Health insurance for cataract in India 

Cataract is one of the most common eye surgeries undertaken in India. As stated in a study, around 74% of adults in India who are more than 60 years have cataract or have undertaken a cataract surgery. The average cost of a cataract surgery can be anywhere between Rs.15,000 to Rs.65,000. Several health insurance companies in India offers coverage for cataract treatments at an affordable rate of premium. A cataract insurance offers minimum Rs.20,000 coverage per eye which can go up to Rs.35,000 or more. A cataract coverage can be availed after a waiting period of 2 years.

Cost of cataract surgery in India

Like other surgeries, cataract surgeries are also a costly affair, especially when done from a reputable hospital in a metropolitan city. While average cataract surgeries for a single eye ranges between Rs.15,000 to Rs.30,000, surgeries that include advanced techniques requires a higher amount. Depending on the advanced treatment and the type of lens selected, the cost can go up to Rs.60,000 for each eye. Post-operative care such as prescription eye drops, and other medicines also add to the sum.

Health insurance coverage for cataract treatment

A health insurance plan with cataract coverage can help you save a huge amount of money in the prime of your life. Reputed health insurance companies offer health insurance scheme which cover the cost of cataract surgeries under their health plans. However, before availing a health insurance policy keep in mind the following terms and condition related to the coverage:

Waiting period:

Most of the health insurance plans with cataract coverage comes with a waiting period of 2 years. This means the policyholders will have to wait for 2 years after the date of policy purchase to avail their cataract coverage. Insurers include this clause in the policy terms to make sure that policyholders shouldn't take a health insurance policy only to meet the expenses of their cataract operation. However, if you buy a health insurance policy with cataract coverage when you are young, you can claim the cataract coverage in the later stages of your life whenever required.

Limit on claim amount:

There is a limit on the amount that can be claimed by the policyholders as reimbursement for a cataract surgery under their health insurance cover. Any additional expenses incurred by the policyholders over the specific sub-limit should be paid on their own. However, the limit in claim amount is not the same across various insurers. Even there are insurers who don't have any limit on the claim amount and pay for the full expense incurred during a cataract surgery. Hence, while buying a health insurance policy keep in mind that you may not be able to avail the full sum insured amount for your cataract surgery. If you want your insurance policy to cover the entire cost of cataract treatment opt for health covers that don't have any specific sub-limit.

No coverage for pre and post-operative care:

The cost of after surgery care which include special glasses, eye drops, medications etc. are not covered by the Health insurance policies for cataract as of now. This means the insurance company will not pay for these expenses and you will have to bear the cost on your own.

Extent of coverage:

A person having cataract in one eye is prone to getting affected by cataract in the second eye. However, the health insurance policy that you are planning to purchase mightn't have the coverage for cataract treatment of both the eyes. Hence, it is important to check the extent of cataract coverage in a specific health insurance plan before buying it. You must also check the other provisions available for treatment of both the eyes.

Health insurance plans in India with cataract coverage

Here are some of the popular health insurance plans from reputed health insurance providers in India which offer cataract coverage:

Insurance Company Plan Waiting period for cataract treatment Admissible claim limit
ICICI Lombard Complete Health Insurance 2 years Up to Rs.20,000 per eye
Religare Health Insurance Care Care Freedom (Senior Citizens) 2 years No sub-limit
Star Health Insurance Senior Citizens Red Carpet Policy 2 years Up to Rs.25,000 (varies based on chosen sum insured)
Oriental Insurance Happy Family Floater 2 years No sub-limit
SBI General Health Insurance 2 years Up to 15% of sum insured subject to a maximum of Rs.25,000 per eye
Apollo Munich Health Insurance Optima Senior 2 years No sub-limit
Bajaj Allianz Health Guard 2 years Up to 10% of the sum insured subject to a maximum of Rs.35,000

Since most of the health insurance policies come for the same waiting period for cataract treatment consider the limit of admissible claim before zeroing your search in on a specific policy. Either choose a plan that has the highest sub-limit or don't have any limit at all. Remember, a health plan with extended coverage will enable you to restore your vision easily without paying thousands of rupees out of your pocket.

What is cataract and methods of treatment

Cataract is the clouding of the eye lenses due to protein denaturation that impairs clear vison. It is an age-specific eye ailment and mostly affect people who are in the age group of 60 years to 70 years. Time and other factors such as smoking, diabetes, excess exposure to sun or radiation, and eye injury may aggravate the disease. However, as a result of the modern lifestyle cataract is no more limited to people over the age of 60. People above 40 years also get affected, however the percentage is low.

Cataract can be treated only through surgery. There are two different surgical methods to remove cataract, namely Phacoemulsification (Phaco) and Extracapsular cataract extraction (ECCE). Advanced laser technology is also used in cataract surgery at present. Depending on the condition of the eye the surgeon decides which type of surgery to opt for. The cataract surgery is performed on one eye of the patient at a time. After complete recovery of the first eye, surgery on the second eye is done. The procedure takes nearly 30 to 45 minutes to complete.

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