If you’re considering SMILE (Small Incision Lenticule Extraction) for vision correction, one of your first questions will be about insurance coverage. There is no one-size-fits-all answer for whether or not SMILE will be covered by insurance. Even if it’s not covered, there are additional considerations like quality of life, the money you could save on glasses or contacts, and the possibility of financing or paying with an FSA/HSA. We’ll address all this and more later on. For now, let’s break down what you need to know about insurance and SMILE laser vision correction.

The Basic Truth About Insurance and SMILE

Most insurance plans don’t fully cover SMILE surgery because it’s classified as an elective procedure. However, there are some instances where SMILE may be covered in part or in whole. Insurance companies typically consider laser vision correction cosmetic rather than medically necessary. However, one of the best ways to determine whether or not you’re covered is by scheduling a free consultation at Laser Eye Institute. While you’re here, we can find out if part or all of your SMILE procedure will be covered by insurance. Even if it’s not, there are still several ways you might get financial help for SMILE.

Partial Coverage Options

Some insurance plans offer partial coverage or discounts for laser vision correction procedures like SMILE. These benefits usually come in a few forms. You might find discount programs through vision insurance or special pricing through vision networks. Some plans offer specific allowances, which are fixed dollar amounts toward laser vision correction. Others might provide reimbursement for a portion of the procedure cost.

To find out if your plan includes any SMILE benefits, check your vision insurance policy details or call your insurance provider directly. Ask specifically about “laser vision correction” or “refractive surgery” benefits.

FSA and HSA Accounts

Many people don’t realize they can use tax-advantaged accounts to pay for SMILE surgery. Flexible Spending Accounts (FSAs) let you set aside pre-tax dollars for medical expenses. Since SMILE qualifies as a medical procedure, you can use these funds to pay for it, potentially saving 20-30% depending on your tax bracket. Health Savings Accounts (HSAs) work similarly but have no “use it or lose it” deadline. If you have an HSA, you can use these tax-free funds for your SMILE surgery.

Employer Benefits to Look For

Apart from FSA and HSA benefits, some companies offer special vision benefits beyond standard insurance. You might find vision benefit allowances specifically for laser vision correction through your employer. Check with your HR department about any vision correction benefits that might not be obvious in your standard benefits documentation.

Comparing Costs: SMILE vs. Contacts and Glasses

When thinking about the cost of SMILE, consider the long-term math. The average person spends hundreds of dollars annually on contacts and solutions. Over 10 years, that adds up to be far in excess of what SMILE would cost. Add the cost of backup glasses and eye exams, and the total climbs even higher. SMILE is a one-time cost that eliminates these ongoing expenses. Many patients find that SMILE pays for itself within a few years, while others even save thousands of dollars over the effective life of the procedure.

Financing Options for SMILE

Over the long term, SMILE is usually cheaper than glasses or contacts. When this is combined with financing, the deal gets even sweeter.  In fact, Laser Eye Institute offers their SMILE patients 0% financing plans for up to 24 months. During certain months of the year, discounts may also be offered in conjunction with financing options, maximizing the savings and minimizing the costs.

Next Steps: Finding Out Your Specific Coverage

There are basically three ways that you can find out what your specific coverages are. First you can contact your insurance company by calling the phone number on your insurance card. Give them the CPT code of “66999” and ask if your current insurance will cover the procedure.

Second, you can contact your company’s HR department and ask them. They may or may not be able to find the right information for SMILE. However, they could tell you if there are any company-specific benefits related to the procedure.

The best option is scheduling a free consultation with Dr. Dan Haddad at Laser Eye Institute. While you’re here, Dr. Haddad will examine your eyes to see if you’re a candidate for SMILE (or another procedure), and our administrative team will confirm what sort of coverage you have and what different payment options may be available. This third option helps you leave the office with an idea of whether or not you’re a candidate, as well as an understanding of what the procedure will cost. If you’re ready to take the next step to learning if your insurance covers SMILE, get in touch with us today to schedule your free consultation!