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Laser Eye Surgery Health Insurance

Name: Laser Eye Surgery Health Insurance
Creator: Savvy
Published: 2023-03-28T16:22:39+10:30

Compare private health insurance policies which offer cover for laser eye surgery through Savvy.

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Written by , updated on July 6th, 2023

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The decision to have laser eye surgery is a life-changing one which deserves careful consideration. It can drastically improve your vision and mean you no longer have to wear glasses or contact lenses. That’s why it’s important to compare quotes and make sure you have maximum cover from your private health insurance to help with the cost.

You can compare a range of health insurance policies through Savvy to help you see which insurers offer cover for laser eye surgery. You'll be able to consider offers from a panel of leading health insurers in one place, so start the process of comparing free online quotes through us today.

What does health insurance for laser eye surgery cover?

You'll have to rely on your private health insurance to help with the cost of your laser eye surgery or fund it yourself. This is because Medicare doesn’t cover any of its costs, as it isn’t considered a medically necessary procedure and is therefore classified as elective surgery.

How much of the cost of your laser eye surgery may be covered by your private health insurance will depend on the particular insurance you have and the policy limits which apply. Because such surgery is usually performed in a day clinic and you aren’t admitted to hospital, cover for laser eye surgery is usually only offered with top-level extras policies. It’s also only offered by very few providers, meaning your options are more limited.

Health funds usually have benefit limits for this type of treatment, which may be per year or lifetime. For example, ahm has a lifetime limit of $1,800 per person with its super extras policy ($900 per eye). Medibank offers cover through its Ultra Health Cover extras policy, with a lifetime limit of $3,500. An exception to the benefit limit rule is BUPA, which offers 100% cover for the cost of laser eye surgery, as long as the surgery is performed by a fund-recognised provider (and eligibility terms and conditions apply*).

*All information and benefit limits correct as of March 2023, but subject to change.

What are the waiting periods before I can get my laser eye surgery done?

All health funds have waiting periods which apply before you can claim any costs for laser eye surgery. This means you’ll need to be a member of a health fund for a specified period before you’re eligible to claim for the cost of your eye surgery. These waiting times vary from fund to fund, as they aren’t mandated by the Australian Government, but are generally between one and three years.

For this reason, it’s important to compare quotes carefully when considering health insurance to cover your laser eye surgery. You can do this right here through Savvy. You’ll be able to consider offers from a panel of insurers, including some which offer cover for laser eye surgery. You can consider quotes for such policies today through Savvy.

How should I compare health insurance cover for laser eye surgery?

When comparing health insurance policies, there are several aspects to consider. Your priorities may depend on whether you’re looking at a comprehensive extras policy for all aspects of your health or specifically to cover your laser eye surgery. Some areas to compare include:

Health insurance cost – most people will want to find the cheapest policy but it’s important to compare carefully to make sure you’re not sacrificing coverage for cost.
Waiting periods – as these range from one year to three years for laser eye surgery, consider whether you’re prepared to wait a while longer to have a policy which may offer broader coverage or better value overall.
Benefit limits – look at what the policy offers in total benefit limits for laser eye surgery, as this will give you an indication of how much you may be out-of-pocket if you do decide to have your surgery.
Coverage – this includes details of exactly what aspects of your laser eye surgery the policy covers. Read the information provided with each policy carefully and look at whether there’s coverage for enhancement procedures, follow-up appointments and other costs such as protective goggles and eye drops which you may need after the surgery.
Pre-existing conditions – check what the extras policy says about eligibility for treatment of pre-existing conditions, as some eye conditions such as short-sightedness, long-sightedness and astigmatism are considered pre-existing conditions.
Reset date – health funds usually offer per-year benefits, which reset on a certain date. For some funds, this date is January 1, while others may set it on July 1. Check the reset date of your health fund, as it may be possible to claim the cost of your surgery over two years, depending on the timing and how close to the reset date you’re intending to have the surgery.
Is it worth it? – when considering if a comprehensive extras policy is worth it, look at offers as a whole. Think about how much you’ll pay in premiums per month and the laser eye surgery waiting period which is involved, as well as the other benefits you’ll gain from the extras policy, before deciding whether it’s worth it.

When considering health insurance for laser eye surgery, it’s a great idea to check with the eye clinic you’re considering using to find out if they work exclusively with any one health fund, and if they have any special offers or deals with a particular health fund which may save you money.

