It can be scary to be diagnosed with a progressive eye condition – just ask those who are living with keratoconus! Thankfully, there are a number of safe and effective treatment options available, including FDA-approved corneal cross-linking – a minimally invasive outpatient procedure for the treatment of progressive keratoconus. While it is reassuring to know that there are treatments for keratoconus, it can also bring new questions and concerns, such as Is this treatment expensive? Will my insurance cover the cost? If not, will I need to deplete my savings account for this?
Look no further, because we’re here to help answer these questions so that you can feel confident with your decision to receive corneal cross-linking and assured knowing more information about insurance coverage. The last thing you want to be thinking about during your treatment and recovery is financial matters, so it’s best to do research and check with your insurance provider beforehand. That way, during your procedure, you can simply focus on your eye health and recovery.
Below, we’re diving into whether or not corneal cross-linking is covered by insurance. Keep reading to learn the answer to this question and to hear from others who have keratoconus and navigated the insurance process.
Is Corneal Cross-Linking Covered by Insurance?
If you are planning to get corneal cross-linking, you’re in luck. Insurance coverage for cross-linking is now widely available! iLink, which is the only cross-linking procedure that is FDA-approved, is eligible for insurance coverage in the US. The goal of iLink FDA-approved cross-linking is to stiffen the cornea to slow or halt further progression of keratoconus and preserve one’s vision.
When it comes to insurance coverage, greater than 95% of the commercially insured population has access to this potentially sight-preserving treatment. There are positive coverage policies from the largest national commercial payers in the US, including United Healthcare, Anthem Blue Cross Blue Shield, Aetna, Cigna, Humana, and HealthNet. In fact, all 50 states have more than six insurance plans that cover the FDA-approved procedure. For most insurance policies, iLink FDA-approved cross-linking is considered medically necessary for someone who has progressive keratoconus. It is also considered medically necessary for those with corneal ectasia post-refractive surgery with documented worsening best spectacle-corrected visual acuity and irregular astigmatism.
Insurance does not typically cover products and procedures that have not been approved by the FDA. For this reason, it is important to confirm with your physician that you are receiving iLink FDA-approved cross-linking. If you are being offered cross-linking that is not FDA-approved, if your insurance does not cover the procedure you are planning to get, or if you are being asked to pay out of pocket, it may be necessary to seek a second opinion.
If someone is treated with an unapproved cross-linking procedure, the FDA has not determined that the drug and devices used are safe and effective. If the procedure is not effective, the patient risks the continued progression of their condition and he or she may need to be re-treated with cross-linking or even worse – corneal transplant surgery.
For additional information on insurance coverage and to view the latest list of insurers that are known to have policies that cover the iLink cross-linking procedure, visit the Insurance Information page.
Hear From Those in the Living with KC Community
If you’re still skeptical about insurance coverage for corneal cross-linking, it may help to hear from some people in the Living with KC community who recently went through the process. Keep reading below to learn about their journeys to finding a physician who performed iLink FDA-approved cross-linking and accepted their insurance.
Bekah: After being diagnosed with progressive keratoconus and fitted for rigid gas permeable (RGP) contact lenses and glasses, Bekah soon found herself focusing on learning everything she could about keratoconus and iLink FDA-approved cross-linking. Hoping she would be able to slow or halt the progression of her condition, Bekah took control of her eye health and researched and visited countless ophthalmologists around her state who were performing the FDA-approved procedure, before finding a doctor that was right for her and that accepted her insurance. To learn more about Bekah’s experience read her Keratoconus Journey today.
Jimmy: Jimmy had been managing his keratoconus with a RGP contact lens for most of his adult life, but when he visited his ophthalmologist for a yearly check-up, it was recommended that he receive iLink FDA-approved cross-linking. When doing some of his own research on the iLink procedure, Jimmy discovered the Living with Keratoconus website, where he learned that his insurance provider would cover the procedure and also discovered the Copay Savings Program. Soon after, Jimmy received FDA-approved cross-linking on his left eye. Now, he is relieved that his condition has not progressed any further. Continue reading Jimmy’s Journey here.
Kyle: Kyle received cross-linking in his right eye in July of 2019 and his insurance company fully covered the FDA-approved treatment. Kyle was eager to schedule the procedure on his other eye in November of 2019. Now that his progressive keratoconus has been treated, Kyle says getting cross-linking was the right decision for him and one he wishes he had made earlier. Learn more on Kyle’s Journey.
Still Have Questions? Don’t Stress!
There is no need to stress about insurance coverage for iLink FDA-approved cross-linking. Instead, start by contacting your insurance provider prior to treatment to see if they currently provide coverage for iLink FDA-approved corneal cross-linking. From there, make sure to confirm with your doctor that they are performing FDA-approved cross-linking before undergoing the procedure. You can also find a list of corneal experts in your area who are familiar with treating progressive keratoconus and offering the FDA-approved procedure by using our physician locator tool.
If you’re still unsure, you can also connect with others in the keratoconus community who may be going through a similar experience. For more information on keratoconus and iLink FDA-approved cross-linking, follow Living with KC on Facebook, Twitter, and Instagram.
The results described on this site are based on data collected regarding short- and intermediate-term efficacy of treatment. Individual results are not guaranteed and may vary.