Private Health Insurance For Laser Eye Surgery

Laser eye surgery is becoming an increasingly popular elective procedure for many Australians. It’s a potential solution for those who want to reduce – or entirely eliminate – dependence on glasses and contact lenses.

But before you decide to go ahead with the surgery, it's important you understand what the surgery involves, any potential side-effects, as well as how much it might cost – with and without private health cover. So let’s guide you through the ins and outs of laser eye surgery and what's covered by private health insurance.

Is laser eye surgery covered by health insurance?

The first question you're probably asking is, "Does health insurance cover laser eye surgery?" The answer is both yes and no. Medicare considers it to be elective, and won't cover any benefits. That means those without private health insurance will have to pay out of their own pocket. The exception to this rule is when the surgery relates to correcting an eye disease.

The bulk of health fund policies don't cover it either, but there are a few that do. Many of these policies provide rebates like LASIK as an incentive of sorts; providing a reason why you should choose them over the competition.

What are the types of laser eye surgery?

Laser eye surgeries have evolved and become more precise over the years – which is a very good thing for patients. Each procedure is slightly different from the others, and its suitability depends on your preferences. Here are the three most common types of laser eye surgery in Australia:

Laser Eye Surgery Costs

Because laser eye surgery is an expensive elective procedure, you’ll want to get a better understanding of the costs involved – especially if you want to take out private health insurance and see out your waiting period. Below is a table highlighting the average costs for different surgeries in 2021–22. Note that the price is for each eye, not both:

Source: Eye Laser Specialists

These figures, while indicative, can vary. Your surgeon's experience, the technology used, where the clinic is located as well as post-operative care can all influence the final bill. It’s recommended that you see a few different surgeons and get multiple quotes to fully understand the potential costs involved.

Which health funds cover laser eye surgery?

Choosing the right health fund can significantly reduce your out-of-pocket expenses. However, there are only a handful of private health cover options available in Australia, and these are usually the top level of combined cover. The health funds that do offer cover for these procedures usually do so as an incentive for you to choose their top plans. Even then, they may only cover a specific type of laser eye surgery cost. For example, if they cover LASIK eye surgery costs and you need SMILE, you’ll want to choose a different fund. All funds that cover such procedures have waiting periods. These are at least one year and can be as long as three years. Here’s a breakdown of some health funds that provide a benefit for laser eye surgery at the time of writing.

Correct at the time of writing (14/08/23)

What do I look for in a policy?

There aren't an unlimited number of coverage options available to those interested in laser eye surgery.

You probably won't be able to be too picky here, but there are a few things you can look for to pick the right one.

Other coverage options

The first thing to look for in a policy is what other benefits are offered. Pick the policy that is most useful to you and your family.

Since all health funds that cover eye surgery only provide it with their comprehensive policy, get the most out of your dollar by looking for one that offers benefits you will use.

Amount covered

If eye surgery is your primary concern, you probably want a health fund that covers all or most of the procedure. We'll get into the pricing below, so you can better compare the general price vs. how much your health fund will cover.

As we've said, most health insurance policies don't cover the entirety of the procedure. You'll need to work within this budget to get the best value out of your health benefits. Regardless of the benefits provided, you're going to have to wait at least a year before you can make a claim.

This means you'll either have to plan well in advance, or consider paying for the surgery entirely out of pocket.

How much will surgery cost?

Depending on where you receive your surgery, the cost generally costs between $1,500 and $4,000 per eye, though it can cost more or less depending on your surgeon and situation.

Having surgery on both eyes? You'll be looking at $3,000 to $8,000 or higher.

Most outlets charge per eye, and some health funds pay benefits on this basis as well.

The cost isn't relegated to the surgery alone, though. There may be consultation fees before you're able to receive the surgery, although this is sometimes included in the total cost.

As you can see, health funds that offer $1,000 to $3,000 for a lifetime limit won't cover the full cost of surgery.

However, many clinics will give payment option plans if the initial cost is too high.

You might be able to find someone who will give you a better rate, but this isn't an area where you want to cut costs.

Do your research on the surgeon, clinic, and type of surgery before you commit.

What are the potential side-effects of laser eye surgery?

Laser eye surgery can significantly improve your vision if you’re a suitable candidate. However, it’s important to be aware of all the potential side-effects and risks – no matter how rare – associated with these procedures.

• Dry eyes: One of the most common side-effects is dry-eye syndrome. It’s more uncomfortable than serious, but it can cause discomfort, itching and a gritty sensation. It usually improves within a few days or weeks, but might persist in some cases.

• Glare, halos and starbursts: Patients can experience glare, halos or double vision, particularly at night, over the days and weeks after the procedure. Again, it’s usually temporary but can become a long-term issue.

• Regression: In some cases, the eye may revert to its pre-surgery prescription, which means you will need follow-up treatments. Ask your surgeon if you are covered for retreatment surgery in case of regression.

