Why Popular Laser Eye Surgery To Correct Your Vision Is Becoming More Affordable
By Rob Turner

(MONEY Magazine) – If you're one of the millions of Americans on the fence about having laser eye surgery to improve your vision, chances are two things are holding you back. One is the uneasy thought of someone applying an ultraviolet laser to your eyeball. The other is the thousands of dollars you'll spend to have this done. While the first may play a larger role (and we have tips for approaching the surgery), we'll focus on the latter. After all, this is MONEY. And we have some good news: The cost is becoming easier to handle as prices fall and employee-benefits programs finally start discounting this increasingly popular surgery.

The method of choice. While there are several kinds of laser eye surgery, the most popular by far is LASIK, or laser-in-situ keratomileusis, which is used to correct nearsightedness, farsightedness and astigmatism. Nearly 95% of the approximately 750,000 people expected to undergo the surgery this year will have this procedure. According to Al Kildani, an analyst who tracks eye-care companies for Pacific Growth Equities in San Francisco, the recent price for LASIK ranged from $999 to $2,750 per eye, averaging $2,176. Kildani adds that because of increased competition, prices are widely expected to fall.

The benefits picture. Until recently, only a few small eye-care benefits providers helped with the cost of surgery. As of Jan. 1, two of the nation's largest managed-care vision benefits firms, Sacramento-based Vision Service Plan (VSP) and Cleveland-based Cole Managed Vision, began to offer laser eye surgery discounts to their combined 79 million members (including dependents), at no additional cost to the employers or workers. Analysts expect more eye-care benefits companies to offer similar plans.

With VSP's Laser VisionCare plan, you'll pay no more than $1,800 for the LASIK procedure as long as you use a VSP-approved surgeon. VSP has partnered with TLC Laser Eye Centers, the largest network of laser eye surgeons in the U.S., and with more than 150 other smaller centers to offer members a 25% discount. (In addition, VSP is marketing a plan that calls on employers to help pay for the surgery, which could appeal to firms that already pay for hundreds of dollars worth of glasses or contacts annually.)

Cole has formed an exclusive alliance with LCA-Vision centers, the nation's third largest laser vision network, to offer members a 15% discount on LASIK. Larry Rapp, LCA's chief financial officer, says that more than half of LCA's 19 centers offer a LasikPlus plan that costs $2,995 for both eyes. A 15% discount would bring the price down to $2,446, or $1,273 per eye.

Blurry tax rules. Even at this lower cost, laser eye surgery still entails a hefty out-of-pocket expense. Is it tax deductible as a medical expense? Probably. While the Internal Revenue Service hasn't issued a regulation on the matter, the agency did okay a deduction for similar surgery in a 1996 private-letter ruling. The IRS defines deductible medical expenses as those that "alleviate or prevent a physical or mental defect or illness." Mark Luscombe, the principal federal tax analyst for tax law publisher CCH, believes that laser surgery meets that definition. In fact, Todd Ransom, a spokesman for H&R Block, the country's largest tax preparer, says his company advises clients that laser eye surgery is deductible.

However, in order to deduct it, your unreimbursed medical expenses for the year must exceed 7.5% of your adjusted gross income. So you may want to put off surgery until a year when you are incurring other big medical expenses.

Looking beyond price. No matter the price, experts caution that finding an experienced, reputable surgeon should be your first priority. A small percentage of patients report problems, including over- or undercorrection. Irving Arons, a Peabody, Mass. consultant on ophthalmic technology, points out that with an experienced surgeon, the complication rate is less than 2%. So ask for an outcome analysis report, which details how many procedures the surgeon has done (500 is a good minimum) and how many patients have had complications.

While price alone is no measure of skill, Arons notes that rock-bottom prices are often an indicator of less experience. "I wouldn't recommend somebody go to a deep discounter to get work on your eyes," he adds. "You've only got two of 'em."

--ROB TURNER