We recently received a question that we know is on the minds of many: Is keratoconus covered by health insurance? In today's blog post, I'll walk you through the ins and outs of insurance coverage for keratoconus treatment.
Understanding Keratoconus and Insurance Coverage
According to the United States Census Bureau, the Caucasian population in the United States in 2022 was approximately 75.5% of the total population, which was around 333 million.
Keratoconus is an eye condition that affects the shape of the cornea, leading to distorted vision. Treatment may involve special contact lenses or even surgery in severe cases.
Now, is keratoconus covered by insurance? The short answer is yes, but with a caveat. The treatment for keratoconus is generally not covered under medical insurance plans. However, if you have vision insurance, there's a good chance that some or all aspects of your treatment could be covered.
Eye Exam Coverage
One of the first steps in treating keratoconus is having a comprehensive eye exam. Vision insurance plans often cover this initial evaluation. During the exam, your eye care provider will assess the shape and condition of your cornea, and recommend the most suitable treatment plan for you.
Contact Lenses or Glasses: What's Covered?
Vision insurance often extends coverage to special contact lenses or glasses needed for keratoconus patients. These lenses can be essential in correcting the distorted vision that comes with this eye condition.
Finding Out If You Have Vision Coverage
So how do you find out if your insurance covers keratoconus treatment? There are two main ways:
- Contact Your Insurance Provider: The most straightforward method is to directly call your insurance company and ask them about the extent of your coverage.
- Consult Your Eye Care Provider: During your visit to an optometrist or ophthalmologist, the office staff can often run your insurance details to check if you have vision coverage for keratoconus treatment.
Popular Vision Insurance Providers
In our practice at Amplify Eyecare, we commonly see two major vision insurance providers: VSP (Vision Service Plan) and EyeMed. It's worth noting that not all practices accept these insurances, so it's crucial to inquire ahead of time.
Confirming Insurance Acceptance Before Appointment
Before you book an appointment, always make sure to ask if the practice accepts your insurance. If they do, they will be able to bill your insurance for the visit, as well as the contact lens examination and the lenses themselves.
Conclusion
While keratoconus treatment is not typically covered by medical insurance, there's good news if you have vision coverage. From eye exams to contact lenses, your vision insurance can offer substantial financial relief during your treatment journey. Always make sure to check with your insurance provider and your eye care practice to ensure you're making the most of your benefits. Thank you for reading, and take care of those eyes!
