Are scleral lenses covered by insurance?

Often, in part or in full, when documented as medically necessary — we are in network with VSP, EyeMed and many others, and we verify your plan before you commit.

Can I use my medical insurance if I have no vision plan?

Frequently yes — keratoconus is a medical diagnosis, and exams and imaging are often billable medically.

Can I use FSA or HSA funds?

Typically yes, for fittings, lenses and care supplies. Check your plan’s list, and time large purchases to the plan year.

Can I use both medical and vision insurance for keratoconus care?

Often, yes, because each one pays for a different part of the care. Keratoconus is a medical diagnosis, so exams, corneal imaging and monitoring visits are often billed to medical insurance, while vision plans often cover part or all of medically necessary scleral lenses. We are in network with common vision plans, including VSP and EyeMed. Call 310-828-2010 with both cards handy and we will check both sides of your coverage before you book a fitting.

What are medically necessary contact lenses?

The term covers lenses needed because an eye condition, such as the irregular cornea of keratoconus, keeps glasses and standard contact lenses from correcting your vision. When that is documented, specialty lenses like sclerals may qualify for medical-necessity coverage, and vision plans often cover part or all of medically necessary scleral lenses. Insurers expect a record, so we assemble it for you: corneal maps, measurements of how clearly you see with glasses, and your history of lenses that did not work.

Medically reviewed by Dr. Brandon Cohenmehr, OD Last reviewed October 24, 2026

Paying for Keratoconus Care

The money questions, answered before the chair.

Keratoconus care runs through two insurance worlds — medical and vision — and knowing which pays for what saves real money. Here is how coverage usually works, and how we check yours before you commit to anything.

Book appointmentOr call 310-828-2010 Accepted insurance

Paperwork and a lens case on a clean desk

Two systems: Medical + vision insurance
Sclerals: Often covered when medically necessary
In network: VSP, EyeMed and many others
First step: We verify benefits — 310-828-2010

How coverage works

Medical pays for the disease. Vision helps with the lenses.

Medical insurance: Keratoconus is a medical diagnosis — exams, imaging and monitoring visits are often billed medically, even if you never bought vision benefits.
Vision plans: Cohenmehr Optometry is in network with common vision plans including VSP and EyeMed; plans often cover part or all of medically necessary scleral lenses.
Medically necessary lenses: When glasses and standard contacts cannot correct an irregular cornea, specialty lenses may qualify for medical-necessity coverage — documentation is our job, not yours.
FSA / HSA: Lens fittings, lenses and solutions are typically eligible expenses, which helps soften out-of-pocket costs.

Bring your cards and we do the verifying — call 310-828-2010 and we check both sides of your coverage before you book a fitting.

The sequence

How we keep surprises off the bill.

01
Verify first
Both medical and vision benefits checked before the evaluation, with the realistic out-of-pocket told plainly.
02
Document necessity
Maps, best-corrected vision and failed-lens history assembled into the record insurers expect.
03
Itemize honestly
Evaluation, lenses, training and follow-ups quoted as line items, so you see what each stage costs.
04
Time it to your benefits
When a plan year or FSA deadline matters, we schedule around it.

Worth knowing

Cost rarely decides the outcome here.

Many scleral patients pay far less than they feared once benefits are verified
The $1,500 Ortho-K special shows how flat pricing can work
Payment questions answered by a human: 310-828-2010

Call about your coverage

Common questions

Paying for care, answered.

Anything else, call the office at 310-828-2010.

Often, in part or in full, when documented as medically necessary — we are in network with VSP, EyeMed and many others, and we verify your plan before you commit.
Frequently yes — keratoconus is a medical diagnosis, and exams and imaging are often billable medically.
Typically yes, for fittings, lenses and care supplies. Check your plan’s list, and time large purchases to the plan year.
Often, yes, because each one pays for a different part of the care. Keratoconus is a medical diagnosis, so exams, corneal imaging and monitoring visits are often billed to medical insurance, while vision plans often cover part or all of medically necessary scleral lenses. We are in network with common vision plans, including VSP and EyeMed. Call 310-828-2010 with both cards handy and we will check both sides of your coverage before you book a fitting.
The term covers lenses needed because an eye condition, such as the irregular cornea of keratoconus, keeps glasses and standard contact lenses from correcting your vision. When that is documented, specialty lenses like sclerals may qualify for medical-necessity coverage, and vision plans often cover part or all of medically necessary scleral lenses. Insurers expect a record, so we assemble it for you: corneal maps, measurements of how clearly you see with glasses, and your history of lenses that did not work.

Paying for care near you

12222 Wilshire Blvd, on the Santa Monica border.

West Los Angeles Brentwood Santa Monica Westwood Beverly Hills Culver City Pacific Palisades West Hollywood Marina del Rey Newport Beach

Also consider

Next step

Want the number before the visit?

Call with your cards handy; we verify both coverages and quote the path honestly.

Call 310-828-2010 Or book online