LASIK (Laser-Assisted In Situ Keratomileusis) is a procedure used to correct the eye’s refractive errors, such as nearsightedness, farsightedness, and astigmatism. Consumers seeking freedom from glasses or contact lenses often face confusion about how this surgery is officially classified. The classification of LASIK is important because it dictates potential insurance coverage and eligibility for tax deductions, specifically whether it is considered cosmetic or medical treatment.
How LASIK is Medically Classified
LASIK is generally not classified as cosmetic surgery by major medical and regulatory bodies. Cosmetic procedures are defined as those performed solely to improve appearance, without correcting a functional defect or disease. LASIK is a form of refractive surgery that corrects a functional impairment in the eye’s ability to focus light onto the retina.
The procedure is instead categorized as an elective medical procedure. This means the surgery is not an emergency and can be scheduled at the patient’s convenience. While LASIK addresses a biological defect, non-surgical alternatives like glasses and contact lenses are available to achieve the same functional outcome. This availability prevents it from being routinely classified as a “medically necessary” treatment.
The Criteria for Elective vs. Necessary
For the vast majority of patients, LASIK is considered elective because corrective lenses are deemed adequate to restore functional vision. The procedure corrects common refractive errors, but the decision to pursue surgery is a matter of preference.
A refractive procedure may be considered medically necessary only in rare circumstances where corrective lenses are not a viable solution.
Exceptions for Medical Necessity
One exception is severe contact lens intolerance, where a patient experiences chronic infection, unmanageable dry eye, or extreme allergic reactions. Another clinical exception involves significant differences in refractive power between the eyes, a condition called anisometropia. Medical necessity may also apply in certain occupational fields, such as for military personnel or specific first responders, where wearing glasses or contacts poses a documented safety hazard.
Anisometropia is often defined by a difference of 2.0 diopters or more between the two eyes, which can cause visual symptoms like headaches, eye strain, and aniseikonia (unequal image sizes). If this difference cannot be adequately corrected with standard glasses or contacts without debilitating side effects, refractive surgery becomes the only functional solution.
Insurance and Tax Implications
The classification of LASIK as an elective medical procedure has significant financial consequences. Standard health insurance plans, including HMOs and PPOs, almost universally deny coverage for routine LASIK. The rationale is that the procedure is considered a convenience, not a treatment for an unmanageable condition, since glasses and contacts are effective alternatives.
Despite the lack of insurance coverage, LASIK’s classification as a medical procedure—rather than cosmetic—offers substantial financial benefits under the U.S. tax code. The Internal Revenue Service (IRS) considers LASIK a qualified medical expense. This eligibility allows consumers to pay for the procedure using pre-tax funds from a Health Savings Account (HSA) or a Flexible Spending Account (FSA). Using these accounts effectively reduces the total cost by the patient’s income tax rate. Furthermore, the unreimbursed cost of LASIK can be included in a taxpayer’s itemized deduction for medical expenses if the total exceeds 7.5% of their Adjusted Gross Income (AGI).