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Terms and conditions
Terms and conditions
Certain lifestyle disorders, such as diabetes and hypertension, can cause various other health disorders. Cataracts is one such common disorder in India, which ultimately leads to blindness if left untreated. Hence, to avoid such risks, having a health insurance plan that covers cataract surgery is crucial for safeguarding your vision.
Our eyes are the main organs through which we perceive the outside world, and it is very important to take care of them in all circumstances.
In this article, you will gain a basic understanding of the types of cataract surgeries that are offered in India, the duration of the waiting time before receiving coverage, and the advantages of getting coverage for cataract surgery under your health insurance plan.
A cataract is a disorder of the eyes in which the natural lens of the eye becomes clouded, reducing vision. It can happen at any age due to several causes, such as lifestyle decisions, smoking, diabetes, etc. As you grow older, the risk of having a cataract increases. If left untreated for a longer time, it could lead to permanent vision loss. cataract surgery is a common and effective method of restoring vision which involves replacing the clouded lens with an artificial one.
The National Institutes of Health's 2017 evaluation of research indicates that Surgery is the only option for treating a cataract. Hence, cataract surgery is performed to remove the cataracts and replace them with an artificial lens. The surgery is performed by an ophthalmologist (eye doctor) and it is only recommended to individuals whose contact lenses or glasses cannot are no longer working for their eye problem.
Over the past 20 years, there has been a complete transformation in the technology utilized in cataract surgery. The following are the six primary types of cataract surgery, having a unique process of replacing the lenses.
Types of Surgery | Meaning & Procedure |
Phacoemulsification | In this type of surgery, an ultrasonic handpiece is used inside the internal lens of the eye that has developed a cataract. The cataract is emulsified and then aspirated. |
Extracapsular Cataract Extraction | ECCE is an older technique that requires a bigger incision in the cornea or sclera (the white portion of the eye) than phacoemulsification. |
Laser-Assisted Cataract Eye Surgery | In LACS, the laser splits the cataract and lens capsule and produces precise incisions on the cornea. |
Femtosecond Laser-Assisted Cataract Surgery | In FLACS, the cataract is broken, the lens capsule is removed, and corneal incisions are made with a femtosecond laser. |
Microincision Cataract Surgery | MICS is a kind of cataract surgery that requires a very small incision, typically smaller than 1.8 mm. In less than ten minutes, this minimally invasive technique can be finished. |
Small Incision Cataract Surgery | SICS is an advanced version of ECCE and is regarded as the safest and most effective method for treating cataracts. |
Many of you dealing with eye issues might have wondered, "Is cataract surgery covered by health insurance?" The good news is, YES!!! However, not all insurers offer coverage for cataract surgery, so it’s essential to review the policy's inclusions before making a purchase. Also, be aware of any sub-limits in your health insurance plan. These limits could restrict the amount of coverage you receive for your cataract surgery.
For example, Mrs. Meghna, aged 38, previously purchased a plan that provided cataract surgery coverage under her insurance. Recently, she started experiencing problems with her vision, and after consulting with a Doctor, she was suggested to undergo Cataract surgery. After checking her insurance, she found that it has a copayment, where the insurance provider will only cover 80% of the cost of the surgery, and the remaining 20% will be paid by her.
Therefore, it is essential that you thoroughly read and review the terms and conditions of your plan before purchasing.
The waiting period for cataract surgery often depends on your insurance company. The waiting period is generally 2 years.
But what does the waiting period mean?
The waiting period in health insurance, as the name suggests, is a time period during which you cannot claim any benefits from cataract surgery that is covered by your insurance. Basically, it is the duration you need to wait to use benefits from your health insurance policy.
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There are different types of cataract surgery and each surgery varies in cost. The cost of surgery differs from one person to another depending on what your doctor has recommended, the city you live in, the hospital you pick, the type of cataract, medication and your age.
For example, the cost of robotic cataract surgery in India will differ from that of laser cataract surgery.
On average, considering all the factors, the cost of robotic surgery ranges between ₹15,000 to ₹2,00,000. (4) Below mentioned is the approximate cost for all the types of cataract surgeries in India.
