Treatment for keratoconus might cost thousands of dollars or more. A corneal transplant can cost anywhere from $13,000 to over $28,000, depending on the type of surgery and whether it’s done as an outpatient operation or requires a hospital stay.
In addition, the price of keratoconus eye checkups and contact lenses are recurring expenses year after year.
Fortunately, most keratoconus-related expenses are frequently covered by health or medical insurance. Medical insurance, in particular, usually covers the majority of the expense of corneal cross-linking or significant keratoconus surgery (less deductibles and copays determined by your policy).
Eye exams (or portions thereof) specifically for the diagnosis and monitoring of keratoconus are frequently addressed as well. Depending on your insurance policy, the cost of keratoconus contact lenses may or may not be entirely covered.
If you don’t have health or medical insurance and aren’t eligible for Medicare or Medicaid, financing firms that specialize in medical expenses offer programs that allow you to pay for keratoconus treatment charges over time at low interest rates.
If you’ve been diagnosed with keratoconus, talk to your eye doctor and insurance company about your perks and responsibilities when it comes to paying for your keratoconus treatment.
Why is keratoconus not covered by insurance?
The long-standing problem with keratoconus is that medical insurance companies rarely realize how specialist contact lenses can help keratoconus patients regain their vision. Medical insurance decision-makers appear to be unfamiliar with keratoconus, and they may even be perplexed as to why you require contact lenses and can’t use glasses. For many people with keratoconus, specialist contact lens treatments and lenses are an out-of-pocket expense. If you have a group vision benefit plan, you are exempt. Medical insurance companies continue to be educated about keratoconus and the necessity for medically necessary contact lenses, according to the National Keratoconus Foundation. Despite the fact that specialized contact lenses are usually more cost effective and successful in restoring vision than corneal transplantation in keratoconus, few medical insurances adequately cover the cost of specialty contact lens prescribing.
Vision benefit plans, such as Vision Service Plan (VSP), EyeMed Vision Care, and Medical Eye Services, are wellness programs that cover routine eye exams and provide discounts on glasses and contact lenses. Vision plans, unlike actual insurance, do not protect you from financial disaster. Although vision benefit plans do not cover eye surgery, some do cover “medically essential contact lenses,” which gives keratoconus patients a boost in coverage.
Is keratoconus considered a medical condition?
- Keratoconus is an eye condition that affects the cornea’s structure, causing vision loss.
- Keratoconus affects about one in every 2,000 people, usually starting in puberty and progressing into the mid-30s.
- Early stages of the condition can be treated with glasses, but as the disease progresses into late childhood and early adulthood, corneal transplantation may be required to restore vision.
- Corneal collagen cross-linking is a technique that can either stop or reduce the progression of keratoconus.
- In the United States, keratoconus is the most common reason for corneal transplantation.
How much does it cost to fix keratoconus?
A corneal transplant, also known as keratoplasty, is a surgical surgery in which ophthalmologists replace the cornea, the transparent covering on the front of the eye that focuses light and allows us to see clearly. The surgeon will remove sick or damaged cornea tissue and replace it with healthy corneal donor tissue obtained from an organ donor during the surgery. Corneal transplant surgery can enhance the appearance of a sick or injured cornea by restoring clear eyesight, reducing pain, and restoring clear vision. You’ll need to protect your eye from harm after surgery. Immediately after the treatment, vision is frequently blurry, but it improves over time. After cornea replacement surgery, complete eyesight might take anywhere from a few weeks to a year to obtain. We’ll look at how much a corneal transplant costs, if it’s covered by insurance, and how financing can assist.
How much does a corneal transplant surgery cost?
Corneal transplants, like all tissue transplant surgeries, can be difficult and require the skill of many people, including the surgical team, the hospital or surgical center, and the donor bank. As a result, the cost of surgery can quickly escalate, with the most recent numbers indicating that a corneal transplant for patients without insurance costs roughly $13,000 for an outpatient treatment and $28,000 for an in-hospital procedure. 1
Are corneal transplants covered by insurance?
When considered medically essential, a corneal transplant is frequently covered by private medical insurance and Medicare. A specialty co-pay, a hospital co-pay, and coinsurance of 10% 50% for the procedure up to the yearly out-of-pocket maximum amount are examples of out-of-pocket charges. 1 Treatment of keratoconus with contact lenses can cost anywhere from $2,000 to $4,000 per eye, depending on the examination, measurements, fitting, and materials used. However, depending on the severity of the disease and the type of contact lenses recommended, this range can be wide or narrow.
How much does a corneal transplant cost with insurance?
Keratoconus frequently necessitates long-term management, which can be costly. This includes everything from therapies like cross-linking to medically prescribed contact lenses. Educating yourself on the many treatment options, keratoconus treatment prices, and which treatments are covered by insurance can help reduce out-of-pocket costs to a minimum.
