here

How does the public and private health systems handle major eye surgery?

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
Private health insurance, by contrast, can cover all major eye surgeries to a certain extent, even corrective laser surgery. Most private health funds offer combined hospital and extras policies, as well as hospital-only and extras-only policies. The level of cover you have depends on the comprehensiveness of your health insurance.
Health insurance policy typeWhat can it cover?
  • Hospital Cover
  • Treatments undertaken as a private patient in a private hospital.
  • Treatments undertaken at private ophthalmology (eye-related) surgery centres.
  • Ancillary 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.

What should I look for when comparing insurance policies?

When comparing health insurance policies for major eye surgery, or for that matter any type of medical service, you should be aware of the terms and conditions, as well as the fine print stating exactly which procedures are covered.

  • Exclusions. These are what the insurer will not pay a benefit for. Exclusions might be for specific procedures, such as corrective surgery, or under specific conditions, such as if you get treatment outside of Australia.
  • Restrictions. These are services that are covered to a limited extent, meaning greater out-of-pocket expenses for you. Restrictions are relatively common in major eye surgery, and you may see certain policies with eye surgery restrictions at the basic level and none at the comprehensive level.
  • Waiting periods. This is the minimum amount of time you must wait between taking out a policy and claiming benefits with it. For in-hospital major eye surgery this is typically two months, while for extras corrective eye surgery it is usually about 12 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. There might be more than one applicable limit. For example, you might have a policy that lets you claim a maximum of $1,000 per year for all hospital surgery, or $1,000 for all eye surgeries. Limits will always apply so make sure to read your policy’s product disclosure statement closely.

When determining which eye surgeries are covered by your private health insurance policy, you should look for terminology including:

  • Corrective surgery, refractive surgery or laser eye surgery. These are all different ways of reshaping the lens to correct vision and remove the need to wear glasses. Depending on the nature of your impaired vision, a different corrective procedure might be undertaken. These procedures vary in cost, and it is possible that only some will be covered by either your hospital or extras policy.
  • Major eye surgery. This encompasses a wide variety of surgical procedures undertaken for the purpose of fixing medical issues, such as glaucoma, rather than simply correcting vision. Each insurer may have their own definition of major eye surgery. Some will pay for any major eye procedure recommended by an ophthalmologist, others will only cover specific treatments or parts of the eye.

Seeking health insurance for major eye surgery? Get in touch with an adviser for a quote

Complete list of providers who offer cover for major eye surgery

Health fund Policies that include cover for non-cosmetic eye surgery Find out more
ahm health fund
  • Hospital only policies
    • Top
    • Deluxe
  • Combined hospital + extras policy
    • Black + White Deluxe Flexi
More info
  • Hospital only policy
    • Gold Hospital
  • Combined hospital + extras policies
    • Smart Combination
    • Smart Start (restricted benefit*)
More info