Type of Cataract Surgery | Average Cost of Cataract Surgery per Eye (INR) | |
Phacoemulsification Surgery | 30,000 - 2,15,000 | |
Femtosecond Laser-Assisted Cataract Surgery (FLACS) | 50,000 - 1,60,000 | |
Small Incision Cataract Surgery (SICS) | 15,000 - 30,000 | |
Microincision Cataract Surgery (MICS) | 60,000 - 70,000 |
Disclaimer: The above-mentioned cost is the average cost of different types of cataract surgery. The cost can vary depending on your age, city, hospital, type of lens and medications.
Before purchasing any Health insurance plan, make sure that it covers the Cataract surgery cost. However, even if the insurer is providing you with Cataract coverage, you must remember a few important things that include:
The senior age group is mostly affected and prone to cataracts, but recent data suggests that people above the mid-40s have started experiencing cataracts due to their lifestyle.
The senior age group is mostly affected and prone to cataracts, but recent data suggests that people above the mid-40s have started experiencing cataracts due to their lifestyle.
No, this would depend on different health insurer’s terms and conditions. Always better to check your policy document or ask your insurer to see if it is covered or not. 😊 At Digit, it is covered under Daycare Procedures.
No, this would depend on different health insurer’s terms and conditions. Always better to check your policy document or ask your insurer to see if it is covered or not. 😊 At Digit, it is covered under Daycare Procedures.
Yes, there is a minimum waiting period of 2 years for cataract surgery at Digit since it comes under specific illnesses.
Yes, there is a minimum waiting period of 2 years for cataract surgery at Digit since it comes under specific illnesses.
No, just because you are diabetic doesn’t mean you will get cataracts. However, it’s said that people who are diabetic (especially high levels) are more prone to getting secondary cataracts too.
No, just because you are diabetic doesn’t mean you will get cataracts. However, it’s said that people who are diabetic (especially high levels) are more prone to getting secondary cataracts too.
This would again depend on your health insurer. However, at Digit – cataract surgeries are covered under Daycare Procedures which are included as a default in all our health insurance options.
This would again depend on your health insurer. However, at Digit – cataract surgeries are covered under Daycare Procedures which are included as a default in all our health insurance options.
This primarily depends on your symptoms and current vision quality. For most people with cataract, it is recommended to get a surgery since it is safe and successfully restores quality of vision. However, the surgery can be delayed basis how affected your eyes are currently. All said and done, your eye specialist will be best suited to give you the right recommendation post an eye checkup and examination.
This primarily depends on your symptoms and current vision quality. For most people with cataract, it is recommended to get a surgery since it is safe and successfully restores quality of vision. However, the surgery can be delayed basis how affected your eyes are currently. All said and done, your eye specialist will be best suited to give you the right recommendation post an eye checkup and examination.
Yes, some insurance providers have a cap on the amount you can claim for cataract surgery, whereas in some insurance policies, you can claim the total sum insured. For example, if the cataract claim limit is ₹30,000 for an amount insured of Rs. 4 lakhs, you can only use ₹30,000 for your cataract surgery. So, it is important to carefully review the policy’s coverage and exclusions before purchasing the plan.
Yes, some insurance providers have a cap on the amount you can claim for cataract surgery, whereas in some insurance policies, you can claim the total sum insured. For example, if the cataract claim limit is ₹30,000 for an amount insured of Rs. 4 lakhs, you can only use ₹30,000 for your cataract surgery.
So, it is important to carefully review the policy’s coverage and exclusions before purchasing the plan.
Yes. Considering the high cost of medical treatment and the growing number of people with cataracts in India, you need to have cataract surgery coverage.
Yes. Considering the high cost of medical treatment and the growing number of people with cataracts in India, you need to have cataract surgery coverage.
Yes, you can purchase standalone insurance for cataract surgery and other eye problems. However, it is recommended that you purchase health insurance that provides coverage for cataracts along with other benefits.
Yes, you can purchase standalone insurance for cataract surgery and other eye problems. However, it is recommended that you purchase health insurance that provides coverage for cataracts along with other benefits.
Yes, some insurance providers cover the cost of premium lenses during cataract surgery. However, not all insurance providers cover the cost of premium lenses. Before purchasing any insurance policy, you must thoroughly check and read the documents.
