Is Keratoconus Treatment Covered by Insurance

Keratoconus is an eye condition that affects the cornea, causing it to become thin and bulge outward. This condition can cause vision distortion and other visual problems, and it can progress over time if not treated. Fortunately, there are several treatments available for keratoconus, but they can be expensive. In this article, we will discuss how keratoconus treatment is covered by insurance and what options are available for patients with this condition.

Understanding Keratoconus

Before we delve into the details of keratoconus treatment coverage, it’s essential to understand what keratoconus is and how it affects the eyes. Keratoconus is a condition that causes the cornea to bulge outward and become thin. This can cause vision distortion, sensitivity to light, and other visual problems.

The exact cause of keratoconus is unknown, but it is thought to be related to genetics and environmental factors. The condition typically starts to develop in the teenage years or early adulthood and progresses over time. It can be diagnosed through a comprehensive eye exam that includes corneal mapping and topography.

Keratoconus Treatment Options

There are several treatment options available for keratoconus, depending on the severity of the condition. These include:

Glasses and Contact Lenses

In the early stages of keratoconus, glasses or soft contact lenses can help correct vision problems. However, as the condition progresses, specialized contact lenses, such as rigid gas permeable lenses or scleral lenses, may be needed.


Corneal cross-linking is a minimally invasive procedure that involves applying riboflavin drops to the cornea and exposing it to ultraviolet light. This treatment strengthens the cornea and can help slow the progression of keratoconus.


Intacs are small, clear crescent-shaped inserts that are placed in the cornea to help reshape it. This procedure can improve vision and reduce the need for specialized contact lenses.

Corneal Transplant

In severe cases of keratoconus, a corneal transplant may be necessary. This procedure involves replacing the damaged cornea with a healthy one from a donor.

Keratoconus Treatment Coverage

The cost of keratoconus treatment can vary widely depending on the treatment option chosen and the severity of the condition. Glasses and contact lenses may be covered by insurance, but specialized lenses and procedures such as cross-linking and intacs may not be covered.

However, the good news is that some insurance companies do cover these procedures. It’s important to check with your insurance provider to see what treatments are covered under your plan. You may also need to get pre-authorization from your insurance provider before undergoing certain procedures.

How to Get Keratoconus Treatment Covered by Insurance

If you have been diagnosed with keratoconus and need treatment, the first step is to talk to your eye doctor. They can recommend the best treatment options for your condition and help you navigate the insurance coverage process.

Your eye doctor may also be able to provide documentation to support the medical necessity of certain treatments, which can increase your chances of getting coverage. It’s important to keep all receipts and documentation related to your treatment to submit to your insurance provider.


Keratoconus can be a challenging condition to live with, but there are treatment options available to improve vision and slow its progression. While some treatments may be expensive, insurance coverage may be available. It’s essential to understand your insurance coverage and work with your eye doctor to get the treatment you need.

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