Laser eye surgery to correct short-sightedness, long-sightedness or astigmatism isn't covered by Medicare or by hospital cover, because it has no Medicare item number. Some extras policies pay a limited benefit towards it, usually after a waiting period. Clinics set their own prices, so the cost is mostly yours.
Key points
- Medicare doesn't pay for laser eye surgery to correct vision. The Medicare items for eye surgery exclude surgery for refractive error.
- Hospital cover generally pays benefits only for treatment with a Medicare item number, so it doesn't cover laser vision correction.
- Some extras policies pay a benefit towards laser eye surgery, usually with an annual or lifetime limit and a waiting period of 12 months or more.
- Clinics set their own prices and usually quote per eye. Ask for an all-inclusive quote.
- Cataract surgery is different: it is covered by Medicare and by Gold hospital cover.
What is laser eye surgery?
Laser eye surgery reshapes the cornea to correct how light focuses on the back of the eye, so you may no longer need glasses or contact lenses. Common types are LASIK, PRK (also called ASLA or surface laser) and SMILE. It's usually done in a clinic or day surgery, both eyes on the same day, and takes minutes per eye.
Not everyone is suitable. An ophthalmologist assesses your eyes, prescription and corneal thickness first, and some people are better suited to lens-based procedures.
How much does laser eye surgery cost in Australia?
There's no government data on laser eye surgery prices, because Medicare doesn't fund it. Clinics set their own prices, usually per eye, and the cost varies with the type of laser, the surgeon and what's included. When you compare clinics, ask whether the quote includes:
- the initial assessment and scans
- the procedure for both eyes
- follow-up appointments, often for a year
- any enhancement (top-up) treatment if your vision needs it
- eye drops and medication.
Does Medicare cover laser eye surgery?
No. The Medicare items for eye surgery specifically exclude surgery to correct refractive error. Medicare can still pay a rebate for an eye examination by an optometrist or a specialist consultation with a referral, but not for the laser procedure itself.
Source: MBS Online, items 42702 and 42810, which exclude surgery for refractive error.
Does private health insurance cover laser eye surgery?
Hospital cover
Generally no. Funds pay hospital benefits for treatment that has a Medicare item number, and laser vision correction doesn't have one. The "eye (not cataracts)" category in Bronze and above covers medical eye surgery, such as retinal or glaucoma procedures, not laser vision correction.
Source: Private Health Insurance Ombudsman, which notes that services without a Medicare item number may attract no fund benefit; privatehealth.gov.au, clinical categories.
Extras cover
Some funds include laser eye surgery in their extras policies. Where it's included, it's usually:
- available only on mid or top-level extras
- subject to a waiting period, often 12 months or more
- capped at a set amount per eye or per lifetime
- sometimes shared with your optical limit.
Check the policy's Private Health Information Statement for "laser eye surgery" or "eye therapy", and ask the fund how much it would pay for your procedure before you book.
Laser eye surgery vs cataract surgery
| Laser eye surgery | Cataract surgery | |
|---|---|---|
| Purpose | Correct vision so you need glasses less | Replace a cloudy lens |
| Medicare | No | Yes |
| Hospital cover | Generally no | Yes, Gold (or a Plus policy that adds it) |
| Extras cover | Some policies pay a limited benefit | Not applicable |
How the costs could fall: four examples
These use an illustrative clinic price of $3,000 per eye. That's not a real quote, so check prices with clinics.
Single, 28, no extras cover
Pays the full $6,000 herself. Medicare and hospital cover pay nothing.
Single, 33, top extras with a laser eye benefit
The fund pays $2,000, so she pays about $4,000.
Couple, both want surgery
No benefit, so the total is about $12,000 for four eyes. Worth checking whether upgrading extras makes sense, given the waiting period.
Single, 66, cloudy lenses
If the problem is cataracts, surgery is covered by Medicare and by Gold hospital cover, so a very different cost applies.
Illustrative only. The $3,000 per eye price and $1,000 benefit are made up for the examples. Real prices and fund benefits vary.
Compare extras policies and check which include laser eye surgery.
Compare health insuranceLaser eye surgery costs: your questions answered
Does Medicare cover LASIK or SMILE?
No. Medicare doesn't pay for surgery to correct refractive error, whichever laser method is used.
Can I claim laser eye surgery on my hospital cover?
Generally no, because it has no Medicare item number. Some extras policies pay a limited benefit instead.
Is there a waiting period for laser eye benefits on extras?
Usually yes, often 12 months or more. Check the policy before you join or upgrade.
Is laser eye surgery tax deductible?
It isn't a general tax deduction for most people. Check with the ATO or a tax adviser about your situation.
Is cataract surgery the same as laser eye surgery?
No. Cataract surgery replaces a cloudy lens and is covered by Medicare and Gold hospital cover. Laser eye surgery reshapes the cornea to correct vision.
How do I compare clinics?
Ask for an all-inclusive quote per eye, covering the assessment, both eyes, follow-ups and any enhancement, and check the surgeon is a registered ophthalmologist.
Sources
- MBS Online, item 42702
- MBS Online, item 42810
- Private Health Insurance Ombudsman, Fact sheet noting services without a Medicare item number may attract no fund benefit
- Australian Government, privatehealth.gov.au, Clinical categories
Things you should know
This article is general information only and doesn't take your personal circumstances or medical needs into account. Konkrd compares policies from a range of funds. Prices, products and offers change often and vary by state, excess and rebate tier. Read a policy's Private Health Information Statement before buying.