Types of health insurance

Hospital cover

This can help you pay for medical treatment if you need to be admitted to hospital. It can help cover the cost of your admission or accommodation and the fees charged by doctors, surgeons and anaesthetists. It can also cover other costs associated with a stay in a private hospital.

Extras cover

This helps cover the costs of health care treatments outside a hospital setting which aren’t covered by Medicare. This can include major and minor dental treatment, orthodontics, hearing aids, physiotherapy, glasses, contact lenses and podiatry (in most cases with annual limits).

Cover for singles

This is a standard health insurance policy designed for a single person, rather than being tailored to cater to the needs of a couple or family. It may include hospital cover plus extras, or either of these types of insurance on their own, depending on what you're after for your health cover.

Cover for families

A family health insurance policy is designed for a family unit including dependent children who may reach up to 31 years of age with some insurers. It offers private health insurance suitable for the whole family and may include shared limits for all members included in your policy.

Cover for seniors

A health insurance policy aimed at seniors is designed to appeal to people who are in the second half of their life. These are often specific Silver Plus policies that offer the same cover as other health insurance policies, with the exception that pregnancy and childbirth cover may not be included.

OVHC

Visitors who are in Australia on a temporary basis for travel, work or study may be able to take out Overseas Visitors Health Cover (OVHC). Many visas issued in Australia come with a requirement to take out this type of insurance, which covers visitors who may not be covered by Medicare.

Ambulance cover

Ambulance cover is generally available either packaged into your private health insurance or on its own as a separate policy or subscription. By having this protection, you could be covered for all eligible ambulance travel in Australia (subject to your insurer's terms and conditions).

Basic hospital cover

The cheapest and most barebones form of private hospital insurance, this can include cover for rehab, in-hospital psychiatric services and palliative care. Having this policy will enable you to avoid paying the Medicare Levy Surcharge (MLS) and Lifetime Health Cover (LHC) loading.

Bronze hospital cover

Bronze hospital cover is a step up from basic insurance, including 18 further clinical categories such as ear, nose and throat, bone, joint and muscle, digestive system, joint reconstructions, gynaecology and chemotherapy, radiotherapy and immunotherapy for cancer.

Silver hospital cover

Silver hospital cover is the second-most expensive type of policy and offers the second-most clinical categories. On top of what's offered by basic and bronze cover, it also includes heart and vascular system, lung and chest, blood, hearing device implantation and dental surgery.

Gold hospital cover

The highest level of private hospital insurance available in Australia, gold policies can offer cover for pregnancy and birth, weight loss surgery, assisted reproductive services and insulin pumps on top of all the categories provided by silver, bronze and basic hospital insurance.

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Frequently asked questions about health insurance for laser eye surgery

If I switch to a higher tier of health cover, will I have to serve additional waiting periods for other health treatments?

Yes – you may have to serve additional waiting periods if you increase your level of health cover. Generally, you’ll only have to serve waiting periods for areas of cover that you haven’t previously held. If you’re swapping funds but staying with the same level of cover, you may not have to re-serve any waiting periods. However, it’s important to check with your insurer if you’re unsure about the waiting periods which may apply to you.

Does Medicare cover laser eye surgery if eye disease is present?

If you’re diagnosed with an eye disease which requires laser surgery to treat, Medicare may cover some or all of the cost if you’re treated as a public patient in a public hospital. This only applies if your ophthalmologist considers the treatment to be medically necessary for an eye disease, which can be the case with conditions such as glaucoma, cataracts and retinal tears.

How much does laser eye surgery cost?

The cost of laser eye surgery will vary depending on the type of surgery you have. For LASIK surgery, which is the most common procedure performed in Australia, you can typically expect it to cost between $1,800 and $3,700 per eye*. If your private health insurance covers laser eye surgery, the amount you will be out of pocket will depend on the policy limits enforced by your health insurer.

*Costs correct as of March 2023, but subject to change.

If I need a follow-up appointment with an optician after my laser eye surgery, will the cost be covered by my health insurance?

This will also depend on the extras policy you buy and whether follow-up appointments with an optician are covered under the terms and conditions of your policy. It may also depend on whether your fund classifies the follow-up appointments as an extension of your laser eye surgery or general optical care. As such, it’s important to check with your insurer before booking your surgery.

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