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Is Cataract Surgery Covered Under Health Insurance?
Certain lifestyle disorders, such as diabetes and hypertension, can cause various other health disorders. Cataracts is one such common disorder in India, which ultimately leads to blindness if left untreated. Hence, to avoid such risks, having a health insurance plan that covers cataract surgery is crucial for safeguarding your vision.
Our eyes are the main organs through which we perceive the outside world, and it is very important to take care of them in all circumstances.
In this article, you will gain a basic understanding of the types of cataract surgeries that are offered in India, the duration of the waiting time before receiving coverage, and the advantages of getting coverage for cataract surgery under your health insurance plan.
Table of Contents
What is a Cataract?
A cataract is a disorder of the eyes in which the natural lens of the eye becomes clouded, reducing vision. It can happen at any age due to several causes, such as lifestyle decisions, smoking, diabetes, etc. As you grow older, the risk of having a cataract increases. If left untreated for a longer time, it could lead to permanent vision loss. cataract surgery is a common and effective method of restoring vision which involves replacing the clouded lens with an artificial one.
What is Cataract Surgery?
The National Institutes of Health's 2017 evaluation of research indicates that Surgery is the only option for treating a cataract. Hence, cataract surgery is performed to remove the cataracts and replace them with an artificial lens. The surgery is performed by an ophthalmologist (eye doctor) and it is only recommended to individuals whose contact lenses or glasses cannot are no longer working for their eye problem.
Types of Cataract Surgeries in India
Over the past 20 years, there has been a complete transformation in the technology utilized in cataract surgery. The following are the six primary types of cataract surgery, having a unique process of replacing the lenses.
Is Cataract Surgery Covered Under Health Insurance?
Many of you dealing with eye issues might have wondered, "Is cataract surgery covered by health insurance?" The good news is, YES!!! However, not all insurers offer coverage for cataract surgery, so it’s essential to review the policy's inclusions before making a purchase. Also, be aware of any sub-limits in your health insurance plan. These limits could restrict the amount of coverage you receive for your cataract surgery.
For example, Mrs. Meghna, aged 38, previously purchased a plan that provided cataract surgery coverage under her insurance. Recently, she started experiencing problems with her vision, and after consulting with a Doctor, she was suggested to undergo Cataract surgery. After checking her insurance, she found that it has a copayment, where the insurance provider will only cover 80% of the cost of the surgery, and the remaining 20% will be paid by her.
Therefore, it is essential that you thoroughly read and review the terms and conditions of your plan before purchasing.
Why should you get a Health Insurance covering Cataract Surgery?
What is the Waiting Period for Cataract Surgery in Your Health Insurance?
The waiting period for cataract surgery often depends on your insurance company. The waiting period is generally 1-3 years.
But what does the waiting period mean?
The waiting period in health insurance, as the name suggests, is a time period during which you cannot claim any benefits from cataract surgery that is covered by your insurance. Basically, it is the duration you need to wait to use benefits from your health insurance policy.
What’s Great about Health Insurance Covering Cataracts?
Key Benefits of Health Insurance by Digit
| Co-payment | No |
| Room Rent Capping | No |
| Cashless Hospitals | 9000+ Network Hospitals across India |
| Inbuilt Personal Accident Cover | Yes |
| Wellness Benefits | Available from 10+ Wellness Partners |
| City Based Discount | Up to 10% Discount |
| Worldwide Coverage | Yes* |
| Good Health Discount | Up to 5% Discount |
| Consumables Cover | Available as an Add-on |
*Available only on Worldwide Treatment Plan.
What is Cataract Surgery Cost in India?
There are different types of cataract surgery and each surgery varies in cost. The cost of surgery differs from one person to another depending on what your doctor has recommended, the city you live in, the hospital you pick, the type of cataract, medication and your age.
For example, the cost of robotic cataract surgery in India will differ from that of laser cataract surgery.
On average, considering all the factors, the cost of robotic surgery ranges between ₹15,000 to ₹2,00,000. (4) Below mentioned is the approximate cost for all the types of cataract surgeries in India.
Disclaimer: The above-mentioned cost is the average cost of different types of cataract surgery. The cost can vary depending on your age, city, hospital, type of lens and medications.
Things to Remember Before Getting Health Insurance that Covers Cataract Surgery
Before purchasing any Health insurance plan, make sure that it covers the Cataract surgery cost. However, even if the insurer is providing you with Cataract coverage, you must remember a few important things that include:
- Waiting Period: You cannot claim for cataract coverage when you are under your waiting period. Therefore, it is your responsibility to ensure that the medical insurance coverage you choose does not need an extended waiting period.
- Limits: Most insurers limit the amount a patient with cataracts can claim. You must pay any expenses incurred above this limit separately. However, the maximum amount of a claim may vary among insurers. Therefore, choose a plan with no limits if you want your health insurance to cover the whole cost of cataract treatment.
- Features: Not every policy provide coverage for every facet of the cataract procedure. Therefore, be sure the insurance you select offers you the most coverage and has all the features you want.
Why is Cataract Surgery Important?
- There is no natural cure for cataracts apart from surgery - Unfortunately, as confirmed by the National Institute of Health, there is currently no natural cure for cataracts apart from surgery. Hence, to improve your vision and get through the symptoms and repercussions of cataracts, you will need to get a cataract surgery done.
- Untreated cataract can lead to partial or complete blindness - Depending on one’s age and eye condition, symptoms can get worse with time and without getting it treated (through surgery of course), it can lead to partial or complete blindness of the affected eye. Hence, it is important to opt for cataract surgery if you or your parent have a cataract in one or both eyes to avoid worse repercussions.
- Successful cataract surgery restores vision - Cataract surgery is considered one of the safest surgeries due to the involvement of advanced medical equipment. And, the good news is that you barely need to be admitted to a hospital as the surgeries require a few hours (recovery is quick too!) as compared to other surgeries. The surgery helps you to restore vision without any side effects!
- Improves the quality of life - You know what they say, eyes are the windows to the soul and the window to the world! They might be just tiny pupils but we’re dependent on them in more ways than we can imagine. Hence, getting a cataract surgery improves not only one’s vision quality but also, overall quality of life.