Healthcare
Is Laser Eye Surgery Covered by Private Health? A Complete Australian Guide
Laser eye surgery has become one of Australia’s most popular long-term solutions for vision correction. With procedures like LASIK, PRK and SMILE helping many people reduce or eliminate the need for glasses or contact lenses, it’s natural to ask:
“Is laser eye surgery covered by private health insurance?”
The short answer: Yes — but not always, and not fully.
Coverage depends entirely on your insurer, your policy type, and the level of Extras or Hospital cover you hold.
This detailed guide explains exactly what is and isn’t covered in Australia.
Is Laser Eye Surgery Considered a Medical or Elective Procedure?
In Australia, private health insurers generally classify laser eye surgery as an elective or non-medically necessary procedure.
Because of this:
- Medicare does not cover it
- Private health cover is limited and varies significantly between funds
Some insurers treat it as a refractive correction procedure and offer partial benefits through higher-tier Extras or top Hospital policies.
Is Laser Eye Surgery Considered a Medical or Elective Procedure?
In Australia, private health insurers generally classify laser eye surgery as an elective or non-medically necessary procedure.
Because of this:
- Medicare does not cover it
- Private health cover is limited and varies significantly between funds
Some insurers treat it as a refractive correction procedure and offer partial benefits through higher-tier Extras or top Hospital policies.
How Private Health Funds Typically Cover Laser Eye Surgery
Below is how most Australian private health insurers approach coverage.
1. Extras Cover (Most Common)
Some mid-to-high level Extras policies provide benefits for:
- Laser eye surgery rebates
- Refractive surgery allowances
- Optical/vision correction benefits
Extras cover usually pays:
- A fixed amount per eye (for example, $400–$1,000), or
- A lifetime limit of around $1,500–$3,000 per person
This reduces the overall cost but rarely covers the entire procedure.
2. Hospital Cover (Less Common)
A small number of premium Hospital policies may include contributions if:
- The procedure is performed in a hospital
- Specific medical criteria are met
- The treatment is deemed clinically necessary (rare)
Hospital cover for laser eye surgery is far less common than Extras cover.
3. Basic and Mid-Level Policies
Most entry-level policies do not include laser eye surgery or any form of refractive correction.
If you are hoping for a rebate, you’ll usually need to hold a higher-tier Extras policy or a comprehensive combined policy.
How Much Does Laser Eye Surgery Cost in Australia?
Typical costs for both eyes are:
| Procedure | Average Cost (per eye) |
|---|---|
| LASIK | $2,200 – $3,500 |
| PRK | $2,000 – $3,000 |
| SMILE | $3,000 – $3,500 |
Your final cost may be reduced depending on your insurer and your level of cover.
Which Health Funds Commonly Offer Laser Eye Surgery Benefits?
Coverage changes over time, but the following insurers have previously offered rebates in selected policies:
- Bupa
- Medibank
- HCF
- nib
- HBF
- GMHBA / Frank
- Defence Health
- Australian Unity
Always check with your insurer for up-to-date information, as benefits vary between products and renewals.
What Private Health Insurance Might Cover
Depending on your policy type, you may receive benefits for:
1. Part of the surgical cost
A set dollar amount or percentage contribution.
2. Pre-operative consultations
Assessment fees before the procedure.
3. Post-operative follow-up appointments
Check-ups after surgery.
4. Lifetime or annual limits for refractive surgery
Often applied once per lifetime or set annually.
What Private Health Insurance Does Not Cover
Most policies exclude:
- The full cost of laser eye surgery
- Cosmetic or non-essential refractive procedures
- Surgery that could be replaced by wearing glasses or contacts
- Anything not classified as medically required
Medicare also does not cover laser eye surgery unless it is required for a rare, medically necessary condition.
How to Check If You’re Covered
Before booking surgery, ask your insurer:
- Does my Extras or Hospital cover include laser eye surgery benefits?
- What is the rebate amount?
- Is it a lifetime or annual limit?
- Are there waiting periods?
- Do I need pre-approval?
- Do I need to use specific clinics or providers?
Always request written confirmation for clarity.
How to Maximise Your Benefits
Upgrade cover before surgery
If your current policy doesn’t include laser coverage, you may upgrade, but waiting periods will apply.
Use partnered clinics
Some insurers have special arrangements with laser clinics for reduced costs.
Compare funds
Some providers offer more generous laser benefits than others, especially in higher Extras tiers.
Ask about payment plans
Laser clinics often offer interest-free options to help spread out costs.
Is Laser Eye Surgery Worth It Even Without Full Cover?
Many Australians consider laser eye surgery a worthwhile long-term investment due to:
- Reduced reliance on glasses or contact lenses
- Long-lasting vision correction
- Convenience in daily life, sports and work
- Potential savings over time on optical products
With partial rebates from private health insurance, the treatment becomes more financially accessible.
Final Verdict: Is Laser Eye Surgery Covered by Private Health?
Yes — but only partially and only under selected policies.
Most Australians only receive:
- Rebates through higher-level Extras cover
- Occasional support from rare premium Hospital policies
Because benefits vary between insurers, reviewing your policy and speaking directly with your health fund is essential before booking treatment.
Also Read This: Struggling with Inconsistent Care? Explore the Benefits of Working with SIL Providers
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