Cataract Surgery Coverage by Star Health Insurance - Plans & Eligibility

Cataract development is one of the most common eye-related issues in the entire world and especially in elderly people. Generally, it leads to making the inside natural lens of the eye cloudy, which affects vision and can end up with blindness if not treated properly. Fortunately, surgical replacement of cataracts is considered a routine and effective operation. Costs associated with such treatment may be quite high, though. Here is when health insurance comes to the rescue. The company, Star Health Insurance, provides comprehensive cover options for cataract surgery so that the financial load on you is least while you secure your vision.

In this article, we are going to find out the importance of health insurance for cataract surgery, key features of Star Health Insurance policy, and how Star Health covers this essential procedure.

The Importance of Health Insurance for Cataract Surgery

Out-of-pocket expenses, without health insurance, may cost quite a few thousands of rupees for a cataract procedure, and this might depend on the hospital and type of cataract surgery.

Health insurance, therefore, tones down such costs by paying partly or in full for the expenses that include hospitalisation cost, surgical charges, and post-surgical care in cataract surgery. 

Key Features of Star Health Insurance Policies

Star Health Insurance is known for its all inclusive health insurance plans, which have different key features that set them apart from other insurance providers.

• Broad Hospital Network: For hassle-free and cashless claims, Star Health Insurance boasts one of the biggest networks of participating hospitals in the nation.
• No Claim Bonus: Policyholders are eligible for a No Claim Bonus for each year they have no claims, which increases the policy amount over time.
• Cashless Hospitalisation: Star Health Insurance offers cashless hospitalisation services, so you don’t have to worry about prepayment.
• Coverage Before and After Hospitalisation: Covers medical expenses incurred before and after hospitalisation, including doctor consultations, diagnostic tests, and medication.
• Lifetime Renewal Option: Most policies offered by Star Health come with a lifetime renewal option, which ensures you are covered as you age and develop age-related diseases such as cataracts. .

Health Insurance Plans Offered by Star Health Insurance

A variety of health insurance plans are available from Star Health Insurance policies that cover cataract surgery. 

• Star Family Delite Insurance Policy and Star Care Insurance Policy: These policies cover hospitalisation expenses for cataract surgery and post-operative expenses. It's the best option for a family who wants comprehensive coverage at low insurance costs.
• Star Family Health Optima Policy: It is a family floater health policy that covers the cost of cataract surgery, along with other medical exigencies for the covered family members, under a single sum insured amount.
• Diabetes Safe Policy: This policy is specifically designed for diabetic patients and covers some of the complications arising due to diabetes, including cataract surgery.
• Aarogya Sanjeevani Policy: Offers cataract surgery coverage subject to a sub-limit of 25% of the sum insured or ₹40,000, whichever is lower.
• Star Super Surplus (Floater) Insurance: This insurance covers cataract surgery, among other health needs, under a floater plan.
• Star Women Care Insurance: As the very name suggests, it is for women, and the product is designed keeping in mind cataract surgery besides other health benefits required by women.
• Star Smart Health Pro: It provides comprehensive health coverage, including cataract surgery, with modern healthcare needs in mind.

These plans will cover the costs associated with cataract surgery quite well and provide financial protection along with access to all the necessary treatments.

Does Star Health Insurance Include Cataract Surgery Coverage?

Yes, cataract surgery is covered under various plans offered by Star Health Insurance namely Star Family Health Optima, Star Comprehensive Insurance, Star Senior Citizens Red Carpet Health Insurance, Star Super Surplus (Floater) Insurance, Star Women Care Insurance and Star Smart Health Pro. These expenses include the surgery and hospitalisation cost and even expenses thereafter. However, a 2-year waiting period will be applicable, and under certain programs, a sub-limit might apply.

Please refer to your policy documents for detailed information on the coverage limit, or contact the toll-free number of Star Health Insurance at 1800 425 2255 or 1800 102 4477.

Eligibility Criteria For Cataract Surgery Coverage Under Star Health Insurance

In order to receive cataract surgery benefits under Star Health Insurance, you have to meet the following requirements:

• Age: Most Star Health policies provide cover to cataract surgery for people aged above 50 years. The Red Carpet Plan is designed only for senior citizens.
• Waiting Period: Cataract surgery is covered usually after a 2-year waiting period from the commencement date. In case you are a fresh policyholder, you may need some time to run before making your claim for this operation.
• Pre-existing Condition Clause: If this cataract is caused by a pre-existing condition, then such will fall under the coverage of a pre-existing illness clause, and longer waiting periods may apply before its coverage becomes effective.

Details on the Types of Cataract Surgery Covered by Star Health

Star Health Insurance usually covers both covers of phacoemulsification (phaco) and extracapsular cataract extraction (ECCE), the two most common types of cataract surgery. These involve:

• Phacoemulsification (Phaco): This is a modern technique wherein an ultrasound device is used to break up the cataract, with an artificial intraocular lens inserted. Phaco surgery involves less invasion and quick recovery.
• Extracapsular Cataract Extraction: The traditional method involves the removal of the lens in one piece and then replacing it with an artificial lens. This is considered the more invasive operation with a longer recovery period.

Some policies may cover premium lenses, such as multifocal or toric lenses; however, this would be at the discretion of the policy terms.

How to Confirm Your Cataract Surgery Coverage by Star Health Insurance

• Inform Star Health: Intimate them about your surgery by calling their helpline or customer service.
• Upload Documents: You can upload any necessary documents here, such as your doctor's recommendation, to preauthorize it.
• Choose your hospital: Go directly to a network hospital for direct admission and receive cashless treatment there, or pay the full amount in advance at a non-network hospital.
• Follow Claim Process: The laid down claim process should be followed.

Conclusion

Cataract surgery has become an important criterion for retaining clear vision, especially at an advanced age. Whichever the case may be, the ideal health insurance scheme should cover such costs, and that's where Star Health Insurance comes in. Being aware of the features included, the eligible candidates, and types of surgery covered can help an individual make an educated decision about their health policy.

FAQs

Ques 1. What is the waiting period for cataract surgery coverage under Star Health Insurance?

Ans. Most policies have a 2-year waiting period for cataract surgery coverage.

Ques 2. Does Star Health Insurance offer cashless hospitalisation for cataract surgery? 

Ans. Yes, Star Health Insurance offers cashless hospitalisation in its network hospitals for cataract surgery.

Ques 3. Are premium lenses covered under Star Health Insurance?  

Ans. Some policies may cover premium lenses like multifocal or toric lenses, but this is subject to policy terms and conditions.

Ques 4. Is there an age limit for cataract surgery coverage?

Ans. Most policies cover cataract surgery for individuals above 50 years, with specific plans like Red Carpet catering to senior citizens.

Ques 5. Can I claim for cataract surgery in both eyes?

Ans. Yes, you can claim for cataract surgery in both eyes, but certain sub-limits may apply per eye, per year.