Why do we insurance, or more specifically, health insurance? Have you ever thought about it? Why do people go through all the formal procedures and yearly/ monthly premium payments just to make sure that they get the insurance at the time they need it? The reason is plain and simple. It is because insurance make sure that if you happen to be in need of medical assistance, you won’t have to bear the medical expenses all by yourself, and in some cases, you would not need to bear even a single penny. That’s why people want health insurance. They want their medical expenses covered at their time of need. And why wouldn’t they? Anyone living in India would know that health expenses are extremely high in the country. Such a situation brings up a very important question. Is LASIK eye surgery covered by health insurance? Well, is it though?
Understanding the Process
LASIK, like any other surgery, is a complicated one. Not the just the surgery itself, but the procedures that are involved in the LASIK eye surgery are complex and intricate. The surgery takes place after a series of tests and evaluations. These tests, as well as evaluations, determine whether a person is a fit candidate for the LASIK surgery or not. These evaluations help doctors understand the need of the patients, their background, their medical history, their ongoing medications, their medical conditions, and then eventually allow them to decide if surgery would be the best option for the given situation. The entire procedure has many steps and can be a job full of hassles if not undertaken correctly. Moreover, it is important to be aware of and explore other alternatives as well. Not everyone is compatible with a LASIK eye surgery and thus it is important to have a ‘plan B’ at hand in case the things do not go as planned. However, in case you do fit the frame for the suitable candidate, you should take into considerations all aspects of the laser surgery.
Exceptions
When it comes to LASIK, people often have the same question again and again. How much does LASIK cost with health insurance? Or, does health insurance cover LASIK or not? The answer, however, is not that good to hear. LASIK eye surgery is not covered by most of the health insurance companies because it is considered as a cosmetic surgery and not a necessary surgery. There are, however, many financial organizations that still intervene to provide financial relief or waiver in some cases. That is why it is advised to not consider the price tag of a LASIK eye surgery as the final price that you would have to pay at the end. There are also a few insurance companies who actually do chip in and pay the bills for their patients. This depends upon a few conditions which are –
• If the eye surgery for the respective refractive error is a result of an injury or an accident.
• If the eye surgery for the respective refractive error is a result of another surgery.
• If the eye surgery is for extreme refractive errors. This being said, there is no standard or parameter set for such measurements. Under this condition, the insurance coverage is usually inconsistent and therefore people should get the facts clear with their insurance provider for more clarity.
• If the eye surgery is undertaken because the person concerned is not able to wear spectacles due to physical deformity or pain. Also, if the patient cannot use contact lenses because of lack of tolerance for contact lenses or any other physical limitation.
The above pointers give us a hint on how a LASIK eye surgery can be insured totally or partially depending on various factors. But even after that, there is no guarantee that the LASIK eye surgery will be covered by the health insurance company. Anyone who has ever been in the hospital for a major/ minor surgery will know that it is quite a troublesome task to get the insurance formalities cleared out for the surgery to begin. In many cases, the cashless facility is not even available, so the payments have to be made before the insurance claim itself. The majority of the Indians being from the upper middle-class section of the society know that claiming insurance can be really troublesome at times.
Present Day Scenario
Today, the insurance plans that cover the LASIK eye surgery are large plans that associate monthly premium schemes to the insurance fund. The benefit of these plans is that with the entire surgery being facilitated but the insurance agency, you can freely go for the surgery and finally achieve the vision of your dreams. It is, however, important to understand that there is a very small number of insurance companies that grant insurance cover for LASIK eye surgeries. But we need to implore and understand why this is so. The reason is that a corrective eye surgery cannot be termed as ‘risk’. An insurance company will only cover for uncertainties or risks. The LASIK eye surgery, on the other hand, is not considered as a risk. Instead, it is considered as a modification or an enhancement. People use spectacles and contact lenses for the majority of their lifetime and are okay with it. However, one fine day they decide to opt for a LASIK eye operation. This is exactly that angle insurance companies use to view patient cases.
But in some cases, where the eyes are severely handicapped or in other words have really high power, for instance -7 to -8, it is possible that insurance companies may cover a part of the entire surgical process. In addition to that, every insurance company has a different policy regarding different situations and thus it always better to clarify such distinctions from the company itself.
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