Insurance Coverage for Corneal Collagen Crosslinking

  1. Cost Of Corneal CrossLinking
  2. FDA-Approved Crosslinking for Progressive Keratoconus
  3. Insurance Coverage in the United States
  4. List of Insurance Companies that Cover Crosslinking
  5. Find a Cornea Specialist

Insurance Coverage in the United States

Since FDA approval in April 2016, many insurance companies have started covering corneal collagen crosslinking (CXL) for progressive keratoconus and keratectasia. for example, Aetna has a published following policy regarding the medical necessity of CXL:

"Aetna considers epithelium-off photochemical collagen cross-linkage using riboflavin and ultraviolet A medically necessary for keratoconus and keratectasia."

List of Insurance Companies that Cover Crosslinking

Below is an updated list of insurance companies that cover corneal collagen crosslinking (CXL) for progressive keratoconus.

Payer Name Payer Region Notes
Aetna National
Kaiser Permanente Az, CA, CO, DC, GA, HI, MD, NV, TX, VA, WA
Blue Cross Blue Shield FEP National
Blue Shield of California CA
Horizon Blue Cross of New Jersey NJ
Blue Cross Blue Shield of Tennessee TN
CareFirst Blue Cross Blue Shield MD, DC, Northern VA
Blue Cross Blue Shield of Massachusetts MA
Blue Cross Blue Shield of Alabama AL
Regence Blue Cross Blue Shield ID, OR, UT, WA
Blue Cross Blue Shield of Michigan MI Coverage begin on 11/1/2017
Independence Blue Cross PA, NJ, DE, MD
Medica Health Plans MN, WI, ND, SD
Blue Cross Blue Shield of South Carolina SC
Blue Cross Blue Shield of Arizona AZ
Blue Cross Blue Shield of Kansas City Kansas City, Northwestern MO, Johnson & Wyandotte Counties
Arkansas Blue Cross Blue Shield AR
Blue Cross Blue Shield of Kansas KS
Blue Cross Blue Shield of Mississippi MS
Blue Cross of Idaho ID Coverage begin on 12/15/2017
Dean Health Plan WI
Blue Cross Blue Shield of Rhode Island RI, CT, MA
John Hopkins HealthCare MD
Tricare Available to all Tricare beneficiaries, including dependents.

FDA-Approved Crosslinking for Progressive Keratoconus

FDA has approved corneal collagen crosslinking (CXL) for progressive keratoconus in April 2016. this approval only covers the crosslinking products developed by Avedro, Inc. this FDA-approved method involves corneal epithelial debridment, hence it is known as epithelium-off or epi-off crosslinking.


Cost of Corneal CrosslLinking

There is limited evidence on the costs of corneal crosslinking, but it may be as high as $2,500 to $4,000 per eye in the United States. a cost-effectiveness study estimated the costs of the total treatment for one person as £928 in the UK National Health Service.


Visit Avedro's website to learn more about insurance coverage and find cornea specialist who perform corneal crosslinking.


2 comments:

  1. I thought blue cross blue shield cover keratoconus surgery! Then why they denied my son cross linking procedure?

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  2. Keratoconus surgery and cross linking are not the same thing. Cross linking is new technology and your plan may not have a medical policy for this service yet. If in fact you plan does have a medical policy for cross linking, did you sons clinical situation fall in line with this policy. Keratoconus surgery, although treats many of the same diagnosis as Cross linking, these are two different procedures. Coverage for ones does not automatically mean coverage for something else.

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