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Health Insurance covering Cataract Surgery

What is Cataract Health Insurance?

A cataract health insurance simply refers to a health insurance policy that covers for the treatment of cataract, a common eye condition faced in old age but, which can also be triggered by injuries to the eye.

At Digit, the treatment for the same is included and covered under our daycare procedures – with no additional cost.

Why should you get a Health Insurance covering Cataract Surgery?

1

A conventional cataract surgery (phacoemulsification) costs Rs 40,000 for each eye, while the new bladeless surgery can cost Rs 85,000 to Rs 1.2 lakh! (1)

2

There is no natural cure for cataract. A 2017 review of studies published by the National Institutes of Health confirmed the only available treatment for cataracts remains surgery. (2)

3

The average age of contracting cataract in the US or Europe is 70+.  But in India, the condition is growing rampant at age 50. (3)

What is Cataract?

Cataract is an eye condition caused by the formation of a dense, cloudy area in the lens of the eye. It is largely common in older people and if left untreated, can lead to partial or complete blindness. 

How is Cataract caused?

There isn’t just one reason or cause for cataract. Although it is common in seniors, in India there has been a trend where cataract is also affecting those at the age of 50!

One of the reasons for the same could be due to the rise and prevalence of diabetes in India. Apart from diabetes and increasing age, the following are some of the causes of cataract:

  • overproduction of oxidants, i.e. oxygen molecules that have been chemically altered due to normal daily life
  • smoking
  • ultraviolet radiation
  • the long-term use of steroids and other medications
  • certain diseases, such as diabetes
  • trauma from past injuries to the eye
  • radiation therapy

Symptoms of Cataract

  • blurry vision
  • trouble seeing at night
  • seeing colors as faded
  • increased sensitivity to glare
  • halos surrounding lights
  • double vision in the affected eye
  • The need for frequent changes in prescription glasses

Types of Cataracts

People are usually under the misconception that cataract is of one kind only and is solely related to old age.

However, this isn’t true. Cataract can be of different types, depending on its cause and which part of the eye it is affecting. Below are the different types of cataract:

  • Nuclear Cataracts: Forms in the middle of the lens and causes the nucleus (center of the eye) to turn yellow/brown.
  • Cortical Cataracts: Wedge shaped, forms around the edge of the nucleus.
  • Posterior Capsular Cataracts: Forms very fast as compared to other cataracts and affects the back of the eye lens.
  • Congenital Cataracts: One of the types of cataracts that isn’t caused due to increasing age but is present from birth or formed during a baby’s first year.
  • Secondary Cataracts: Caused due to another disease or underlying health condition such as diabetes and glaucoma. Additionally, even the use of steroids and other medications can lead to cataract.
  • Traumatic Cataracts: Sometimes, trauma cataracts can develop after an injury to the eye, although this may take years to happen too.
  • Radiation Cataracts: Forms after a person goes through radiation treatment for cancer. 

Is there a way to prevent Cataracts?

Yes, cataracts can be prevented primarily by maintaining your eye health and overall health and wellbeing as well. Some of the ways to prevent cataracts include:

  • Wear sunglasses out in the sun to protect your eyes from UVB rays. 
  • Go for regular eye checkups, especially if you commonly face eye problems or are above the age of 65.
  • Stop smoking!
  • Have a regular intake of fruits and vegetables that contain antioxidants.
  • As it goes with preventing other diseases as well – always try and maintain a healthy weight.
  • If you are diabetic, keep your diabetes level in check. 

Are there any risk factors associated with Cataract?

Yes, there are some people who are unfortunately more prone to cataracts than others. Some of these risk factors include:

  • increasing age
  • heavy alcohol intake
  • regular smoking
  • obesity
  • high blood pressure
  • previous eye injuries
  • family history of cataracts
  • too much sun exposure
  • diabetes
  • exposure to radiation from X-rays and cancer treatments

Why is a Cataract Surgery important?

  • There is no natural cure for cataract apart from surgery - Unfortunately, as confirmed by the National Institute of Health there is currently no natural cure for cataract apart from surgery. Hence, to improve your vision and get through the symptoms and repercussions of cataract, you will need to get a cataract surgery done.
  • Untreated cataract can lead to partial or complete blindness - As per one’s age and condition of the eye, symptoms can get worse with time and without getting it treated (through a surgery of course), it can lead to partial or complete blindness of the affected eye. Hence, it is important to opt for a cataract surgery if you or your parent does have cataract in one or both eyes to avoid worse repercussions.
  • A cataract surgery successfully restores vision - The good news in this all is that cataract surgery is actually one of the safest surgeries, thanks to medical advancements. In fact, you barely need to be admitted for a few hours so it’s also a very short process (recovery is quick too!) as compared to other surgeries and the best bit is that it successfully restores one’s 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 

How much does a Cataract Surgery cost in India?

