Keratoconus is a progressive eye disease that affects the shape of the cornea, leading to distorted vision and increased sensitivity to light. While there is no cure for the condition, there are various treatment options available to help manage its symptoms. In this blog, we'll break down the costs associated with each treatment option so you can have a better understanding of what to expect.

Does my vision plan or health insurance cover the cost of keratoconus treatment?

Contact lenses are typically considered medically necessary if they are the only way to improve your vision. Keratoconus treatment services often (but not always) qualify as medically necessary contact lenses. Vision plans may also refer to this as visually necessary contact lenses. However, traditional contact lenses are usually considered an elective benefit. The requirements for medically necessary coverage may vary between vision plans. Because each insurance plan coverage is different it is not possible to give specific answers without being evaluated by our optometrist and assessing the specific details of your insurance plans coverage.

Insurance for Scleral Lenses

Most medical insurance plans cover scleral lens fittings (but not lenses) for Keratoconus and vision insurance may also cover it. To ensure the best coverage, please let us know if you have a vision insurance plan and contact our office to check your plan coverage and any potential out-of-pocket costs.

Medicare and Scleral lenses for keratoconus

Medicare does not cover the cost of the lenses but the fitting of lenses is covered by CPT code 92072. Speak with our office for more information about coverage.

Is Corneal Crosslinking for keratoconus covered by health insurance?

Despite FDA approval and a CPT code for corneal crosslinking, there is no guarantee that your medical insurance plan will cover the cost of this procedure. Since FDA approval of corneal collagen crosslinking (CXL) for keratoconus in April 2016, more (but not all) insurance companies have begun covering this procedure for progressive keratoconus and keratectasia.

What are the different treatment options for keratoconus and how much do they cost?

• Scleral lenses - One popular treatment option for keratoconus is the use of scleral lenses. These lenses are designed to fit over the entire cornea and provide a smooth surface for light to pass through, improving vision. The cost of fitting scleral lenses can vary depending on your location, but on average, you can expect to pay anywhere from $1800 to $5000. The cost of each lens can also vary, with prices ranging from $800 to $1500. Learn more about medically necessary contact lenses.
• Gas permeable lenses - Another option for keratoconus patients is the use of gas permeable lenses. These lenses are less expensive than scleral lenses but may not be as effective for all patients. On average, the cost of gas permeable lenses is a little less than scleral lenses. However, it's important to discuss with our eye doctor whether these lenses are a good option for you.
• Corneal crosslinking - Corneal crosslinking is a procedure that strengthens the collagen fibers in the cornea to slow down or stop the progression of keratoconus. Not all patients are candidates for this procedure, so it's important to discuss with your ophthalmologist whether this is an option for you. The cost of the procedure can range from $3000 to $6000 per eye, depending on the eye surgeon and location. It's important to discuss with your ophthalmologist whether this procedure is covered by your insurance.
• Corneal transplant - In some cases, a corneal transplant may be necessary to improve vision in patients with severe keratoconus. This is usually considered a last resort option, and the cost can range from $13,000 to $30,000. It's important to discuss with your ophthalmologist and surgical coordinator whether this procedure is covered by your insurance.

Learn about the costs of keratoconus treatment and make an informed decision

The cost of keratoconus treatment can vary depending on the type of treatment and your location. Furthermore your exact diagnosis and treatment plan will need to be compared with your vision plan, commercial medical insurance, or government insurance to determine what coverage you have.  It's important to discuss with our optometrist the different treatment options available and the associated costs so you can make an informed decision.

Patients who need medically necessary contact lenses and care for keratoconus visit our clinic from all over California, and we are proud to be a leading provider of medically necessary contact lenses for patients from Santa Clarita, Palmdale, Lancaster, and San Fernando Valley.