Budgeting for Orthokeratology: Costs and Insurance

Budgeting for Orthokeratology: Costs and Insurance

Orthokeratology, or Ortho-K, is a non-surgical vision correction option that uses specially designed gas-permeable lenses to reshape the cornea overnight. It offers a glasses- and contact-free experience during the day, making it especially popular among children with progressive myopia and active adults. However, as with any specialty eye care treatment, it's important to understand the financial investment and explore ways to manage the cost.

Understanding the Cost of Ortho-K

The cost of Ortho-K can vary depending on several factors, making it important to understand what’s included in the overall investment. The process typically begins with a comprehensive eye exam and corneal topography mapping to determine if a patient is a good candidate for treatment. These initial services usually cost between $100 and $300.

A major portion of the expense comes from the design and customization of the Ortho-K lenses themselves. Since these lenses are specially made to fit each patient’s eyes, this customization can cost anywhere from $1,000 to $2,500 per eye. In addition to the lenses, several follow-up visits are required to monitor the progress and effectiveness of the treatment. These visits are often included in the initial package fee, but this may vary by provider.

Over time, ortho-K lenses typically need to be replaced once a year. Replacement costs are often similar to the initial lenses, so it’s important to factor this into your long-term budgeting. Pricing can also vary based on your location and the provider's specific services, but many optometry clinics offer flexible payment plans or financing options to help manage the cost.

Is Ortho-K Covered by Insurance?

In most cases, Orthokeratology is considered an elective or cosmetic procedure, which means it’s not typically covered by standard vision insurance. However, there are a few ways to reduce out-of-pocket costs:

• Check for Out-of-Network Reimbursement: Some vision insurance plans offer partial reimbursement for services received out of network. Ask your provider about submitting a claim for reimbursement.

• Use HSA or FSA Funds: Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) can be used to pay for Ortho-K. These pre-tax funds can significantly reduce your financial burden.

• Explore Medical Necessity Options: In cases of high myopia progression, especially in children, some insurance companies may consider partial coverage under specific medical necessity criteria. Ask your eye care provider for supporting documentation if needed.

Budgeting Tips for Ortho-K

When budgeting for Ortho-K, it’s helpful to ask about all-inclusive packages. Many providers offer bundled pricing that includes the initial exam, lenses, and follow-up visits. This approach can be more cost-effective than paying for each component separately and may simplify your financial planning.

Another option to explore is payment plans. Some optometry clinics provide monthly financing options, allowing patients to spread out the cost of treatment over time. This can make Ortho-K more accessible and manageable, especially for families or individuals on a budget.

It’s also important to consider the long-term value of ortho-K. While the initial cost may seem high, Ortho-K is a worthwhile investment compared to years of purchasing glasses or daytime contact lenses. For some, it may even delay or reduce the need for future refractive surgery, offering both financial and lifestyle benefits over time.

Get Started at University Optometric Center Today

Orthokeratology offers freedom from daytime corrective lenses and can help manage myopia progression, especially in children. While it may come with a higher upfront cost, strategic budgeting and understanding your insurance options can make this investment more manageable.

Contact University Optometric Center to schedule an Ortho-K consultation and learn more about pricing, payment options, and how we can help make clearer vision more affordable for your family. Visit our office in Irvine or Newport Beach, California. Please call (949) 216-8900 or (949) 476-2870 to book an appointment today.