• Under-correction or over-correction: There’s a risk that the surgery might not achieve the desired level of correction, leading to either under-correction (requiring glasses or contacts) or overcorrection (which can be more difficult to fix).

• Infection or inflammation: Although quite rare, infections and inflammation can occur post-surgery which, if not treated promptly, might lead to vision problems.

• Corneal-flap complications: LASIK involves creating a corneal ‘flap’. Complications can arise during the healing process, such as wrinkles or dislocation, which can affect your vision.

• Epithelial in-growth: In some cases, cells from the surface of the eye can grow under the flap, causing visual disturbances.

• General pain and discomfort: Temporary pain, discomfort or redness in the eyes should all be expected in the days following the surgery.

The good news is that the majority of laser eye surgery patients achieve improved vision with minimal side-effects. But potential complications do exist, and the likelihood of experiencing them will depend on your eyes and the type of surgery you choose. As a patient, you should always undergo a thorough consultation and eye evaluation to determine whether or not you’re a suitable candidate for your preferred procedure.

Which issues can laser eye surgery fix?

Laser eye surgery is used to take care of common vision problems, such as near-sightedness (myopia), far-sightedness (hyperopia) and astigmatism. Here's how it can correct these issues:

1. Near-sightedness: Those who are near-sighted have difficulty seeing distant objects clearly because the light entering the eye focuses in front of the retina rather than directly on it. SMILE, LASIK and PRK for myopia involve reshaping the cornea to reduce its curvature. This redirects the light to focus directly on the retina, thereby improving long vision.

2. Far-sightedness: Far-sighted people can see distant objects more clearly than those that are close up because light focuses behind the retina. Laser eye surgery for hyperopia increases the cornea’s curvature and allows light to converge directly onto the retina.

3. Astigmatism: Astigmatism is when the cornea is irregularly shaped, leading to distorted or blurred vision at all distances. Laser eye surgery can smooth and reshape the cornea, correcting these irregularities and helping the eye to focus light evenly onto the retina.

Laser eye surgery may help you overcome these common refractive errors. Whether or not it’s suitable for you will depend on your eye health, corneal thickness and the stability of your prescription – all of which must be checked during a comprehensive evaluation and consultation with an ophthalmologist. In most cases, laser eye surgery is a long-lasting solution that can reduce or even eliminate your need for glasses and contact lenses.

Is it better to get laser eye surgery when you are young or old?

There is no ‘ideal age’ for laser eye surgery. Instead, your ophthalmologist or surgeon will check your suitability for the procedure with an intensive examination of your eye structure and health. The decision should be made on a case-by-case basis in consultation with an eye professional.

Here are some of the advantages and potential drawbacks for different age groups:

• Younger (20s to 40s):

  • Pros: Many people in their 20s and 30s have stable vision, making them suitable candidates. You can enjoy the benefits of clear vision without the need for glasses or contacts for an extended period.

  • Cons: The long-term stability of your prescription must be checked, as significant eye changes can happen during your 20s.

• Older (50s and beyond):

  • Pros: For those in their 50s and older, laser eye surgery can still be a good option for reducing your dependence on glasses or contacts for distance-vision correction.

  • Cons: Presbyopia is more likely to affect people in their 40s and beyond, and laser surgery doesn’t fully address this issue. Reading glasses might still be necessary for near vision.

Younger people tend to enjoy longer-lasting benefits, but older adults can still enjoy a greatly improved quality of life with improved vision from laser surgery, even if they still need reading glasses in later life.

Frequently Asked Questions

Does Medicare cover laser eye surgery?

No, as it’s an elective procedure Medicare doesn’t cover laser eye surgery. Private health insurance can cover some of the cost.

Is LASIK covered by BUPA?

BUPA does offer cover for LASIK under some of its highest-tier policies. Learn more about BUPA and its policies.

Is laser eye surgery covered by HCF?

HCF does not currently include laser eye surgery as one of its extras.

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Chris Stanley is the sales & operations manager of health insurance at Compare Club. With extensive experience and expertise, Chris is a trusted leader known for his deep understanding of health insurance markets, policies, and coverage options. As the sales & operations manager of health insurance, Chris leads a team of dedicated professionals committed to helping individuals and families make informed decisions about their health insurance needs.

Meet our health insurance expert, Chris Stanley

Chris's top health insurance tips

• 1

  Australia’s public health system is world-class, but wait times for public hospitals can be long, inconvenient - and leave you living in constant pain while you wait.

• 2

  An appropriate private health insurance policy can speed up your surgery, relieving your pain sooner.

• 3

  Family health cover means your children are covered under the same policy as you.

• 4

  Many health insurance policies come with a 12-month waiting period for pregnancy-related cover, so it’s a good idea to get a family policy organized well before starting your family. This means your child will be covered from birth until at least their early twenties (depending on which health fund you select).