Table of Contents
Orthokeratology, or Ortho-K, is an eye care option that uses customized contact lenses to reshape the cornea’s curvature. This reshaping corrects nearsightedness, astigmatism, and other refractive errors by temporarily updating vision in a non-invasive way. Ortho-K contact lenses are worn at night and removed during waking hours, allowing for clear eyesight without glasses or daytime contact lenses.
Orthokeratology (Ortho-K) is a specialized contact lens treatment that uses rigid gas-permeable contact lenses to temporarily reshape the cornea, which can help correct refractive errors such as myopia (nearsightedness). While Ortho-K is a popular and effective option for many people, not all insurance plans cover it.
Coverage for Ortho-K can vary widely depending on the insurance plan and the specific provider.
Is Ortho-k Covered By Insurance?
No, Ortho-K or Orthokeratology is not usually covered by typical insurance as an elective vision procedure. Ortho-K costs from $500 up to $4000. However, you can use the following health savings plan to reduce drastically Ortho-K costs:
- Flexible spending account, or FSA health savings plan
- Medical spending account, or HSA health savings plan
- Section 125 health savings plan
- Flex 125 health savings plan
- Tax health savings plan
- Cafeteria health savings plan
Please see this example of how to cover the insurance part of your Ortho-K procedure:
A Health Savings Account (HSA) is a savings account that allows individuals to save pre-tax dollars to pay for qualified medical expenses, such as doctor visits, prescription medications, and medical procedures. In addition, one of the benefits of having an HSA is the ability to use the funds to partially pay for elective medical courses not covered by insurance, such as Ortho-K.
Ortho-k is a non-surgical procedure that uses specialized contact lenses to reshape the cornea while the patient sleeps, resulting in improved vision. The method can be expensive, and insurance companies typically do not cover it. However, individuals with an HSA can use the funds to pay for the procedure, making it more affordable partially.
According to the guide, an individual with an annual deductible of $1,500 (in 2023) and a medical claim of $3,500 would pay the first $1,500 to cover the yearly deductible. Once the deductible is met, the insured pays 10% to 20% of the remaining $2,000, while the insurance company covers the rest.
For example, if the Ortho-K procedure costs $3,500, the individual would use their HSA funds to pay for the first $1,500 to meet the deductible. Once the deductible is completed, the individual would pay 10% to 20% of the remaining $2,000, between $200 and $400. The insurance company would cover the rest of the cost of the procedure.
Using an HSA to pay for the Ortho-K procedure can make it more affordable for individuals who may not have been able to pay for it out of pocket. In addition, by regularly contributing to their HSA, individuals can prepare for future medical expenses and ensure they have the funds necessary to cover the cost of elective medical procedures like Ortho-k.
It’s important to note that coverage for Ortho-K may be limited, and some plans may only cover it for certain age groups or specific conditions. Therefore, it’s always best to check with your insurance provider or eye care professional to confirm coverage and any out-of-pocket costs.
Ortho-K Procedure and Costs
Obtaining Ortho-K lenses requires several appointments with an optometrist to ensure proper fitting. During these visits, the optometrist takes detailed measurements of the patient’s eyes so that a set of custom-made Rigid Gas Permeable (RGP) lenses can be ordered for the individual’s needs. The patient then wears these lenses at night while sleeping, acting as a corrective tool to reshape the surface of their eyes. These visits also check for potential health issues resulting from such lenses and ensure any underlying conditions are considered when choosing an appropriate lens type.
When considering the cost associated with Ortho-K treatment, it is essential to consider all aspects of therapy, including evaluation fees, follow-up visits, and any necessary maintenance fees throughout the treatment period. Depending on a patient’s needs and doctors’ recommendations, prices for this type of treatment can range anywhere from $1000 up to USD 4000, depending on the location and frequency required for treatments or follow-up visits. In most cases, however, it should be noted that orthokeratology is considered an affordable option compared to other forms of vision correction, such as laser eye surgeries, which can cost thousands depending on the circumstance and procedure needed to achieve desired results.
Overall, orthokeratology offers a safe long-term solution without the need for surgical intervention to improve one’s vision while providing accessibility and affordability options when looking into eye care solutions not only now but well into future years.
Health Savings Plans and Ortho-K
In addition to traditional health insurance plans, another option for those seeking financial assistance with their ortho-k treatment is a flexible spending account (FSA) or health savings account (HSA). These accounts allow individuals to set aside pre-tax dollars to pay for medical expenses such as ortho-K treatment. While these accounts may help offset the cost of ortho-k therapy, they do have specific qualifications that must be met to qualify for them. Therefore, you should always talk with your employer or financial advisor if you’re considering using either option to pay for your ortho-k treatment.
For some individuals who need vision correction but don’t have insurance or an FSA/HSA available, other financing options can help cover the cost of ortho-k treatment. For example, many eye care clinics offer payment plans, allowing patients to spread their payments over time rather than paying the entire amount upfront. Additionally, many eye care clinics accept major credit cards as forms of payment so that patients can use their existing rewards points or cash-back bonuses from their cardholder programs to cover some of the costs associated with orthokeratology treatment.
When it comes down to it, understanding if you’re eligible for insurance coverage on Orthokeratology treatments can be a tricky process. It will ultimately depend on your policy’s coverage requirements and any existing tax benefit programs you may be eligible for. That being said, exploring your payment options could make all the difference in affording the quality vision correction solutions you need with Orthokeratology treatments—and ultimately help you achieve better sight without glasses or contacts!
From 2022.,Jason writes educational insurance articles for Promtinsurance.com.
Please read :
Jason Martin biography
Write email: jason@promtinsurance.com