New to PROSE - FAQs

About Costs and Insurance

Please note that BostonSight® Network Clinics are independently operated. Please contact them individually for specific information and questions regarding costs, insurance and financial assistance.

Q. Does insurance cover BostonSight PROSE treatment?

A. Approximately 80% of the patients treated at our Needham, MA, facility are covered in part or in full for PROSE treatment through their insurance providers and/or financial assistance. BostonSight staff members work closely with each patient and his/her insurance provider to obtain insurance reimbursement whenever possible and connect patients with additional lodging, meals and transportation support to make the treatment process as affordable and convenient as possible. Financial assistance is available for those who qualify.

Q. How long does it take to get insurance approval?

A. For BostonSight, Needham, MA patients, typically, the insurance prior-authorization process takes 2-6 weeks. In certain cases the approval process is completed faster and in other cases it may take longer. This is dependent upon the particulars of an individual case, how quickly necessary information can be gathered and forwarded, and the specific procedures and policies of individual payors and insurance companies. 

Q. Does Canadian health insurance cover BostonSight PROSE treatment?

A. Canada has a publically-funded health insurance system that is individually governed by the provinces. Since BostonSight PROSE treatment is not currently available in Canada, provincial health insurance carriers will consider coverage. They have covered the initial consultation and more than half of BostonSight PROSE treatment costs for more than 90% of the PROSE patients treated at our Needham, MA facility. Please note that BostonSight Network members have no involvement in attaining pre-authorization for Canadian patients. The patient’s ophthalmologist or family doctor must submit a request to the appropriate province for out-of-country medical authorization.

Q. Why is BostonSight PROSE treatment so expensive compared with being fit with scleral lenses?

A. Ultimately we cannot speak to the affordability or effectiveness of scleral lenses fitted by other providers for a variety of conditions with various treatment goals.  Like other medical treatments and services, the out-of-pocket direct and indirect costs for BostonSight PROSE treatment vary depending on a number of factors, including but not limited to: insurance, availability of financial assistance, treatment length/process and clinic location proximity. For each patient, these costs may be higher or lower than the costs associated with commercially available scleral lenses fit by other eye care providers.

Almost 80% of the patients treated at our Needham, MA headquarters were covered in part or in full for PROSE treatment through their insurance providers and/or financial assistance. PROSE staff work closely with each patient and his/her insurance provider to obtain insurance reimbursement whenever possible and to provide additional lodging, meals and transportation support to make the treatment process as affordable and convenient as possible.

Q. How much are replacement PROSE devices?

A. For pricing, please contact the BostonSight Network location where you received PROSE treatment. Some insurance companies cover part or all of the fee for a replacement device