Ultimate Guide: Insurance Coverage for Cataract Surgery

If you or any of your family members are experiencing a hazy vision and are above the age of 50, it is most probably due to a cataract. As age increases, the chances of a cataract increase. But what exactly is a cataract? A cataract is a condition of the eye that is caused by a dense cloud forming in the eye’s lens. It is common in elderly individuals, and if untreated, leads to the depletion of vision and even blindness in extremes. Not just age, but even injuries to the eye are a reason for its formation. Performing a surgical procedure is essential to ensure that the vision remains unaffected.

The reasons for cataract formation

Cataracts aren't formed due to only one reason in particular. Although it is commonly observed in the age group above 50 years, overproduction of oxidants, smoking, exposure to ultraviolet radiation, prolonged use of steroids and other medicines, diabetes, injury to the eye, and radiation therapy are some reasons why cataract formation occurs.

What are some symptoms to identify cataract formation?

The most common reason why people undergo check-ups is hazy vision. Blurry vision is the primary symptom of a cataract. Followed by it, trouble in vision during the night, faded colors, increased sensitivity to glares of light, halo formation around a light, double vision, and frequent change of prescription glasses are some reasons how you can identify the formation of a cataract.

Is cataract surgery covered by medical insurance?

Yes, health insurance companies offer coverage for cataract treatments. However, just like the standard policy terms define a waiting period in health insurance, similarly, insurers levy a waiting period before such policy coverage is effective for cataract treatment. This duration is generally 24 months but may vary according to the insurance policy’s terms.*

Why is it important to seek health insurance coverage for cataract surgery?

With the rising cost of medical treatment, even a small medical procedure can put a dent in your bank account. While there is no natural cure for a cataract, as confirmed by a 2017 review of studies published by the National Institute of Health, it is essential to get operated on via a surgical procedure. Moreover, the treatment cost of a cataract starts at ₹40,000 for phacoemulsification, which is a conventional method of treatment. The modern-day bladeless treatments cost between ₹85,000 to ₹1.20 lakhs. To bear such high treatment costs may not be possible always and online health insurance sought for its treatment can serve as a financial backup.*

Why is it essential to get operated on for cataracts?

Cataract surgery is recommended as it helps in the following ways:

• Restores clear vision: With cataract surgery, any blurriness in your vision can be restored to normal. With the advancement in medical science, the treatment takes not more than an hour, and thus, no admission to a hospital is required. The treatment is classified as a day-care procedure.
• Avoids complete loss of vision: A cataract surgery helps to prevent the loss of your eyesight, thereby avoiding a complete or even partial loss of vision.
• Enhances the quality of life: Since vision is one of the critical sensory cues, treating a cataract helps to restore the quality of life.

These are some of the different points to know about health insurance coverage for cataract surgery. Plans such as individual/family health insurance, senior citizen policy as well as the Arogya Sanjeevani policy cover cataract surgery. Make sure to select a plan that provides comprehensive coverage with an adequate sum insured for optimal financial security.   *Standard T&C Apply Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read the sales brochure/policy wording carefully before concluding a sale.