Black, brown, green, gray or blue..whatever the colour, our eyes are considered our most valuable asset. Often called the ‘windows to the soul’ by the more poetically inclined, our eyes are vital in perceiving the world around us. And like any precious asset, we protect them behind UV sunglasses and under hats to ensure they are functioning optimally. However, ageing is the one weapon against which we have no protection. The ageing process leads to certain conditions like far sightedness, which can be corrected with prescription glasses, and the more serious ailment referred to as a cataract.
Cataract operations tend to afflict individuals health insurance in the prime of their life and are sometimes a last resort in an effort to ensure the individual can see. A clouding of the lens in the eye characterises a cataract, which is generally brought on by age, but could be exacerbated by smoking, prolonged exposure to the sun and diseases like diabetes.
And like most surgeries, cataract operations come with a hefty price tag. While the price has come down thanks to advances in surgical sciences, an average cataract surgery for a single eyes can set you back by as much as Rs.30,000. Depending on the type of lens selected, this could go up to as much as Rs.50,000 per eye. Factor in post-operative care like prescription eye-drops and this could rise to quite a sum.
With a host of payments to make in the prime of one’s life, having to shell out for a cataract surgery is often an added burden. To save you from paying a lakh to restore vision to your eyes are health insurance companies, who now cover the cost of cataract surgeries under their health plans.
Health Cover For Cataract Operations:
Insurance companies cover cataract operations under their policies, subject to certain terms as mentioned below:
Waiting Period - insurance companies that cover cataract operations have a waiting period of around 2 years before a claim relating to a cataract surgery will be settled. Insurers take this step in order to protect themselves from policyholders whose only reason for taking the health insurance policy is to fund the cost of a cataract operation.
Limit on Claim Amount - in cases where policyholders choose an expensive lens, insurance companies do not want to go out of pocket due to cataract surgery reimbursements. For this reason, they have a limit on the amount that can be claimed as reimbursement for a cataract surgery. Insurers have different limits on the amount that can be claimed towards cataract surgery. For example, Apollo Munich does not have any limit while Bajaj Allianz has a limit of either 10% of the Sum Assured or Rs.35,000, whichever is lower.
Pre and post-operative care in the form of special glasses, medication etc. is not covered by the insurance policies in the market at present, so policyholders will have to pay for these on their own.
So if you require a cataract surgery in the near future, rest assured that your health insurance provider will cover a portion of the cost.
GST rate of 18% applicable for all financial services effective July 1, 2017.
Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.