Medicaid does not cover LASIK in most states, because it is classified as a cosmetic procedure rather than a medical necessity

LASIK is an elective surgery that reshapes your cornea to correct vision. Medicaid programs across the country treat it the same way they treat other elective surgeries — they do not pay for it. The surgery improves your vision but does not treat an underlying disease or injury, which is the standard Medicaid uses to decide what it will fund.

A small number of states have made exceptions in specific cases. For example, if LASIK is medically necessary to treat a condition like keratoconus (a progressive corneal disease), some state programs may cover it. But this is rare, and you would need documentation from an eye doctor that the surgery is not optional. Even then, approval is not may provide.

The cost of LASIK ranges widely depending on your location and the provider, but typically falls between $1,500 and $3,000 per eye. Because Medicaid will not pay, you would cover this cost yourself, through a payment plan with the surgery center, or through private insurance if you have it.

Key Takeaways

  • Medicaid classifies LASIK as elective and cosmetic, so standard coverage does not include it in any state.
  • A few states may cover LASIK only if an eye doctor documents that it treats a medical condition like keratoconus, not just refractive error.
  • You can contact your state Medicaid office to ask whether your specific situation qualifies for an exception, but approval is uncommon.
  • If Medicaid will not cover LASIK, you may be able to use a flexible spending account (FSA) or health savings account (HSA) if you have one through an employer.

What Medicaid will cover instead of LASIK

Medicaid covers vision correction that does not involve surgery. This includes eyeglasses and contact lenses, though the coverage and limits vary by state. Most state Medicaid programs cover one pair of glasses per year for adults, and more frequent replacements for children. Some states cover contacts instead of or in addition to glasses.

Medicaid also covers eye exams to determine your prescription, and treatment for eye diseases or injuries — such as cataract surgery, glaucoma treatment, or corneal repair after an accident. The distinction is that these treatments address a medical problem, whereas LASIK addresses a refractive error (nearsightedness, farsightedness, or astigmatism) that can be corrected with glasses or contacts.

If you are looking for a way to reduce your out-of-pocket cost for vision correction, ask your Medicaid caseworker what your state covers for glasses or contacts. You may also have options through your employer if you work — some employers offer vision insurance as a separate benefit, or you can contribute pre-tax dollars to an FSA to pay for vision care.

How to ask your state Medicaid program about exceptions

If your eye doctor has told you that LASIK is medically necessary for your condition, you can contact your state Medicaid office to ask whether they will consider covering it. You will need to provide medical documentation — a letter from your eye doctor explaining why LASIK is not optional for you, what condition it treats, and why glasses or contacts cannot address the problem.

Your state Medicaid office is usually run by the state health department or a separate agency. You can find the contact information on your Medicaid card, or by calling 211 and asking for your state Medicaid program. When you call, ask to speak with someone who handles coverage decisions or prior authorization requests.

Be prepared for a long process. Even with medical documentation, most requests for LASIK coverage are denied. If your state does consider it, you may need to submit the request in writing and wait several weeks for a decision. Some states require you to try glasses or contacts first and document that they do not work for your condition before they will even review a LASIK request.

Private insurance and payment plans as alternatives

If you have private health insurance through an employer or a spouse's employer, check your plan documents or call the insurance company to ask whether LASIK is covered. Some plans do cover it, especially if it is deemed medically necessary. The coverage and out-of-pocket cost depend entirely on your specific plan.

Many LASIK surgery centers offer payment plans that let you spread the cost over 12 to 24 months with little or no interest. Some also offer discounts if you pay in full upfront. If you have an FSA or HSA through your employer, you can use those pre-tax dollars to pay for LASIK, which reduces your taxable income and lowers your overall cost.

Before committing to LASIK, get quotes from at least two providers in your area. Prices vary significantly, and the cheapest option is not always the best — look at the surgeon's experience, the technology used, and what is included in the price (such as follow-up visits and enhancements if your vision does not correct fully).

When LASIK might be considered medically necessary

Medicaid may cover LASIK if you have a condition where glasses or contacts cannot correct your vision adequately, or where wearing them causes a medical problem. Keratoconus is the most common example — the cornea gradually thins and becomes cone-shaped, making vision correction difficult and progressive. In this case, LASIK (or a related procedure called corneal cross-linking) may be the only effective treatment.

Other rare conditions where LASIK might be medically necessary include severe astigmatism that cannot be corrected with standard glasses, or a condition where the eye's surface is too irregular for contact lenses. However, even in these cases, Medicaid does not automatically cover it. You need a letter from your eye doctor stating that the condition meets your state's definition of medical necessity, and you may need to appeal if the initial request is denied.

The key difference is that Medicaid looks at whether the procedure treats a disease or injury, not whether it improves your quality of life. Wanting to see without glasses is not a medical reason in Medicaid's view, even if it would make your daily life easier.

Frequently Asked Questions

Can I use my Medicaid to pay for LASIK if I pay out of pocket first and ask for reimbursement?

No. Medicaid does not reimburse for LASIK after the fact. If your state does not cover it upfront, paying yourself and then requesting reimbursement will not work. The only exception would be if you received prior authorization in writing from your state Medicaid program before the surgery, which is extremely rare.

Does Medicare cover LASIK?

No. Medicare, which covers people 65 and older, also does not pay for LASIK. It covers eye exams and treatment for eye diseases, but not elective vision correction surgery. If you are on Medicare and interested in LASIK, you would need to pay for it yourself or through private insurance.

What if I live in a state that does not cover LASIK — can I travel to another state to have it done and then ask my state Medicaid to pay?

No. Your state Medicaid program only covers services provided within your state, with rare exceptions for specialized care that is not available locally. Traveling out of state for LASIK would not change the coverage decision. You would still need to pay for it yourself.

Are there any Medicaid programs that do cover LASIK?

A very small number of state Medicaid programs have covered LASIK in specific medical cases, but this is not standard practice anywhere. Your best approach is to contact your state Medicaid office directly and ask whether they have ever covered LASIK and under what circumstances. Be specific about your condition and have your eye doctor's documentation ready.