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Is Catarct Surgery Covered Under Health Insurance

Posted On : 08 April 2021, 3 Years Ago. Health-Insurance Total Read 2794

Is cataract surgery covered by insurance

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Eyes allow us to see the world in its various hues and shades. They paint a picture before us of what's there. The need to take proper care of eyes cannot be overstated. There are various eye-conditions that develop either as a result of old age or medical conditions, which require medical treatment. This is where comprehensive and affordable health insurance gets into the picture.

Cataract is an eye condition in which the eye lens gets hazy, and vision is impaired. Cataract is an old-age disease that commonly occurs after the age of 60, and it requires surgery. As per estimates by the WHO, more than 65% Indians over the age of 60 have had cataract. Since the cost of surgery can be costly, a cataract insurance coverage can help save on the bill and ensure quality treatment as well. While opting for a cataract health insurance, it’s important to check for what’s covered and the options provided.

Cataract Insurance Coverage

These are the following factors that need to be evaluated before buying a cataract insurance coverage:

Waiting Period

Normally, the minimum waiting period in case of cataract insurance coverage is 2 years, so it's advised to buy the insurance plan well in advance. The waiting window exists because cataract is a pre-planned surgery that normally doesn’t require immediate hospitalization. Before the prespecified time lapses, you cannot make an insurance claim for reimbursement.

Claim Limit

There's a certain cap on the claim that can be made in the case of cataract surgery. Maximum amount that can be claimed under cataract insurance coverage is mostly a percentage of the insured sum. However, there are also health insurance policies without any claim limit where the patient is entitled to complete claim of the cataract surgery expense. While selecting the health insurance plan, look for this carefully, and choose the plan that provides the maximum claim amount.

Pre-and-Post Surgery Expense

After cataract surgery, eye drops, medications, special glasses are needed. These are usually not covered by the insurance company and the expense will have to be borne by the patient. It needs to be kept in mind that while the cataract surgery expense is covered under the health insurance plan, but post-surgery expenses or the bill of accessories like glasses, eye medicines etc. is not included at all.

Coverage Range

Cataract usually occurs in one eye, but in certain cases it can affect both the eyes. Most cataract insurance coverage policies only provide cover treatment only for one eye, so while buying the policy, carefully check for the options and coverage available for treatment of both the eyes, if need be. It's always better to pick up the insurance plan that covers everything related to a particular disease and provides lots of benefits.

What are Cataract Symptoms?

Some of the common cataract symptoms include:

Blurred eyesight
Impaired night vision
Heightened brightness sensitivity
Double vision
Colours appear to be faded
Spectacle number changes frequently

When is the Need for Surgery?

Cataract is diagnosed via tests like slit-lamp test, visual acuity test and dilated eye test. Since cataract cannot be treated without surgical intervention, doctors recommend surgery if cataract is detected. Though there may be cases where cataract is not impairing the vision and there are no symptoms as well. In these rare cases, surgery may not be required as cataract is not causing any trouble. In severe cases, and if not operated timely, cataract can lead to inflammation and conditions like glaucoma.

How is Cataract Treated?

The only way to treat cataract is through surgery. There are two most common surgeries: Phacoemulsification (Phaco) and Extracapsular cataract extraction (ECCE). These days laser treatment surgery is also increasingly being used. The whole surgery takes about 40 minutes and at a time, only one eye is operated. If there's cataract in both the eyes, then the second eye is operated only after the recovery of the first eye.

Ways to Prevent Cataract

While cataract is an age-related disorder, there are certain ways using which it can be prevented:

Reduce UV exposure and wear sunglasses while venturing outside
Undergo regular eye check-up
Eat diet that's rich in antioxidants
Go for regular healthcare check-ups to diagnose any disease that increases the risk of cataract
Quit smoking

Cataract Surgery Cost

Cost of a cataract surgery depends on factors like health facility, lens type and surgical procedure used. The cost can vary depending on the city too, though usually it falls in the range of Rs. 10,000 - Rs, 1 Lakhs. Advanced treatment further adds to the cost. Due to modern medical facilities, cataract is a surgery with a high success rate. Most patients are discharged from the hospital within the same day of surgery. It’s important to select a health insurance plan that's affordable, offers a good cover limit and covers related expenses as well.

Conclusion

Cataract is a widespread eye disorder that’s generally associated with old age. There’s no way to treat it other than surgery. This is where the importance of health insurance springs up, as surgeries are usually costly and need to be planned in advance.

Clouded vision, reduced night vision, blurred eyesight are some of the common cataract symptoms. If you observe any of these symptoms, consult a doctor and go for an eye check-up. Cataract can be prevented by cutting down on smoking, eating antioxidant rich diet and wearing sunglasses while venturing out. It’s best to buy cataract insurance coverage in advance so that when the need arises you can avail the benefit of it. While choosing the health insurance plan that best suits you, patiently go through all the terms & conditions. Buy affordable health insurance coverage for elders in your family and help protect their eyes.

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