Policyholder Services

Will OMIC cover me for the performance of phakic implants?

Updated 12/9/2015

Yes. OMIC offers coverage to qualified insureds for procedures performed with implants specifically approved by the FDA for phakic use, provided the patient’s anterior chamber depth and degree of myopia and astigmatism fall within FDA-approved guidelines. Off-label treatment of patients between the ages of 18 and 21 or over age 45 is permitted subject to special consent language. OMIC also offers coverage for phakic implant procedures performed under and in accordance with an American IRB-approved clinical study.

Due to concerns regarding the risk of endophthalmitis or other serious vision-threatening complications associated with intraocular surgery and the difficulties the company would likely experience defending a resulting claim if the procedure were performed in a setting that did not meet existing standards for sterile conditions, OMIC requires that phakic implant surgery be performed only in a hospital or outpatient surgical center approved for cataract surgery. Full sterile technique must be followed.

Please note that OMIC’s standard policy excludes coverage for intraocular refractive surgery procedures unless specifically added by endorsement. All requests for coverage are subject to underwriting review and approval of a supplemental questionnaire and adherence to the company’s underwriting guidelines. Please contact your underwriting representative to discuss OMIC’s guidelines and obtain approval prior to scheduling patients for phakic implant procedures.

No coverage will extend for any phakic implant procedures performed unless the physician has specifically applied and been approved for coverage and the policy has been amended accordingly.

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#1. Consistent return of premium.

Publicly-traded insurance companies exist to make profits for shareholders while physician-owned carriers often return profits to their policyholders. Don’t underestimate this benefit; it can add up to tens of thousands of dollars over the course of your career. OMIC has one of the most generous dividend programs for ophthalmologists and has returned more than $20 Million to our members through dividends.