Laser eye surgery in Spain, costs, clinics and caution

Key rules

• Cost: You pay in full, because public health does not cover laser surgery in general and most private policies exclude it.
• Price: Prices are quoted per eye and vary by technique, clinic and prescription, so get a written quote per eye.
• Candidate: The surgeon decides if you are suitable after a full exam with corneal topography.
• Clinic check: Check the clinic's health-centre authorisation and the surgeon's licence before you pay.
• Red flags: Pressure, guaranteed results and unusually low prices are reasons to walk away.

Who pays for it

You pay. Laser eye surgery is treated as elective, so the public health system does not cover it in general. Rare exceptions exist for medical cases, such as extreme anisometropia (a big difference between the two eyes) or when you cannot use glasses or contact lenses. Ask your public ophthalmologist if you think you qualify.

Most private health insurance policies also exclude it. Some insurers offer discounts or add-on cover, so read your policy before you book.

What affects the price

Clinics quote per eye, so check whether a figure is for one eye or both. The price depends on three things:

• Technique. Surface laser (PRK) is generally the cheapest. Femtosecond LASIK and SMILE are generally the dearest. Standard LASIK sits in between.
• Clinic. Prices vary a lot between clinics and cities.
• Degree of correction. A stronger prescription can change the quote.

Quotes often include follow-up visits, but not always. Get the price in writing, per eye, and ask what the follow-up covers. Prices change, so ask each clinic for a current figure rather than relying on a number you saw online.

Are you a suitable candidate

The surgeon decides, after a full exam that includes corneal topography (a map of the shape of your cornea). In general you need:

• to be an adult, usually 18 or older
• a prescription that has been stable for at least a year
• healthy corneas that are thick enough
• a refractive error within treatable limits

You are usually not suitable if you have keratoconus or corneal ectasia, thin corneas, an active eye infection or severe dry eye, uncontrolled glaucoma, uncontrolled autoimmune or diabetic disease, or if you are pregnant or breastfeeding. Unrealistic expectations also count against you. If you have presbyopia or cataracts, laser may not help, and lens surgery may be the better option.

How to check a clinic

Do these checks before you pay anything:

1. Confirm the clinic is authorised as a health centre by the regional health authority. The national register of health centres, REGCESS, lists them.
2. Confirm the surgeon is a licensed doctor and an ophthalmology specialist. The provincial Colegio de Médicos can confirm this.
3. Look for membership of the Sociedad Española de Oftalmología or a similar society.
4. Ask which laser model they use and how much experience the surgeon has.
5. Expect a thorough preoperative exam before any price is agreed.

Warning signs

Walk away if you meet any of these:

• pressure to decide fast
• no thorough exam
• guaranteed results
• prices far below the market
• a push to take out financing

Get quotes from at least two or three clinics and compare them for the same technique. The checklist below gives you the questions to take with you.

Checklist

• Ask each clinic for a written price per eye, and ask what the follow-up visits cover.

• Ask which technique the quote is for: surface laser (PRK), LASIK, femtosecond LASIK or SMILE. Surface techniques are generally cheapest and femtosecond and SMILE the dearest.

• Ask your Colegio de Médicos (the provincial doctors' college) to confirm the surgeon is a licensed doctor and ophthalmology specialist.

• Check that the clinic offers a full preoperative exam, including corneal topography, before any price is agreed.

• Confirm you fit the basics: 18 or older, a prescription stable for at least a year, and no keratoconus, thin corneas, severe dry eye, pregnancy or breastfeeding.

• Walk away if you meet pressure to decide fast, guaranteed results, prices far below the market or a push to take financing.

Frequently asked questions

Does public health or private insurance pay for laser eye surgery in Spain?

No, the Spanish public health system does not generally cover laser eye surgery, because it is treated as elective. Rare exceptions exist for medical cases, such as extreme differences in prescription between the eyes or when you cannot use glasses or contact lenses. Most private policies exclude it too, but some insurers offer discounts or add-on cover, so ask yours.

Can I have laser surgery if my prescription keeps changing?

No, laser surgery is usually only suitable once your prescription has been stable for at least a year. You also need to be 18 or older with healthy corneas of enough thickness. Pregnancy and breastfeeding are also reasons to wait.

What if I have presbyopia or cataracts, can laser still help?

Laser may not be the right option if you have presbyopia (age-related loss of close focus) or cataracts. Lens surgery is often considered instead. The surgeon decides after corneal topography and other tests.