Why is laser eye surgery often not covered by insurance?

Refractive (vision) surgery as it is called is considered “elective” rather than “medically necessary” by commercial and government medical insurance programs. This is because historically nearsightedness, farsightedness and astigmatism were not considered medical conditions. These were the business of Optometry and considered a trivial enough issue financially they could best be handled through self-pay.

Many conditions are now treatable with surgery in a way undreamed of even a few decades ago. But with this increase in treatment options has come surging demand that cannot be paid for in a sustainable way. Whether through medical insurance or a socialized medical payment system, the costs cannot be off-loaded to the public without eventually rationing care.

Although in the earliest days of RK and LASIK there was some limited coverage, it was decided quite quickly that demand would quickly outstrip available medical financial resources. So LASIK, ICLS, PreLex, SMILE, and PRK remain personal responsibility.