Evaluating Keratoconus Treatment Options
Working with your doctor to determine the best treatment option for you is a good idea, however FDA-approved keratoconus treatments include:
Soft Contacts – While soft contacts do not address the underlying condition, they can improve your vision in many circumstances. If the degree of corneal distortion is not too severe, mild and early cases of keratoconus can be handled with standard non-specialty soft contact lenses. Soft astigmatism correcting contact lenses are usually necessary in these situations. Soft contact lenses for keratoconus may or may not be fully covered by your insurance plan. Soft contact daily disposables can cost anywhere from $55 to $95 each box (8 boxes/annual supply).
Intacs are thin, plastic semi-circular rings that are surgically implanted beneath the cornea’s surface. They flatten the keratoconic cornea and change its shape when injected into it. Major medical insurance companies frequently cover Intacs for the treatment of keratoconus. Patients should inquire with their eye surgeon and their health insurance company for more information.
Corneal Cross-linking (CXL) The only FDA-approved minimally invasive cross-linking procedure for progressive keratoconus is CXL with Photrexa eye drops and ultra-violet light from Avedro’s KXL device. It works by forming new collagen cross-links, which causes the cornea to harden, slowing the disease’s progression. The FDA approved this corneal cross-linking technique in April 2016, and it is now covered by 50 insurance companies.
Rigid Gas Permeable Contact Lenses (RGPs) – RGPs are rigid contact lenses that can transfer oxygen and are composed of durable plastic. Scleral lenses are gas permeable lenses with a wider diameter that cover the entire cornea as well as a portion of the sclera, the white of the eye. RGPs are enclosed by a soft lens liner or skirt in hybrid contacts. RGP lenses must be fitted by an eye doctor, and the expenses can range from hundreds to thousands of dollars. RGPs are not covered by many insurance policies since they are considered ‘cosmetic.’ These lenses can cost anywhere from $75 to $325 per lens (2 lenses/annual supply).
Corneal Transplant Surgery – If the cornea becomes dangerously thin and/or contact lenses no longer restore vision, a corneal transplant may be the only therapy choice. The cornea is removed and replaced with a donor cornea during surgery. Most insurance policies cover corneal transplants, although they can cost anywhere from $13,000 to $27,000.
Understanding Your Options
The National Keratoconus Foundation and the Keratoconus Group are two support and advocacy organizations that provide extra resources and personal insights into managing keratoconus treatment expenses and insurance coverage concerns.
The National Keratoconus Foundation developed a Keratoconus Insurance Reimbursement Form to help insurance companies understand and explain keratoconus, as well as the treatment choices available to treat and manage the condition. When completed and presented by a doctor or their office staff, this document may assist in obtaining reimbursement for FDA-approved keratoconus treatment costs.
In addition, patients without health insurance, Medicare, or Medicaid coverage have a number of financial help options. Consult your doctor to see if they provide financial aid or are willing to set up a payment plan to help you manage the expense of your care.
Following a keratoconus diagnosis, it’s critical to communicate freely with your doctor and be honest about any insurance or payment concerns you may have, as they may have additional solutions to help you through your keratoconus journey.
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Can keratoconus be cured naturally?
Keratoconus Reversal However, regardless of the source of your Keratoconus, there is no way to reverse it naturally or medically with diet, exercise, medicines, or other therapy.
How do you fix keratoconus?
Keratoconus can be treated with eyeglasses or contact lenses in mild to moderate cases. This will almost certainly be a long-term treatment, especially if your cornea stabilizes over time or as a result of cross-linking. Lenses
What is the recovery time for a cornea transplant?
After surgery, you should be able to return to work or your normal routine in 1 to 2 weeks. However, your vision will remain fuzzy. Heavy lifting should be avoided for 4 weeks or until your doctor says it’s acceptable.
Can you wear glasses with keratoconus?
We routinely create glasses for our keratoconus patients using corneal topography (3D corneal shape analysis), aberrometry (light waveform blur analysis), and complicated lens design tools such as SHAW lens.
In summary, glasses are attainable for many keratoconus patients with the right skill and tools, and while they aren’t always as clear as personalized contact lenses, they are often quite valuable to have as a secondary kind of vision correction.
How can I naturally thicken my cornea?
There are always ways to strengthen your cornea and eyes, whether you wear glasses or contact lenses or have had LASIK. Consider these best practices for maintaining clear eyesight and healthy eyes.
Some of these suggestions will be known to you, while others will be completely new to you. Here are some methods to strengthen your cornea and eyes whether you have dry eyes, focus troubles, or simply want to understand how to keep your eyesight for a lifetime.
Remember how your mother had you eat all of your vegetables and then gave you fruit as a dessert? Mom, like so many other things in life, was correct once more. Many of the foods we detested as youngsters also include nutrients that help to improve your cornea and eyes.
The brighter they are, the better they are in protecting and strengthening your vision.