Does Medi-Cal Insurance Cover Laser Eye Surgery?

When it comes to laser eye surgery, such as LASIK or PRK, Medi-Cal, California's Medicaid program, typically does not cover these procedures since they are considered elective in nature. However, Medi-Cal may cover certain eye care services related to medical conditions, such as cataract surgery, or specific eye diseases. The best way to determine eligibility is to contact your Medi-Cal provider or review the specific benefits outlined in your coverage plan.

When Does Medi-Cal Cover Laser Eye Surgery?

While primary laser eye surgeries like LASIK or PRK are generally not covered, services related to medical eye conditions can be quite different. If contact lenses or glasses are not providing adequate vision, and laser surgery is necessary to correct the issue, then Medi-Cal may cover the procedure.

Covered Medical Procedures

Cataract Surgery: If there is no other way to treat the problem, cataract surgery is usually covered. Retinal Surgery: Procedures like laser retinopexy for retinal tears or detachments are also often covered.

For specific medical problems, Medi-Cal coverage can include:

Laser Procedures for Medical Conditions

PRP (Pan Retinal Photocoagulation): Used for treating proliferative diabetic retinopathy (PDR) and retinal vein occlusion (RVO). Focal Macular Laser: Applied to treat diabetic macular edema (DME). Photodynamic Therapy (PDT): Effective for macular degeneration and other diseases. Nd:YAG Capsulotomy: Used to remove a membrane that can grow on the back of the lens after cataract surgery. ALT/SLT (Argon Laser Trabeculoplasty): For glaucoma. LPI (Laser Peripheral Iridotomy): For angle closure glaucoma. Laser Iridotomy (Sty for Plateau Iris Syndrome): For specific ocular conditions.

Excluded Procedures

Mediterranean Laser Assisted Cataract Surgery and femtosecond laser assisted cataract surgery are also not covered by Medi-Cal.

Important Considerations

This information is meant for general informational purposes and should not be considered professional medical advice. Always consult your doctor before starting any new treatment or surgery. In case of a medical emergency, please call your doctor or 911 immediately if you are in the United States.