Where Cigna’s rules for scleral lenses live
Cigna is a large insurer with separate medical and vision products, and the answer depends on which one you’re asking.
Cigna medical plans. Cigna publishes its medical coverage policies in an A to Z index. When we checked it in October 2026, it had policies on related eye topics, such as corneal remodeling and intraocular lens implants, but no policy dedicated to scleral lenses or therapeutic contact lenses.[3] That doesn’t mean a Cigna medical plan never pays for them. It means the answer sits in your plan’s own documents, so you need to ask.
Cigna Vision plans. Cigna Vision benefit summaries include a separate benefit for therapeutic contact lenses, with written criteria. That’s what most of this page is about.
What Cigna Vision says about therapeutic contact lenses
The Cigna Vision schedules of coverage we read, issued by Cigna Health and Life Insurance Company and serviced by EyeMed, list two kinds of contact lens benefit: elective and therapeutic.[1]
They say coverage for therapeutic contact lenses will be provided:[1]
- when visual acuity cannot be corrected to 20/70 in the better eye with eyeglasses, and fitting contact lenses would reach that level of vision; and
- in certain cases of anisometropia (a large prescription difference between the eyes), keratoconus, or aphakia (no natural lens in the eye),
as determined and documented by your vision eye care professional.
The same wording appears in a 2024 Cigna Vision schedule for a different employer, which suggests it’s standard language rather than a one-off.[2] Neither document names scleral lenses. They describe a benefit for therapeutic contact lenses in general.
What falls outside it
The schedules say that contact lenses fitted for other therapeutic purposes, or to address narrowed visual fields from very high minus or plus prescriptions, are covered under the ordinary elective contact lens benefit instead.[1] That benefit is usually a smaller allowance.
If you wear scleral lenses mainly for severe dry eye or another ocular surface disease, that wording suggests the vision plan may treat them as elective. Ask your Cigna medical plan whether it covers them as a treatment.
The therapeutic benefit can still have limits
In the 2025 schedule we read, the therapeutic benefit was covered in full in network, with an out-of-network allowance and a once-per-12-months frequency.[1] Scleral lenses are custom devices, so ask how the benefit applies to them in particular. Another employer’s plan can have different amounts and frequencies.
Plans differ, so read your own schedule
Each employer chooses its own Cigna plan design. Cigna’s own outline of its vision insurance says there may be frequency and dollar limits, that some plans pay out of network based on usual and customary amounts, and that your plan documents control.[4] Benefits can also differ by state.
Look for a document called a schedule of vision coverage or summary of benefits. Find the contact lens section and check whether it lists a therapeutic or medically necessary benefit, and what it pays in and out of network.
What to ask Cigna
- Do I have a Cigna Vision plan, a Cigna medical plan, or both?
- Does my vision plan have a therapeutic contact lens benefit? What does it pay in and out of network?
- Does keratoconus qualify under my plan? What documentation is needed?
- Does my medical plan cover scleral lenses used to treat ocular surface disease?
- Is prior authorization needed for the fitting or the lenses?
- How often can I use the benefit, and does it cover replacements?
Write down the date, the representative’s name, and a reference number.
If your plan doesn’t cover enough
Many fitters work outside insurance networks and give you an itemized receipt to file yourself. See our guides to out-of-network claims, HSA and FSA funds, and medically necessary contact lenses.
Common questions
Does Cigna cover scleral lenses for keratoconus?
Cigna Vision schedules we read cover therapeutic contact lenses in certain cases of keratoconus, as determined and documented by your eye care professional, or when vision can't be corrected to 20/70 in the better eye with glasses. They don't name scleral lenses specifically. Ask Cigna whether your plan has the therapeutic benefit and how much it pays toward scleral lenses.
What does 'cannot be corrected to 20/70 in the better eye' mean?
It means that even with your best glasses, your better-seeing eye can't read the 20/70 line on the eye chart, and contact lenses would get you to at least that level. Your eye care professional measures and documents this.
Does Cigna cover scleral lenses for dry eye?
The Cigna Vision wording we read says contact lenses fitted for other therapeutic purposes are covered under the ordinary elective contact lens benefit. Ask whether your Cigna medical plan covers scleral lenses used to treat severe ocular surface disease, and get the answer in writing.
Is Cigna Vision the same as my Cigna medical plan?
No. Cigna Vision is a separate vision benefit, and the schedules we read are serviced by EyeMed. Your medical plan has its own documents and rules. You may have one, both, or a vision plan from another company.