Bupa logo

  • Hospital only policies
    • Top Hospital
    • Standard Hospital (restricted benefit*)
    • Budget Hospital (restricted benefit*)
  • Combined hospital + extras policies
    • Ultimate Health Cover
    • Top Hospital with Platinum Extras
    • All other Bupa combined policies have restricted benefits*
More info
cdhlogo
  • Hospital only policies
    • Young Silver Hospital
    • Silver Hospital (restricted benefit*)
    • Thrifty Hospital (restricted benefit*)
  • Combined hospital + extras policy
    • Smart Cover (restricted benefit*)
More info
cua
  • Hospital only policies
    • 100% Private Hospital Cover
    • 90% Private Hospital Cover
    • 75% Private Hospital Cover
    • Public Hospital Cover (restricted benefit*)
More info
GMHBA health fund
  • Hospital only policies
    • Premium Hospital
    • V Plus Premium Hospital
    • V Plus Ultimate Hospital
More info
Frank
  • Hospital only policies
    • Max Hospital
    • Top Hospital
    • Basic Hospital + some private (restricted benefit*)
    • Basic Hospital (restricted benefit*)
More info
HBF
  • Hospital only policy
    • Top Hospital
More info
HCF
  • Hospital only policies
    • Premium Hospital
    • Mid Plus Hospital
More info
Health.com.au
  • Hospital only policy
    • High Hospital
  • Combined hospital + extras policy
    • High
More info
hcilogo
  • Hospital only policy
    • Hospital Cover
More info
logo health partners
  • Hospital only policies
    • Gold Value Hospital excluding Maternity
    • Gold Value Hospital with Maternity
    • Gold Hospital
  • Combined hospital + extras policy
    • Prime Living
More info
HIF Logo
  • Hospital only policies
    • GoldSaver (restricted benefit*)
    • GoldStar Hospital
    • Gold Hospital
More info
latrobehealthlogo
  • Hospital only policies
    • Top Hospital
    • MemberShare
    • CoverWise
    • Loyal Members
    • Family Care
More info
medibank
  • Hospital only policies
    • Complete Hospital
    • Top Hospital Essentials
More info
onemedifundlogo
  • Hospital only policy
    • Private Plus Hospital
More info
nib
  • Hospital only policies
    • Top Hospital
    • Advantage Hospital
More info
peoplecare provider page link
  • Hospital only policies
    • Premium Hospital - $250 Excess
    • Premium Hospital - $500 Excess
More info
phoenix health fund provider link
  • Hospital only policy
    • Top Hospital $500 Excess
  • Combined hospital + extras policies
    • Top Hospital Nil Excess & Top Extras
    • Value 500
More info
queensland country health fund provider link
  • Hospital only policies
  • Value Plus Hospital Cover
More info
St. Lukes Health Logo
  • Hospital only policies
    • Hospital Platinum
    • Hospital
    • Budget 500 (restricted benefit*)
  • Combined hospital + extras policies
    • Platinum Plus
    • Platinum
    • Gold
    • Silver
    • Packaged Bronze Plus
    • Packaged Budget 500 (restricted benefit*)
More info
Transport Health Logo
  • Hospital only policies
    • Top Hospital
    • Top Hospital with Excess
    • Top Hospital with Co-Payment
    • Basic Hospital (restricted benefit*)
More info
westfund provider link
  • Hospital only policy
    • Gold Hospital
    • Gold Hospital 500
  • Combined hospital + extras policies
    • Platinum
    • Platinum Plus
    • Gold
    • Gold Saver
    • Gold Classic
    • Gold Public
    • Platinum Public
More info
CBHS Health Fund LogoRestricted fund**
  • Hospital only policies
    • Comprehensive Hospital
    • Active Hospital
    • Limited Hospital (restricted benefit*)
    • Basic Hospital (restricted benefit*)
  • Combined hospital + extras policies
    • Prestige
More info
defencehealthlogo

Restricted fund**

  • Hospital only policies
    • Premier Hospital
  • Combined hospital + extras policy
    • ADF Total Package
More info
navyhealthlogo

Restricted fund**

  • Hospital only policies
    • Premium Hospital
    • NT Hospital (Northern Territory only)
    • NT Hospital 300 (Northern Territory only)
More info
doctorshealthfundlogo

Restricted fund**

  • Hospital only policies
    • Top Cover
    • Prime Choice
More info
policehealthlogo

Restricted fund**

  • Combined hospital + extras policies
    • Platinum Plus
    • Platinum Health
More info
rthealthlogo

Restricted fund**

  • Hospital only policies
    • Premium Hospital
    • Smart Hospital
More info
teachers

Restricted fund**

  • Hospital only policies
    • Top Hospital
    • Mid Hospital (restricted benefit*)
    • Basic Hospital (restricted benefit*)
  • Combined hospital + extras policy
    • StarterPak (restricted benefit*)
More info
tuh

Restricted fund**

  • Hospital only policies
    • Total Care Hospital
  • Combined hospital + extras policy
    • Ultimate Choice
    • Easy Choice
More info

*Benefit only applies if you are treated as a private patient in a public hospital. If you attend a private hospital you will incur significant out-of-pocket expenses for your treatment.
**Restricted funds only provide cover to members of specific industries, groups and organisations. In some cases family members may also be eligible to join.

Compare health insurance for major eye surgery

When you get your quotes, just click refine search and then choose major eye surgery under hospital cover and optical under extras cover to view the range of cover available to you.

Picture: Shutterstock

Andrew Munro

Andrew writes for finder.com, comparing products, writing guides and looking for new ways to help people make smart decisions. He's a fan of insurance, business news and cryptocurrency.

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