Is Refractive Lens Exchange Covered By Insurance?

Refractive lens exchange (RLE) surgery, also commonly called clear lens exchange (CLE) surgery, is an eye surgery intended to correct refractive errors and reduce the need for eyeglasses or contact lenses. It is a proven avenue for sharp and clear vision but is often a significant investment for most people. The cost of RLE eye surgery leads many potential candidates to wonder whether insurance covers the procedure. Here’s what you need to know about this eye surgery and insurance coverage.

What Are the Benefits of RLE?

RLE surgery is a refractive procedure designed to address a range of vision issues, including nearsightedness (myopia), farsightedness (hyperopia), and astigmatism, by replacing the eye’s natural lens with an artificial intraocular lens (IOL). This surgical technique is similar to cataract surgery, but RLE is performed primarily for vision correction rather than cataract removal. Eye surgeons often recommend RLE to individuals who are not candidates for LASIK surgery, such as those with dry eye syndrome, thin corneas, or presbyopia, an age-related condition that causes a decline in near vision. Unlike vision correction surgery like LASIK, where patients may require reading glasses or surgical refinements over time, RLE offers a more permanent solution and often reduces future dependency on corrective lenses. With an IOL, individuals maintain clear vision and avoid the development of cataracts in the future.

How Much Does RLE Surgery Cost?

RLE surgery generally costs approximately double that of LASIK. The cost can vary significantly and ranges, on average, between $2,000 and $8,000 per eye. Several factors influence the price, including the region, the expertise of the ophthalmologist and eye surgeon, the IOL type, the technology and surgical method used, and the required time for the surgical procedure and recovery care. Different lenses are available to help you achieve your vision goals, including multifocal IOLs, or accommodating IOLs, that restore both distance and near vision. These premium lenses are more expensive than regular monofocal lenses, which are often selected to correct long-distance vision only. With regular IOLs, individuals will generally require reading glasses after surgery. Toric lenses are another premium option often recommended for individuals with astigmatism.

At Swagel Wootton Eye Institute, we’re proud to offer a range of premium IOLs to fit your budget, lifestyle, and vision needs.

Does Insurance Cover RLE?

RLE is most often considered an elective procedure, so it’s typically not covered by insurance. Depending on your plan type and coverage details, it may be covered when deemed medically necessary, such as in cases of severe vision loss or retinal detachment. Insurance companies use specific criteria to determine if a service is medically necessary. It’s crucial to review the terms and conditions of your particular insurance plan to determine whether RLE surgery is covered.

How Can I Pay for RLE Surgery?

At Swagel Wootton Eye Institute, we believe every patient should have the opportunity for clear vision and improved quality of life. We offer financing options through our preferred lenders, CareCredit and Alphaeon Credit. These options provide deferred interest for up to 24 months and flexible payment plans spread over 60 months for those who qualify. We also accept payments from health savings accounts (HSAs) and flexible spending accounts (FSAs), which are often available through employer health insurance plans and can help offset the total cost using pretax dollars.

See Clearly with RLE From Swagel Wootton Eye Institute

Our world-class eye doctors are experts in lens replacement surgery. Our trusted team can answer your questions about the surgery, including the benefits and risks of RLE. We will provide a comprehensive eye exam, determine if you are a candidate, and review surgery costs, lens options, and any necessary pre- or post-operative care during your consultation. We can even help you verify if your insurance coverage may apply. Request an appointment today to learn more about RLE, LASIK, PRK, or other refractive surgery options.