Does Cataract Surgery Comes Under Health Insurance?

Cataract, which is generally known as clouding of the eyes, is the most common disease among the people of India. The condition of the eyes gradually develops over time. The symptoms of cataracts in the eyes include blurred and double vision. Moreover, the condition blocks natural vision, causing great discomfort. Slowly, this leads to blindness or loss of vision. Hence, it is necessary to remove the cataract with proper eye treatment. Sometimes, treatment of cataracts can cause a financial burden for you and your loved ones. Read on to find out if cataract surgery is covered under health insurance in detail! 

Is Cataract Surgery Covered Under Health Insurance?

Yes, there are many health insurance plans that cover cataract surgery. With specific criteria, one can choose a plan for their cataract surgery. These criteria include a waiting period of 2 years, an average expense of Rs. 15,000–35,000, and are given in sublimity. Mostly, people prefer to buy senior citizen plans covering cataracts for their elderly members of the family. This coverage includes hospitalisation, surgery, medical expenses, and post-surgery expenses as well.

Health Insurance Plans Available For Cataract Surgery in India

The list of cataract surgery health insurance companies and plans is mentioned in the table below:

List Of Health Insurance Plans Which Cover Cataract Surgery

Let’s look at the features and benefits of each health insurance plan in detail: 

ICICI Lombard Complete Health Insurance

The complete health insurance plan offered by ICICI Lombard Insurance Company can be purchased after the age of 18 years. The following are the benefits that are offered  under the policy- 

1. Cashless hospitalisation
2. Maximum tax benefit up to RS 15,000

Care Health Freedom

The Care Freedom health insurance plan is only available to the country's senior citizens. Hence, people over 60 years of age can buy a policy that covers the treatment for cataracts too. Besides this, the following benefits of the Care Health Insurance Plan are mentioned below-

1. It provides a 100% restoration benefit.
2. The room rent would be 1% of the SI
3. The ICU charges would be 2% of the SI
4. Pre and post-hospitalisation covers up to 75% of all payable expenses
5. Lifelong renewability

Star Health Senior Citizen Red Carpet

The senior citizen red carpet policy offered by Star Health Insurance is available for people over the age of 18 years. Hence, the health insurance plan will provide you with coverage against cataracts from the early years of your life. The following benefits of the plan are- 

1. The policy is available for 1, 2, or 3 years and can be renewed.
2. The insured sum is available in the form of an individual and a floater sum basis.
3. All daycare procedures are covered.
4. The fees of the surgeon, medical practitioner, consultation, and specialist cover up to 25% of the sum insured per hospitalisation.
5. There is no third-party administrator.

Oriental Insurance Happy Family Floater

Another health insurance policy that provides coverage against cataracts is the Happy Family Floater Plan offered by Oriental Insurance. Some of the reasons why the Happy Family Floater Plan would be a good fit for senior citizens include: 

1. The maximum entry age is 65 years.
2. The term of the policy is 1 year and can be renewed for life.
3. A premium of 5.5 % is charged if TPA services are not opted for.

SBI General Retail Health Insurance

Another health insurance plan option is the SBI Retail Health Insurance Policy provided by SBI General. The basic features of the plan are mentioned below- 

1. The maximum age of entry is 65 years.
2. The sum insured ranges from Rs 50,000 to Rs 5 lakh.
3. The policy term is one year.
4. The policyholder will get a bonus of 5% of the SI

HDFC Ergo Optima Senior 

The Optima senior plan of HDFC Ergo Health Insurance provides coverage against cataracts for senior citizens above the age of 61 years. The following are the benefits of this plan: 

1. It is exclusively for senior citizens.
2. The expenses of in-patient hospitalisation will be covered for more than 24 hours.
3. Cumulative bonus of 5% for every claim-free policy
4. The sum insured can be increased only at the time of renewal.

Bajaj Allianz Health Guard

Bajaj Allianz's health guard plan offers cataract coverage and includes the following benefits:--

1. The policy is renewable for a lifetime.
2. The policy can be taken for 1, 2, or 3 years.
3. The in-patient hospitalisation coverage includes surgeons, medical expenses, and consultant and specialist expenses.
4. Daycare procedures are included in the coverage.
5. The sub-limit per eye is 20 % of the sum insured

Conclusion

With a variety of health insurance plans available, one must take enough time to decide what to avail of. These companies have their terms and conditions. So, select a cataract surgery coverage plan that meets your requirements.

FAQs

1. Is Cataract Surgery Covered under Health Insurance?

Yes, cataract surgery is covered under certain health insurance plans in India. These plans typically have specific criteria such as a waiting period of 2 years and coverage for expenses ranging from Rs. 15,000 to 35,000.

2. Which Health Insurance Plans Cover Cataract Surgery in India?

Several health insurance companies offer coverage for cataract surgery in India. Some notable options include ICICI Lombard Complete Health Insurance, Care Health Freedom, Star Health Senior Citizen Red Carpet, Oriental Insurance Happy Family Floater, SBI General Retail Health Insurance, HDFC Ergo Optima Senior, and Bajaj Allianz Health Guard.

3. What are the Benefits of ICICI Lombard Complete Health Insurance for Cataract Surgery?

ICICI Lombard's Complete Health Insurance plan offers cashless hospitalisation and maximum tax benefits of up to Rs. 15,000. This plan can be purchased after the age of 18.

4. Can Senior Citizens Get Coverage for Cataract Surgery under Care Health Freedom Insurance?

Yes, Care Health Freedom Insurance is designed for senior citizens aged 60 and above and covers cataract treatment. It includes benefits like 100% restoration, ICU coverage, and pre and post-hospitalisation expenses.

5. What are the Key Features of Star Health Senior Citizen Red Carpet Insurance for Cataract Coverage?

Star Health Senior Citizen Red Carpet policy is available for individuals aged 18 and above. It offers flexible policy durations (1, 2, or 3 years), covers daycare procedures, and includes surgeon and specialist fees up to 25% of the sum insured per hospitalisation.

6. Does HDFC Ergo Optima Senior Provide Coverage for Cataract Surgery for Senior Citizens?

Yes, HDFC Ergo Optima Senior is exclusively for senior citizens aged 61 and above, and it covers cataract surgery. It includes benefits such as coverage for in-patient hospitalisation expenses and a cumulative bonus for claim-free policies.