This blog explores Digit Insurance’s coverage policies for LASIK surgery and explains when refractive error correction is covered under their health insurance plans.
This article discusses Digit’s specific exclusions for LASIK surgery, coverage thresholds for refractive errors, detailed policy comparisons, and alternative options if LASIK is not covered under your current plan.
Key Takeaways
- Digit Insurance does not cover LASIK surgery for refractive errors below 7.5 diopters.
- LASIK may be covered only if your refractive error exceeds 7.5 diopters and is deemed medically necessary.
- Implantable collamer lenses, femto laser procedures, and multifocal lenses are excluded from Digit’s LASIK coverage.
- Digit Complete Care and Total Protect policies provide minimal to no LASIK coverage.
- Alternative insurance providers or out-of-pocket payment options may be more viable for LASIK coverage.
Understanding Digit Health Insurance’s Policy on LASIK Surgery
Digit Health Insurance policies have set terms when it comes to vision correction treatments, including LASIK surgery. The most notable exclusion is refractive error correction. Digit explicitly states that expenses for refractive errors below 7.5 diopters are not covered. This means that LASIK surgery, which is used to treat refractive errors such as nearsightedness or farsightedness, will only be reimbursed if your refractive error is above the 7.5 diopter threshold.
If your refractive error is below 7.5 diopters, you will be required to pay for LASIK surgery out of pocket. The company’s health policies have clear exclusions related to LASIK and similar eye surgeries, making it essential to understand your specific policy terms before planning any vision correction procedures.
LASIK Coverage Under Different Digit Health Plans
Digit Health offers several health insurance plans, each with different terms and exclusions for LASIK surgery. Understanding how LASIK is treated under these plans will help you make an informed decision.
Digit Complete Care Policy
The Digit Complete Care Policy is one of the most popular plans offered by the insurer. Unfortunately, this policy does not cover LASIK surgery or any other refractive error correction procedures. Whether you need LASIK to treat nearsightedness, farsightedness, or astigmatism, this plan excludes coverage for all vision correction procedures, including glasses, contact lenses, and LASIK surgery.
The policy also clearly states that expenses related to refractive error correction treatments for errors less than 7.5 diopters are not covered. If your refractive error is over 7.5 diopters, LASIK surgery may be covered, but this is an exception rather than the rule under this plan.
Digit Total Protect Policy
Similar to the Complete Care policy, the Digit Total Protect Policy does not cover LASIK or any other treatments for refractive errors. The exclusion for “eye sight and optical services” includes laser surgery, and no exceptions are made, even if your refractive error exceeds the 7.5 diopter mark. This makes the Total Protect policy one of the most restrictive when it comes to LASIK coverage.
Digit Top-Up Policy
The Digit Top-Up policy follows a slightly different approach. While it still excludes most refractive error treatments, it provides limited coverage for LASIK surgery if the refractive error exceeds 7.5 diopters. However, even in this case, implantable collamer lenses are still excluded from reimbursement.
For those with refractive errors higher than 7.5 diopters, LASIK surgery might be covered, but it’s important to check with Digit’s customer service to ensure that the specific surgery meets the policy’s requirements and the terms are clearly defined.
When Is LASIK Covered by Digit Insurance?
There are a few specific scenarios when LASIK surgery might be covered under Digit Health Insurance:
Refractive Error Over 7.5 Diopters
As mentioned, Digit Insurance may cover LASIK surgery only if the refractive error is above 7.5 diopters. However, you will need to consult with your ophthalmologist and provide proof of your visual impairment to meet the medical necessity criteria. This threshold is the primary determining factor for coverage eligibility.
Medically Necessary Surgery
LASIK is only covered if it is deemed medically necessary, not purely for cosmetic reasons. For instance, LASIK might be considered necessary if glasses or contact lenses cannot adequately correct the vision, or if a person experiences discomfort or pain while using them. The insurer will evaluate whether the procedure is essential for the patient’s quality of life and visual health.
No Alternative Solutions
If other treatments like glasses or contacts are insufficient in correcting the refractive error, LASIK may be covered as the most effective solution, provided it meets the 7.5 diopter requirement. This requires documentation from your ophthalmologist demonstrating why LASIK is the only viable option.
