Is Cataract Surgery Covered Under Health Insurance?

Yes, you can get coverage for cataract surgery under your health insurance plan. However, some health insurance policies might not cover it, and some would include it. So, it should be checked properly in the policy details at the time of buying the policy. If you are already covered under a health insurance policy then you can check the same in the policy documents and list of inclusions.

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    What is the Cataract Surgery Cost in India?

    In India, it is common to have cataracts among those who are 40 years and above. The chances of the disorder increase with the increase in age. In cataract surgeries, the average cost can range from Rs 35,000 to Rs 85,000 in India.

    The most common is the Phacoemulsification Cataract Surgery but there are also other types of cataract surgeries. You need to get it done based on what your doctor has recommended, your age, the city where you live, and the hospital you have picked. The cost of surgery also varies in India. We have mentioned below three different types of cataract surgeries in India:

    • Phacoemulsification Cataract Surgery- This type of cataract surgery costs around Rs 40,000 for the eye affected.
    • Extra capsular Cataract Surgery-The cost of this surgery will range from Rs 40,000 to Rs 60,000 for the eye affected.
    • Bladeless Cataract Surgery- As no incision methods are used, this type of surgery is new and technical. It can be more expensive than other surgeries and can cost around Rs 85,000 to Rs 120,000.

    However, the costs can vary from one city to another and from one hospital to another.

    Why is a Cataract Surgery Required?

    To treat cataracts in the eyes, surgery is recommended. With surgery, you can have a clear vision, and save yourself from any other repercussions.

    • Restores vision- Cataract surgeries are successful in restoring your vision and safety. With medical advancements, the process does not take longer than 30 minutes. There is no hospital admission and you need rest for few days. It restores your vision without any side effects.
    • Prevents from partial or complete blindness- If not treated the symptoms can get worse and can lead to partial or complete blindness. Therefore, if recommended one should always go for cataract surgery, be it you or your parents.
    • Improves the quality of life- Getting a cataract surgery will enhance your quality of vision and you will be able to lead a good quality of life without dependency on others, and have no problem watching Television as well.

    Waiting Period in Cataract Surgery

    Before filing a cataract surgery claim you need to serve the waiting period. Usually, most health insurance companies have a waiting period of 2-years for cataract-related treatments. But, make sure that you speak to your insurer or check the policy wordings at the time of purchase.

    What would be the Claim Limit?

    The Health Insurance Company decides the claim limit for cataract health insurance. You can check the policy inclusions and exclusions to know the limit up to which you can get compensation.

    Some insurance companies can have claim limits for cataract health insurance while some insurers might not have set any such claim limit. It is decided based on the sum insured and can be on a percentage basis. For instance, it can be 10% of the sum insured up to a maximum of Rs 25,000.

    Is Cataract Surgery covered under Group Health Plan?

    Yes, some group health insurance plans do cover surgery for cataracts. You can with your employer for the same or read the policy copy. There is a possibility that there might not be any waiting period in a group health insurance plan.

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    Written By: PolicyBazaar - Updated: 23 July 2021

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