Cataract Surgery Health Insurance

Cataract is one of the common disorders in India. It is known to cloud the vision by forming a layer. This extra layer develops over time and thus becomes prominent in old age. People over the age of 50 generally have to undergo cataract surgery. According to the National Centre of Biotechnology Information, cataract has been reported to be responsible for 50-80% of the bilaterally blind in India. Hence, it is imperative that every individual suffering from cataract gets it operated.

 

Here’s why getting financial backing, therefore , becomes important:

• Cataract has No Natural Cure

If you think you can try a zillion home remedies to get rid of the cataract in your eyes, you are totally wrong. You cannot reverse cataracts without surgery. This means, you cannot avoid the surgery to avoid the cost.

• Waiting Period

Most health insurance plans with a cataract cover have a waiting period of 2 years. It means, you will have to wait for 2 years after purchasing the policy to avail this benefit. The waiting period in health insurance is added to the policy to ensure that policyholders do not buy health insurance just to undergo a certain treatment or surgery. Hence, buying a health insurance plan with cataract coverage at a young age can help you claim reimbursement.

Important Update (Dated May 30, 2024) – Good news for Health Insurance policyholders! According to the Master Circular on Health Insurance Business 29052024 rolled out on May 29, 2024 by IRDAI, insurers are to decide on the request for cashless claims within 1 hour of receiving the request. Also, the final claim is to be granted within 3 hours after the policyholder’s discharge from the hospital. Insurers have been directed by IRDAI to establish necessary systems and procedures for this process by July 31, 2024.

 

The Master Circular on Health Insurance Business 29052024 circular is available here - https://irdai.gov.in/document-detail?documentId=4942918

Though ophthalmologists are exploring alternatives, surgery is the only option to treat cataract as of now. It can help you steer clear of any repercussions arising out of the worsening of your cataracts. Here are a few reasons you must undergo the surgery if you are diagnosed with this eye condition:

• Restores Vision

Cataract surgeries help you restore your vision without any side effects. Thanks to medical advancements, the procedure takes not more than 30 minutes. There is no hospitalisation required for observation, however, you need to take rest as per the doctor's recommendation.

• Prevents Partial or Complete Blindness

Untreated cataracts can worsen the symptoms, leading to partial or complete blindness. Hence, it's always best to undergo the surgery before the condition aggravates.

• Improves the Quality of Life

If you suffer from cataracts, you know that life suddenly turns blurred. Performing random activities like reading a newspaper, crossing roads at night, watching television, etc., can get challenging. Undergoing a cataract operation enhances the quality of vision. It helps you lead a quality life without being dependent on anyone.

In India, cataracts are common among people over 40 years of age. The condition generally declines with age. Cataract surgeries can cost anywhere between ₹35,000 to ₹85,000. The most common type of cataract surgery is phacoemulsification cataract surgery. However, there are also different types of surgeries for this condition. You will have to go for the one your doctor recommends. The cost of cataract surgery in India varies depending on the type. Check out the below table to explore the common types and their costs:

Note: The above costs can vary from city to city and hospital to hospital.

Now that you know the purpose and cost of cataract surgery, let’s further understand how to buy cataract cover in health insurance:

 

Step 1: Head over to our ‘health insurance premium calculator’ page.

 

Step 2: Provide the necessary details about whom you wish to insure, along with your personal information.

 

Step 3: Pick from the list of available health insurance plans. Opt for cataract surgery insurance coverage and other preferred add-on covers.

 

Step 4: Upload important documents and make your health insurance premium payment online.

 

Step 5: And that’s it! Your policy will be sent to you shortly via email.

You can claim the cost of undergoing cataract surgery in the following ways:

• Reimbursement Claims

To file reimbursement claims, follow the below steps:

 

1. Inform your insurance company about the hospitalisation. This is usually done via either a toll-free number or through their website.

2. Pay the medical bills post discharge.

3. Submit important documents like original bills and receipts to your insurer for reimbursement.

4. After verification, your claim amount will be reimbursed.

• Filing Cashless Claims

Here’s a step-by-step guide to raising cashless claims:

 

1. Ensure you visit a network hospital.

2. Inform your insurance company about the hospitalisation and register the claim via a toll-free number or through their website.

3. Once the treatment is done and you are discharged, your insurer will verify your case and settle the bill with the hospital.

Cataract is a common condition people develop after entering their 40s. Hence, it is imperative that you have cataract covered under insurance. Depending on the type of surgery your condition requires, the cost can go anywhere from ₹40,000 to ₹1,20,000. So, do not delay any further and check out the range of health insurance plans and cataract coverage available on Bajaj Markets. We have different types of add-on covers and policies from multiple leading insurers in store for you.