Medical Contact Lenses

The following article will provide information about the different types of medical contact lenses that are available for different conditions.

Medical Contact Lenses in Manhattan

Non-Elective Contacts

Contacts are considered medical devices because they require an optometrist's prescription. However, since in most cases they are used for cosmetic reasons or personal preferences, they are considered “elective” and health insurance companies won't cover the cost. 

Yet in certain instances, contacts are listed as medically necessary for vision correction, and health insurance plans may pay for them. The following article explores several examples of medical lenses and the reasons they may be prescribed.

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What Kinds of Conditions Require Medical Contacts?

There are several types of ocular diseases and conditions in which standard glasses cannot provide adequate corrective measures. In these instances, contacts become a necessity rather than a cosmetic option. The following conditions sometimes require such lenses:

  • Ametropia: These include cases where someone has such a high prescription that is no longer effective. Myopia (nearsightedness) is a type of ametropia, and myopia management often involves the use of contact lenses to slow down the progression of the condition.In these examples, contacts provide superior benefits.
  • Anisometropia: An ocular condition where the eyes have unequal focus or power.
  • Aphakia: A condition involving the absence or removal of an ocular lens, either from trauma, surgery, or an underlying condition.
  • Dry Eye Syndrome: People with severely dry eyes are sometimes prescribed lenses that provide a more moisturized environment. Scleral lenses are sometimes prescribed for this condition.
  • Corneal Irregularities: Corneas that are shaped differently. Keratoconus is an ocular disease that causes structural damage and alters the shape from spherical to cone-shaped. Other corneal complications that are treated with contacts include Fuchs’ dystrophy which causes a thickening of the cornea, blurriness, and sensitivity to light/glare; and Lattice dystrophy, which can cause pain (a sensation that something is in the eye), tearing, blurriness, and sensitivity to light and glare.
  • Corneal surgery: Sometimes complications involving scarring occur after corneal surgeries such as Lasik, Prk, and LASEK. In such instances, standard glasses are inadequate and speciality contacts may be necessary. These include the use of scleral lenses which rest on the sclera portion of the eye, rather than the cornea.

Types of Contacts for Medical Purposes

The above-mentioned conditions require lenses to correct eyesight since standard glasses cannot provide adequate visual acuity. They come in the following types:

  • Hybrid: a combination of soft and hard providing crisp vision with the comfort of a soft lens.
  • Gas permeable: Permits the optimal flow of oxygen to the ocular region.
  • Scleral: These differ from other lenses in that they sit on the sclera rather than the cornea.
  • Soft: While they are more comfortable than hard options, they usually don't provide the best vision for health reasons.
Types of Contacts for Medical Purposes
Additional Information

Additional Information

Many health insurance plans will cover the cost of contacts when they are essential. Speak with your provider.

Common Questions

In most instances, they are not covered, although hi-tier plans may differ.
They are only considered medical because they require a prescription. Health insurance plans generally agree that standard glasses are sufficient and most are only willing to cover instances where they are necessary. In those instances where glasses are not an option, they may be considered a necessity. Unless they are essential, most health plans consider them elective
Medical Contact Lenses
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Contacts For Health Reasons

Contacts are sometimes prescribed for ocular conditions where standard glasses cannot provide sufficient improvement of eyesight. Under such circumstances, they are considered a necessity for vision correction, and a patient may be covered under health insurance. Types of lenses include those that sit on the sclera, gas permeable types, hybrid, and soft options. For specifics on your health insurance’s policies, speak with a provider to find out more.

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