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  • Health Insurance for Cataract in India

    Health Insurance
    • Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
    • 10,000+ hospitals for cashless treatment
    • Claim up to Rs. 55,000 deduction under section 80D**

    According to a study, nearly 74% of all adults over the age of 60 in India have cataract or undertaken surgery for that. Cataract refers to the clouding of eye lens that interferes with vision. If left untreated, cataract can lead to blindness. Cataract is more common among the elderly population than the youth. The only way to treat cataract is through surgery. Advancements in medicine have made it possible to use laser technology for cataract surgery. However, the cost of surgical treatment can be expensive if advanced techniques are used in the procedure. This is where a health insurance plan with cataract coverage can help you out.

    Coverage for cataract treatment

    The terms of coverage for cataract may vary from one insurer to another. There are many health insurance companies in the market that provide coverage for cataract. However, there are some plans that exclude cataract from the list of covered illnesses. You must read the policy document carefully to know whether cataract coverage is offered by your health insurance plan. Cataract surgery is likely to cost Rs.30,000 to Rs.50,000 for a single eye in a reputed hospital in a major city. Before providing coverage for cataract treatment, a health insurer may set forth certain conditions.

    Things to note in health insurance plans

    As noted, more and more health insurers in the market have started providing coverage for cataract treatments. With the increase in lifestyle-related diseases, it is not uncommon for someone in their 40s or 50s to get cataract. Health insurers are aware of this fact. Hence, they provide coverage for cataract only upon satisfaction of certain terms and conditions.

    • Waiting period: Most of the health insurers in the market have disease-specific waiting periods for certain conditions. Typically, most insurance companies provide cataract coverage after a waiting period of 2 years. The waiting period clause is mainly used by insurers to discourage people from taking insurance just for the purpose of cataract surgery. If you enter a health insurance cover at a young age, you will not have any issues getting coverage for cataract surgery.
    • Sub-limit: For cataract treatments, the full sum insured amount of a health insurance policy may not be available. Specific sub-limits are set for cataract treatments in most health insurance covers. Any additional expenses incurred for cataract treatment must be paid from one’s own hand. Though not common, there are some health insurance plans that do not have any specific sub-limit for this treatment. If cataract treatment is a major requirement for you, you must choose your health insurance cover accordingly.
    • Extent of coverage: Cataract is not a disease that spreads from one eye to another. However, if you have cataract in one eye, there is an increased possibility of getting cataract in the other eye also. Hence, it is better to check whether the sub-limit available for cataract treatment is available for each eye. Also, check for any other provisions when it comes to getting treatment for both eyes.

    Cataract coverage in group insurance plans

    One of the advantages of employer-provided group insurance plans is that there will be no waiting period for any pre-existing conditions. Even for conditions like cataract, treatment benefits are offered immediately without any waiting period. Moreover, there may not be any sub-limit when cataract is covered by a group insurance policy. If you wish to know whether your group insurance covers cataract, you must check the policy document or contact the service provider and enquire about it.

    Health insurance plans that offer cataract coverage

    Some of the health insurance plans that offer cataract coverage can be listed as follows:

    Insurer name Plan name Waiting period >Extent of coverage
    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

    These are some of the health insurance plans in the market that offer coverage for cataract surgery. In addition to the ones listed here, cataract coverage is offered by many service providers in the industry. If you think you need protection for cataract, you must verify its availability before you subscribe for a policy cover.

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