If you meet these conditions, it’s crucial to get a clear statement from your doctor and have all necessary documentation ready before applying for coverage under your policy. Without these, the insurer may deny your claim.
What Digit Insurance Does Not Cover for LASIK?
Even if LASIK surgery is covered under your policy, certain treatments and procedures will not be reimbursed by Digit Insurance. These exclusions are important to understand before proceeding with any vision correction procedure:
Implantable Collamer Lenses
If you undergo LASIK and your doctor recommends implantable lenses as part of the procedure, Digit Insurance will not cover the cost. This is true even if your refractive error exceeds 7.5 diopters.
Femto Laser Procedures
Digit excludes the coverage of femto laser procedures, which are advanced LASIK techniques that use femtosecond lasers for greater precision. These cutting-edge procedures fall outside the scope of Digit’s covered services.
Multifocal Lenses
LASIK procedures that involve the use of multifocal lenses or other advanced types of lenses are excluded from coverage. This limits your options if your ophthalmologist recommends these advanced lens technologies.
Glasses and Contact Lenses
Even if LASIK is not covered, any basic optical treatments like glasses or contacts are also excluded in Digit’s policies. This comprehensive exclusion of vision correction methods makes it essential to plan ahead if you need any form of vision correction.
These exclusions make it important to carefully review your policy and determine whether LASIK will be a financially viable option if you plan on undergoing the procedure.
Alternatives if LASIK Surgery Is Not Covered
If LASIK is excluded from your Digit Insurance policy, there are still some steps you can take to make the procedure more affordable:
Explore Other Insurers
Other insurance providers might offer coverage for LASIK surgery. Be sure to compare policies to find one that includes vision correction procedures. Some insurers have more favorable terms for refractive error corrections and may cover LASIK even for lower diopter values.
Look for Supplementary Coverage
Some insurance companies offer add-ons or riders that include coverage for laser eye treatments or other specialized surgeries. Adding a rider may help make LASIK more affordable without switching providers entirely. Check with Digit about available riders or supplementary coverage options.
Self-Pay Options
If LASIK is not covered under your current plan and you don’t want to switch providers, consider paying for the surgery out-of-pocket. Many LASIK centers offer financing plans or installment options to make the surgery more affordable. Some also provide discounts for cash payments or bundled procedures.
Bottom Line
Digit Insurance offers limited coverage for LASIK surgery, primarily for refractive errors greater than 7.5 diopters. Even then, implantable lenses and advanced laser procedures are excluded. If your refractive error is lower than 7.5 diopters or your procedure involves excluded treatments, you’ll need to cover the costs yourself. Always consult your policy and insurer for specific details before moving forward with LASIK surgery. Understanding these limitations upfront will help you plan financially and explore alternative coverage options if necessary.
FAQs
Does Digit Insurance cover LASIK surgery?
Digit Insurance only covers LASIK surgery if the refractive error exceeds 7.5 diopters. If your refractive error is less than 7.5 diopters, LASIK will not be covered under any of Digit’s standard health insurance plans.
Is LASIK surgery covered under Digit Top-Up policy?
LASIK surgery may be covered under the Digit Top-Up policy if the refractive error is greater than 7.5 diopters. However, the policy excludes implantable collamer lenses and other advanced procedures, even if the refractive error threshold is met.
What’s excluded from LASIK coverage in Digit Insurance?
Femto laser procedures, multifocal lenses, implantable collamer lenses, glasses, and contact lenses are all excluded from LASIK coverage, even if the refractive error is higher than 7.5 diopters.
Can I get LASIK if my refractive error is below 7.5 diopters?
No, Digit Insurance will not cover LASIK if your refractive error is below 7.5 diopters, regardless of other factors or medical necessity. You would need to pay for the procedure out-of-pocket or explore alternative insurance providers.
What should I do if LASIK is not covered by my Digit policy?
You can explore other insurance providers, look for supplementary coverage or riders from Digit, or consider self-pay options with financing plans offered by LASIK centers. Compare your options before making a final decision.