While the Phacoemulsification Cataract Surgery is the most common form of cataract surgery, there are also other types of surgeries for cataract.

Based on what your doctor has recommended, the city you live in, the hospital you pick and how old you are, the cost of a cataract surgery in India will differ. Below are what it would approximately cost for the three different types of cataract surgeries in India:

Phacoemulsification Cataract Surgery Extra capsular Cataract Surgery Bladeless Cataract Surgery
What is it: The most common surgery practiced for cataract, using local anesthesia before making small incisions in the affected cornea in order to break down and remove the cataract. What is it: Similar to the Phacoemulsification cataract surgery, but incisions required here are larger than usual. What is it: This surgery doesn’t use any incision methods but instead treats the cataract through a computer-guided femtosecond laser which dissolves the cataract.
Cost: It costs around Rs 40,000 for the affected eye. Cost: Between Rs 40,000 to Rs 60,000 for the affected eye. Cost: Given that this surgery is fairly recent and very technical in nature, it is more expensive than other surgeries, i.e. around Rs 85,000 to 120,000 for the affected eye.

Source

Disclaimer: The above are only approximate costs and may differ from hospital to hospital, and city to city.

What’s great about Digit’s Health Insurance Covering Cataract?

Simple online processes - From the process of buying a health insurance policy to making claims is paperless, easy, quick and hassle-free! No hard copies, even for claims! 

No Age-based or Zone-Based Co-payment - Our health insurance comes with no age-based or zone-based copayment. This means, during health insurance claims, you need not pay anything from your pocket. 

No Room Rent Restriction - We understand that everyone has different preferences. That’s why we have no room rent restrictions. Choose any hospital room you prefer. 

SI Wallet Benefit - If you exhaust your Sum Insured during the policy period, we refill it for you.

Get treated at any hospital - Choose from 16400+ of our network hospitals in India for a cashless treatment or opt for a reimbursement.

Wellness Benefits - Get exclusive wellness benefits on the Digit App in collaboration with top-rated health and wellness partners.

Key benefits of Health Insurance by Digit

Co-payment No
Room Rent Capping    No
Cashless Hospitals   16400+ 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

How to claim for a Cataract Surgery in Digit’s Health Insurance?

Digit’s Health insurance covers cataract surgery under ‘Daycare Procedures’ as this qualifies as a medical treatment that needs hospital admission for under 24-hours due to medical advancements in treatment.

If you wish to get a cataract surgery done, and are insured with us – below is how you can make a claim:

A. Reimbursement Claim

  • Let us know of the scheduled surgery and hospitalization in advance, or within two days of admission. However, since a cataract surgery is usually scheduled in advance, it’s better to inform us earlier, to avoid any last-minute problems! 
  • You can inform us by calling us at 1800-258-4242 or email us at healthclaims@godigit.com and we will send you a link to upload all your required documents. Post the surgery, we will ensure the reimbursement is made at its earliest.

B. Cashless Claim

  • If you’d like to go for a cashless claim, you can first choose the network hospital you want to get the cataract surgery done in here.
  • Let us know at least 72-hours in advance at the above number or email.
  • Display your e-health card at the network hospital desk and ask for the cashless request form. If all is good, your claim will be processed right there!

FAQs related to Health Insurance covering Cataract

Which age group is prone to cataract?

Largely, the senior age group is more prone to cataract. 

Do all medical health insurance cover cataract surgery?

No, this would depend on different health insurer’s terms and conditions. Always better to check your policy document or ask your insurer to see if it is covered or not 😊 At Digit, it is covered under Daycare Procedures.

Is there a waiting period for cataract surgeries?

Yes, there is a minimum waiting period of 2 years for cataract surgery, at Digit, since it comes under specific illnesses.

If I have diabetes, does this mean I will get cataract too?

No, just because you are diabetic doesn’t mean you will get cataract. However, it’s said that people who are diabetic (especially high levels) are more prone to getting secondary cataract too.

Do I have to separately get an add-on cover for cataract surgery?

This would again depend on your health insurer. However, at Digit – cataract surgeries are covered under Daycare Procedures which are included as a default in all our health insurance options.

Does everyone with cataract need surgery?

This primarily depends on your symptoms and current vision quality. For most people with cataract, it is recommended to get a surgery since it is safe and successfully restores quality of vision. However, the surgery can be delayed basis how affected your eyes are currently. All said and done, your eye specialist will be best suited to give you the right recommendation post an eye checkup and examination.