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If contact lenses are the only method that can improve your vision then contact lenses are usually considered medically necessary. Medically necessary contacts are most often used in keratoconus treatment. Keratoconus is a disorder of the cornea that leads to progressive changes in its shape and structure. Over time, the cornea becomes increasingly thinner and steeper. These changes result in the formation of high levels of irregular astigmatism and myopia.

Here is a list of the most common conditions treated with medically necessary contacts:

  • Keratoconus
  • Pellucid marginal degeneration
  • Post-refractive surgery complications (such as LASIK and PRK)
    Eye diagram
  • Corneal transplants (penetrating keratoplasty)
  • Severe dry eye syndrome
  • High refractive error
  • Irregular astigmatism
  • Corneal ectasia
  • Recurrent Corneal Erosions
  • Corneal Dystrophies
  • Stevens-Johnson Syndrome
  • Sjogren’s Syndrome
  • Exposure Keratopathy
  • Non-Healing corneal Epithelial Defects
  • Neuropathic Corneas
  • Corneal scars
  • Bullous keratopathy

Scleral contact lenses are the most common medically necessary contact lens treatment used. Scleral contacts are large-diameter gas permeable contact lenses specially designed to vault over the entire corneal surface and rest on the “white” of the eye (sclera). In doing so, scleral lenses functionally replace the irregular cornea with a perfectly smooth optical surface to correct vision problems caused by keratoconus and other corneal irregularities.

Does My Insurance Cover Medically Necessary Contact Lenses?

Your medical plan will not cover the fitting of contact lenses for medically necessary conditions; however, most vision plans do offer coverage. Your medical plan will cover the diagnosis and monitoring of your condition. They will also cover surgery should that become necessary.

Want to know more about medically necessary contact lenses?

Request Appointment for medically necessary contact lenses consult.