Ask the Health Leaders: Insurance Impacts

One of the difficulties of living with chronic dry eye can be the financial impact. People face out-of-pocket costs when insurance does not cover treatment. It can get expensive living with dry eye.

We wanted to take a closer look at the impact of insurance (positive or negative) on our Health Leaders. So we asked, "Has insurance positively or negatively impacted your dry eye treatment? How do you manage this?"

Read through their responses below. And be sure to share in the comments if you can relate or if you have had a different experience!

Chronic dry eye and insurance

Response from Sharon

I have meibomian gland dysfunction which led to my chronic dry eye diagnosis. My optometrist recommended I have intense pulsed light (IPL) treatments. The first obstacle was traveling 150 miles for treatment. I was surprised to learn IPL is not covered by insurance. At $800 a treatment that left me out.

My optometrist now manually expresses the meibomian glands periodically, a procedure Medicare will cover.

Response from Ava

Overall, it is more positive than negative. My insurance hasn’t denied coverage but a lot of the dry eye field is outside of insurance coverage. Hopefully, that will change in the future.

My medical insurance plan has paid for my many eye exams, punctal plugs, and prescription eye drops. However, I need a lot of things that my insurance doesn’t cover. Not having insurance coverage for specialized testing and treatments, such as serum eye drops, is really hard.

For the most part, I wouldn't say I'm managing it; I just go without a lot of things I need for my chronic dry eye because I can’t pay for them out of pocket. These are mostly the more costly things, like IPL treatments or LipiFlow. Even though it’s hard on my wallet, I pay for a couple different types of over-the-counter eye drops (these are so much more expensive than one would expect), supplements to help with dry eye, special eyeglasses, and things like humidifiers to help in the winter.

My vision insurance doesn’t help at all with my dry eye. They cover about 80 percent of my vision exam, once a year, and only contribute $120 yearly towards either contacts or glasses. Because my contacts are so expensive, I have not upgraded my glasses in years and this does negatively affect me. I hardly wear my glasses because they are out of date, but it’s not healthy to wear my contacts so much.

I shouldn't need a side hustle to pay for dry eye treatments, but it feels like I won't get the treatment I need unless I find a way to bring in more income.

Response from Nina

Thankfully, in my case, for the most part, insurance has been a positive for me. I am extremely grateful that I am able to get my scleral lenses as well as my daily lenses covered fully, as they are the most important part of my eye health overall.

The downside of chronic dry eye is that most of the products I use to manage it are over-the-counter, such as my Bruder eye mask, gauze pads, daily lubricant eye drops, and nightly gel drops and/or gel ointments when needed. This all adds up, especially when I am needing to use more during a severe flare-up, and that all comes out of my pocket.

I do wish there was more help financially for these products for chronic dry eye patients. But overall in my case, since kerataconous, corneal scarring, and vision loss play a major part – I am just grateful I get the lenses covered so I can see properly.

For eye drops, I tend to buy them in bulk at Costco, which is much cheaper than buying them elsewhere, and I always look to buy them when they are on sale and buy an extra box when they are. That way I never really pay full price and never run out. So I tend to look out for coupons and sales, and it does add up and help, in my experience!

Response from Amanda

When I was finally diagnosed with chronic dry eye in 2021, I had no idea I would have another fight on my hands. That was with the insurance company. I had already been buying artificial tears while searching for a doctor that could help me. I remember thinking to myself how expensive those were. I was going through boxes of artificial tears every 2 days and they were $22.99 a box.

When I had my first dry eye exam, it was not covered by my insurance. When the prescriptions for Xiidra and doxycycline were sent to my pharmacy I was shocked when they told me it would be about $500 a month for both. I remember just sobbing and calling my eye doctor. Apparently, I had to fail another medication that cost less before my insurance would pay for Xiidra.

Not only was I frustrated, I imagine my eye doctor was also. She knew which medication would work best for me. Luckily, these pharmaceutical companies have coupons you can use and I was finally able to get the eye drops I desperately needed. Dry eye is financially draining and I am hoping that insurance companies will realize how precious our eyesight is.