Is Cataract Surgery Covered by Oriental Health Insurance?

What is Cataract Surgery?

Cataract surgery is the surgery conducted to treat cataract disease. The surgery involves removing the natural lens of the eye and placing an artificial lens in its place. The surgery is recommended when cataract disease makes it difficult for the affected person to see clearly and interferes with day-to-day activities.

Cataract surgery is an expensive procedure. In India, the average cost of cataract surgery is between Rs 50,000 to Rs 1,27,000. However, the surgery cost can vary depending on the type of surgery and its location. For instance, laser cataract surgery is more expensive than traditional cataract surgery. Similarly, getting a cataract surgery done in a metropolitan city is costlier than in a small city.

This brings us to the question of whether Oriental health insurance plans cover the cost of cataract surgery. Let’s find out.

Does Oriental Health Insurance Cover Cataract Surgery?

Yes. Oriental health insurance provides coverage for cataract surgery under Oriental Mediclaim Insurance, Oriental Happy Family Floater and Oriental Health of Privileged Elders plans. These plans cover cataract surgery as a day care procedure as the surgery does not require 24-hour hospitalization.

Oriental Health insurance plans will not only cover the cost of the cataract surgery, but also surgeon’s fees, operation theatre charges, surgical appliances’ cost, nursing fees, cost of diagnostic tests, etc. Moreover, the insurance company will also pay for the medical expenses incurred before the surgery and on post-surgery follow-up.

Waiting Period for Cataract Surgery Under Oriental Health Insurance

Although Oriental health insurance plans provide coverage for cataract surgery, the coverage is not available from day 1 of the policy. You need to first spend the waiting period applicable under the policy to avail coverage for cataract surgery.

All Oriental health insurance plans offering coverage for cataract surgery come with a fixed waiting period of 2 years. This means after two policy renewals, you can raise a claim for cataract surgery under your Oriental health insurance policy.

However, if you were diagnosed with a cataract before you purchased your Oriental health insurance policy, pre-existing diseases waiting period will apply. This will happen because cataract disease will be considered a pre-existing disease by the insurance company.

In the case of a pre-existing disease, Oriental health insurance plans will cover the cost of the cataract surgery after a waiting period of 2 years or 4 years. The pre-existing waiting period varies as per the Oriental health insurance plan. Hence, you must go through your policy documents carefully to find out the waiting period for pre-existing diseases under your policy.

Summing It Up

Cataract is a common problem among people above 50 years in India. Since cataract surgery is the only way to treat this eye disease, its cost can reduce your savings substantially.

However, people with Oriental health insurance plans do not have to worry about the cost of the cataract surgery as it is covered by the insurance company. However, make sure to check the exact waiting period for cataract surgery under your Oriental health insurance policy before raising a claim.