Is Cataract Surgery Covered by Health Insurance?

Your Guide to Cataract Surgery Coverage in Health Insurance

What Is a Cataract?

A Cataract is a clouding of the lens in the eye, which is caused by protein buildup in the body. Finally, this leads to reduced vision and loss of sight if left untreated. Cataracts can be surgically removed through a Day Care procedure that restores vision.

Is cataract surgery covered by health-insurance?

Yes, several health insurance plans in India cover the cost of cataract surgeries. However, they often possess a claim limit and a waiting period, besides other specifications.

Is cataract surgery covered by private health insurance? 

Yes, in general, cataract surgery is covered by some private health insurances in India, but their coverage varies between policies. Many health insurances cover cataract surgery following a waiting period of 1 or 2 years. 

What health insurance covers cataract surgery?

Many health insurance plans cover cataract surgery. In some cases, you may know which insurance cover cataract surgery, but you lag in finding the best one. However, for selecting a health insurance policy for cataract surgery, you can consider things such as: 

• Coverage limits per eye.
• Coverage limits per policy period. 
• Network hospital options.
• Waiting period for pre-existing illnesses.
• Insurer's credibility
• Sum insured that determines the coverage limits.
• Service quotient 

Check what insurance covers cataract surgery considering all these factors before you buy a suitable one. 

Does Mediclaim cover Cataract Surgery?

A few mediclaim policies cover cataract surgery, but not all. The cataract surgery insurance coverage in India is needed for people with:

• Diabetes
• Family history of cataract
• Hypertension
• Excessive exposure to UV rays or ionizing radiation (such as cancer radiation therapy, X-rays, etc.)
• Excessive smoking and drinking
• Eye injury, inflammation, or surgery
• Vitamin deficiency
• Long-term consumption of corticosteroid medicines

How is cataract surgery covered by insurance?

Mostly, the health insurance covers cataract surgery following a waiting period of 1 or 2 years. The cataract surgery covered by insurance mainly depends on the below factors:

• Coverage
• Waiting period
• Policy terms
• Add-ons
• Claim process
• Cost

During the time you choose a health insurance plan, you may find an answer to the question: Is cataract surgery covered in health insurance? At that time, also check the above factors concerned with the cataract surgery insurance.

Does insurance cover cataract surgery in India? Is cataract surgery covered by insurance in India?

Yes, many health insurance policies in India cover cataract surgery. But, their coverage can differ, so review your policy documents or consult a health insurance calculator before you choose them.

Types of Cataract

There are three primary types of Cataracts:

1. Nuclear Sclerotic Cataracts – This type of Cataract progresses slowly and takes several years of gradual development before it begins to affect vision.
2. Cortical Cataracts – People with Diabetes are at risk for developing cortical Cataracts.
3. Posterior Subcapsular Cataracts – People who use steroids, Diabetic, extreme nearsightedness and/or Retinitis Pigmentosa may develop this type of Cataract.
    

Signs of having Cataracts

You may encounter the following symptoms:

• Your vision is cloudy or blurry.
• Colours look faded.
• You can’t see well at night.
• Lamps, sunlight or headlights seem too bright.
• You see a halo around lights.
• You experience double vision (this sometimes goes away as the Cataract gets bigger)
• Consult with your ophthalmologist periodically for power correction and change your glasses if needed.
   

Cataract risk factors

Some risk factors influencing the development of the disease can be,

• Ageing
• Diabetes (Cataracts can form earlier if you have Diabetes)
• Family history of Cataracts at a young age
• Years of excessive exposure to the sun and UV rays
• Smoking
• Obesity
• High blood pressure
• Past eye injury or inflammation
• Previous eye surgery
• Steroid medication use
   

Ways to prevent your Cataracts from getting worse

Here are some ways to prevent your Cataracts from progressing,

• Have regular eye exams.
• Watch your blood sugar levels if you have Diabetes.
• Quit smoking.
• Reduce alcohol consumption.
• Eat a balanced diet and foods containing antioxidants.
• Wear sunglasses.
   

Diagnosis of Cataracts

Your doctor will examine your eyes and analyse your medical history and symptoms to see if you have a Cataract. Your doctor may conduct several tests – Visual acuity test, Slit-lamp examination, Retinal exam and Applanation tonometry.

Treatment of Cataract

According to 2017 review of studies published by the National Institutes of Health, the only available treatment for Cataracts remains surgery.

When can you have the Cataract surgery?

The right time for Cataract surgery is when your Cataracts interfere with your quality of life and glasses and/or contact lenses no longer satisfy your visual needs.

How much does Cataract Surgery cost in India? 

The average Cataract surgery cost in India varies depending on the location, types of lens implanted and surgical procedures involved. The surgery costs may range from Rs. 10,000 to Rs. 1,00,000. If undergoing surgery in metropolitan cities, the costs may be higher.

Cataract surgeries involving advanced techniques are often costed higher. Post-operative medications and care can add up to the sum.

Why do you need to buy Health Insurance for Cataract Surgery in India?

Over time, Cataracts become worse and interfere with vision. Cataracts occur not only in old-aged adults but in younger people, too. Injury, certain medications and genetic conditions can result in Cataracts among youngsters.
There is no natural cure for Cataracts apart from surgical treatments. Moreover, untreated Cataracts can end up with partial or complete blindness. Cataract surgery successfully restores vision without any side effects.

Savings are essential for everyone, regardless of earnings, spending patterns or stages of life. Health Insurance policies with Cataract coverage can help you save your lifetime savings. Reputed insurers offer Health Insurance policies which cover the cost of Cataract surgeries under their affordable health plans. Some insurers cover Cataract treatment under specific diseases category after certain waiting periods.

If you purchase a Health Insurance Policy with Cataract coverage when you are young, you can claim the Cataract coverage in the later stages of your life if needed. However, before availing a Health Insurance policy, read the terms and conditions related to the coverage.

Star Health Insurance offers Senior Citizen Red Carpet Insurance Policy, which takes care of the healthcare needs of senior citizens in the age group of 60 to 75 years. This plan covers Cataract surgery up to specific limits based on Sum Insured options.

Star Comprehensive Insurance Policy and Star Health Premier Insurance Policy also cover the cost of a Cataract treatment up to the limits mentioned in the policy. For more information on the coverage, read the policy wordings and clauses.

Conclusion

A Cataract is one of the most common eye surgeries undertaken by many individuals. A Health Insurance plan with extended coverage can easily get your vision back without having to spend much out-of-pocket. Knowing the terms and conditions of the policies, you can take a selected Health Insurance plan for your Cataract surgery.

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