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Medically Necessary Contact Lenses


Most people think of contact lenses as simply a way to correct vision instead of wearing eyeglasses. However, there are really two categories of contact lenses: elective vision correction and medically necessary contact lenses. When you have an eye condition that prevents regular eyeglasses or contacts from giving sharp vision, your eye doctor may prescribe medically necessary contact lenses.

After an eye exam at one of our optometry offices in Lee's Summit, Clinton, Sedalia, and Warrensburg, Missouri, our eye doctor will perform a precise contact lenses fitting to find the best type of lenses. There’s a wide variety of contact lenses available – with a type for just about every ocular condition.

Medical conditions that need specialty contact lenses

  • Keratoconus: eye disease that leads to structural damage to the cornea, so the eye bulges into a cone shape instead of rounded
  • Pellucid Marginal Degeneration: a degenerative, nonhereditary condition that involves thinning of the corneal periphery
  • Aphakia: the lens of the eye is absent or has been removed
  • Post-corneal transplant: scarring can lead to an irregular corneal surface
  • Corneal dystrophies:  a group of rare genetic ocular disorders in which abnormal material builds up in the cornea
  • Ametropia: very high vision prescription; the higher your vision prescription, the lower the vision quality you can generally get from glasses and soft contacts
  • Anisometropia: a refractive condition where the eyes have unequal power, generally with a difference of 3.00 diopters
  • Severe dry eye syndrome: insufficient tear film leaves the eye without enough lubrication, causing painful irritation

Types of medically necessary contact lenses

  • Rigid gas permeable contact lenses: hard, oxygen permeable lenses often used to fit a distorted cornea
  • Hybrid contact lenses: with a soft periphery and a hard center, they’re typically prescribed for very high astigmatism or corneal irregularity
  • Scleral contact lenses: specialized rigid gas permeable contact lenses with an extra-wide diameter so the contacts rest on the whites (sclera) of the eye; often prescribed to treat keratoconus and other corneal disorders

Insurance coverage

All of these specialty contact lenses are intended to provide crisp, comfortable vision for people with an eye disease or problem. They are not classified as cosmetic contact lenses. However, medical insurance companies still don’t always cover them fully – every vision care and medical plan has its own definition of what qualifies as a medical necessity.

Generally, though, the insurance benefits are greater than what you’ll receive for elective contacts, and some vision insurance plans that don’t offer coverage for elective contact lenses will pay a benefit for medically necessary contact lenses.

Eye exams and contact lenses fittings

If you’re having trouble seeing - even with eyeglasses or contact lenses, book an eye exam. The problem could be as simple as needing a new prescription, or you could need a different type of medically necessary contact lenses. Contact the closest office of Eyecare Specialties in Lee's Summit, Clinton, Sedalia, or Warrensburg, Missouri, to schedule an eye exam.

At Eyecare Specialties, we put your family's needs first. Talk to us about how we can help you maintain healthy vision. Call us today: 816-317-0012 or book an appointment online to see one of our Lee's Summit eye doctors.

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