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Is Cataract Surgery Covered Under Health Insurance?

Published On Jun 07, 2021, Updated On Jul 02, 2021

A cataract health insurance is general health insurance that covers the cost of treatment of cataracts, which is a common eye condition faced in old age, or might get triggered due to injuries. In this condition, there is a formation of dense and cloudy areas in the lens of an eye. This medical condition is primarily common among people of old age, and if not treated can lead to partial or complete blindness. 

Is Cataract Surgery Included Under Health Insurance?

Yes, under certain provisions, the cost of cataract surgery is included under health insurance. There are a few health insurance policies that do not offer this service, hence you must read all the policy-related terms beforehand. It is preferably better to choose a senior citizen plan if the patient is in its late adulthood. 

Why Do We Need Insurance For Cataracts?

Having health insurance for cataracts can save you a huge sum of money. Also, it is considered to be a risky surgery. Therefore, you should have health insurance for cataract surgery because: 

1. Cataract surgeries are slightly off the budget and are expensive. The conventional charge of cataract surgery costs around Rs. 40,000 for an eye and the case of new bladeless surgery, the cost ranges from Rs. 85,000 to Rs. 1.2 Lakhs. 

2. According to medical experts, there is no natural cure for cataracts. The only way to cure cataracts is through surgery, which has certain risk factors like:

3. In India, the average age of contracting cataracts is 50 years while in the US and Europe it is 70+ years. 

Risk Factors Involved In A Cataract Surgery

The rate of contracting cataracts is higher these days, and almost everyone contracted to it has to undergo surgery. But, certain pre-existing conditions in humans, increase the risk of the surgery. These conditions include:

  • Increasing age 
  • Obesity 
  • High blood pressure
  • Heavy consumption of alcohol and tobacco products
  • Eye  injuries
  • Diabetes
  • Exposure to radiations from X-rays and cancer treatments 

Therefore, these risks might increase the cost of treatment, for which we must have insurance, else it might cost you a fortune. 

Why Is It Important To Have Surgery For Cataracts?

The cost of treatment for cataracts is unavoidable in many ways. There is no escape to this loophole, as in the case of ignorance, it might lead to serious repercussions. It is important to have cataract surgery done on time, because:

  • There is no natural cure for cataracts and the only way to get back a normal vision is through surgery. 
  • If not treated for long, cataracts can lead to temporary or permanent blindness of an individual. 
  • Successful surgery of cataracts restores normal vision with no aid instrument required. People can continue living their normal lives. 
  • Cataract surgery improves the quality of life. The very thought of getting stuck with an improper vision is in itself a nightmare, therefore, it is evident for ensuring the smooth functioning of our lives. 

Terms And Conditions Involved In Availing The Benefits of Health Insurance For Cataracts

It is important as well as beneficial to have health insurance for cataract surgeries, but certain terms and conditions are to be kept in mind for availing of the available services:

1. Waiting period

Mostly the health insurance policies with cataract coverage come with a minimum waiting period of 2 years starting the date of the policy, to avail the services. This clause is included in the policies to ensure that the insurance is not taken for the sole purpose of cataract surgery. 

2. Claim amount limit

There is a limit on the amount that can be claimed for cataract surgery. Any additional expenses incurred by the policyholders have to be met on their own. The claim amount differs from one insurer to the other. 

3. No coverage for pre and post-operative care

Under this condition, the amount for facilities required before or after the operation like the medication, eye drops, spectacles, etc is not covered in the policy. 

4. The extent of coverage

Some insurers provide the policy claim for the surgery of one eye while many cover the charges required in treating both eyes. This detail has to be checked thoroughly before buying the policy. There are high chances of contracting a cataract in the other eye when one is already prone to it. 

Conclusion

There are various facilities and services available to insurers. Therefore, while purchasing the health insurance policy, you must check the terms and conditions along with the offerings, with utmost care. However, as observed above, one should not be ignorant towards buying a health insurance policy. 

Read More: 

How to Get Vaccinated for Covid-19?

Things to Know About Life After Recovering From COVID-19

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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