Medically Necessary Contact Lenses For Keratoconus and Irregular Astigmatism

Popular topics on this page:  What are Medically Necessary Contacts medically necessary contact lenses Will My Health Plan Cover It  medically necessary contacts What Conditions Qualify visually necessary contact lenses Do I Qualify for Medically Necessary Contacts 

Medically Necessary Contact Lenses

What are Medically Necessary Contact Lenses

If contact lenses are the only method that can improve your vision then contact lenses are usually considered as medically necessary.  Most keratoconus treatment services will qualify for medically necessary contact lens benefits. Some vision plans refer to this same benefit as visually necessary contact lenses. Most often, vision plans consider traditional contact lenses an elective benefit. The requirements for medically necessary contact lenses vary slightly between vision plans.

The degree of coverage for medically necessary contact lenses varies widely. Some vision plans offer up to 100% coverage. Vision plans with a medically necessary contact lens benefit are;

  • VSP -Vision Services Plan
  • Spectera
  • Superior
  • EyeMed
  • Davis
  • Humana


Does My Health Insurance Plan Cover Medically Necessary Contact Lenses?

No, your medical insurance does not have a medically necessary contact lens benefit. However, we will try to coordinate your plan benefits between both your vision plan and medical plan. 

What Conditions are Treated With Medically Necessary Contact Lenses

This varies between vision plans. Medically necessary contacts are most often used in keratoconus treatment and pellucid marginal degeneration. However, we often use medically necessary contacts to help patients experiencing complications after eye surgeries such as LASIK and corneal transplants. Scleral contact lenses are the most common medically necessary contact lens treatment used; however, SynergEyes hybrid contact lenses are also commonly used.

Here is a list of the most common conditions treated with medically necessary contacts;1

  • keratoconus
  • pellucid marginal degeneration
  • post-refractive surgery complications (such as LASIK and PRK)
  • corneal transplants (penetrating keratoplasty)
  • dry eye syndrome
  • high refractive error
  • irregular astigmatism
  • corneal ectasia
  • keratitis
  • corneal scars
  • corneal transplant failure/rejection
  • bullous keratopathy


How Can I Find Out if I Can Benefit From Medically Necessary Contact Lenses

We have a lot of experience in treating patients with medically necessary contact lenses and have dealt with virtually every vision plan. Please call the Total Eye Care Colleyville office at (817) 416-0333 for more information. You can also schedule a complimentary consult with Dr. Driscoll where he can discuss which treatment options may be best for you.


1Harmon H, Caswell J. Vision insurance FAQ: frame, lens & contact lens benefits. website