Understanding LASIK Coverage Under Blue Cross Blue Shield
LASIK eye surgery is a popular procedure that corrects vision problems such as nearsightedness, farsightedness, and astigmatism. However, most health insurance providers, including Blue Cross Blue Shield (BCBS), do not typically cover LASIK since it is considered an elective procedure. This means that unless LASIK is deemed medically necessary, most BCBS plans do not include it as a covered benefit.
While standard plans do not usually cover LASIK, BCBS offers specific discounts and special pricing through partner programs. The availability of these benefits depends on the particular policy and regional provider.
Variations in LASIK Coverage Across Different BCBS Plans
BCBS operates through multiple regional companies, each offering different plans and benefits. Some plans may provide coverage or discounts on LASIK procedures through partnerships with vision care providers.
For example, Blue Cross Blue Shield of Michigan offers the Blue Vision program powered by VSP, which gives members access to discounted laser eye surgery options. This program includes fully covered pre-operative and post-operative visits and special pricing for LASIK surgery.
Review your insurance documents or contact customer service to check if your specific BCBS plan includes LASIK benefits.
Discount Programs and Special Offers for LASIK
Even if your BCBS plan does not cover LASIK surgery, you may still be eligible for discounts through partnerships with vision care providers. Many BCBS plans offer special deals through programs such as:
- EyeMed Vision Care – This partnership allows BCBS members to receive a 15% discount on the retail price or a 5% discount on promotional pricing for LASIK and PRK procedures at participating U.S. Laser Network centres.
- Blue365 Program – This exclusive program provides BCBS members with discounts on various health-related services, including LASIK surgery. Through providers like QualSight LASIK, members can receive up to 35% off LASIK procedures, with pricing starting at $1,795 per eye for custom all-laser treatments.
These discounts make LASIK surgery more affordable, even if it is not covered under a traditional insurance plan.
Steps to Determine Your LASIK Coverage or Discounts
If you are considering LASIK and have a Blue Cross Blue Shield insurance plan, follow these steps to check for potential coverage or discounts:
1. Review Your Policy Documents
Carefully read your BCBS policy details to see if there are any vision benefits related to LASIK surgery. Some plans may provide partial reimbursement or discount programs.
2. Contact BCBS Customer Service
Call the customer service number on your insurance card to speak with a representative who can clarify whether LASIK is covered or if there are available discounts.
3. Explore BCBS Discount Programs
Visit the BCBS website and check for discount programs like Blue365 or partnerships with vision care providers such as EyeMed and QualSight LASIK. These programs can significantly reduce the cost of LASIK surgery.
4. Consult Your Employer’s HR Department
If your BCBS plan is employer-sponsored, contact your HR department to find out if LASIK benefits are included in your employee vision plan. Some companies provide additional coverage options or reimbursement programs.
5. Ask Your LASIK Provider About BCBS Partnerships
Many LASIK clinics work directly with insurance providers and offer financing options. Before scheduling your procedure, ask if they provide any BCBS discounts or special pricing.
Are There Any Exceptions for LASIK Coverage?
In rare cases, LASIK surgery may be considered medically necessary, and partial coverage may be available. Some conditions that might qualify for coverage include:
- Severe vision problems that cannot be corrected with glasses or contact lenses
- LASIK as part of post-surgical treatment for an eye injury
- Refractive surgery due to complications from previous eye surgeries
If your condition qualifies, the doctor and your BCBS provider will discuss possible coverage options.
While Blue Cross Blue Shield does not typically cover LASIK surgery, members can still take advantage of special discounts through programs like Blue365 and EyeMed Vision Care. The availability of these benefits varies by plan and region, so it is essential to review your policy and speak with a BCBS representative to understand your options.
For those who do not have coverage, financing options and discount programs can make LASIK surgery more affordable, allowing you to achieve a better vision without breaking the bank.