Yes, some insurance providers cover the cost of premium lenses during cataract surgery. However, not all insurance providers cover the cost of premium lenses. Before purchasing any insurance policy, you must thoroughly check and read the documents.
People with vision loss that makes it difficult for them to do daily tasks like driving, reading, or watching TV are usually advised to get cataract surgery. When suggesting cataract surgery, the doctor may also consider other factors, such as age, genetics, high UV exposure, and certain medications.
People with vision loss that makes it difficult for them to do daily tasks like driving, reading, or watching TV are usually advised to get cataract surgery. When suggesting cataract surgery, the doctor may also consider other factors, such as age, genetics, high UV exposure, and certain medications.
Yes, almost all insurance providers have a waiting period for cataract surgery. Most have a waiting period of 1 to 2 years, after which you can claim the amount for your surgery. At Digit, the waiting period is two years, which comes under specific illness coverage.
Yes, almost all insurance providers have a waiting period for cataract surgery. Most have a waiting period of 1 to 2 years, after which you can claim the amount for your surgery. At Digit, the waiting period is two years, which comes under specific illness coverage.
No, not every policy covers cataract surgery. However, Digit provides coverage for cataract surgery in its health insurance under daycare procedures. If you have a policy other than Digit, please ensure that it includes the cost of cataract surgery.
No, not every policy covers cataract surgery. However, Digit provides coverage for cataract surgery in its health insurance under daycare procedures. If you have a policy other than Digit, please ensure that it includes the cost of cataract surgery.
No, not all health insurance covers the cost of pre-operative consultations for cataracts. But Digit provides you coverage for the cost of your pre-operative consultation with the doctor, depending on the number of days you opt for or mention in your policy.
No, not all health insurance covers the cost of pre-operative consultations for cataracts. But Digit provides you coverage for the cost of your pre-operative consultation with the doctor, depending on the number of days you opt for or mention in your policy.
Yes, Digit covers the cost of intraocular lenses (IOLs) only if they are Monofocal. However, Digit does not cover multifocal IOLs.
Yes, Digit covers the cost of intraocular lenses (IOLs) only if they are Monofocal. However, Digit does not cover multifocal IOLs.
Yes, there are some chances that you will have to pay additional out-of-pocket costs associated with cataract surgery. This is because some insurance providers have sub-limits on the total amount you can claim for the cataract surgery. Always check and read the documents to ensure that you are not encountering any additional out-of-pocket costs for cataract surgery.
Yes, there are some chances that you will have to pay additional out-of-pocket costs associated with cataract surgery. This is because some insurance providers have sub-limits on the total amount you can claim for the cataract surgery. Always check and read the documents to ensure that you are not encountering any additional out-of-pocket costs for cataract surgery.
There are several factors you may consider before choosing a health insurance plan for cataract surgery. These factors include: Coverage Benefits Policy Premium Hospital Network Total Sum Insured
There are several factors you may consider before choosing a health insurance plan for cataract surgery. These factors include:
You can get a separate vision insurance plan to cover cataract surgery, but buying health insurance is more advantageous as it comes with additional benefits and coverage that could also cover your overall health.
You can get a separate vision insurance plan to cover cataract surgery, but buying health insurance is more advantageous as it comes with additional benefits and coverage that could also cover your overall health.
Yes, some people are unfortunately more prone to cataracts than others. Some of the risk factors include: Increasing age Heavy alcohol intake Regular smoking Obesity High blood pressure Previous eye injuries Family history of cataracts High sun exposure Diabetes Exposure to radiation from X-rays and cancer treatments
Yes, some people are unfortunately more prone to cataracts than others. Some of the risk factors include:
No, so far, there is no alternative to cataract surgery. Hence, health insurance is essential to cover the expenses incurred due to cataracts so that you don't have to pay any costs yourself.
No, so far, there is no alternative to cataract surgery. Hence, health insurance is essential to cover the expenses incurred due to cataracts so that you don't have to pay any costs yourself.
No, not all health insurance provides coverage for pre- and post-surgery expenses. However, Digit has something more for you. 🙂 At Digit, we cover your pre and post-surgery expenses depending on the policy you have, which includes costs involved in diagnosis, tests, doctor’s consultation, and recovery.
No, not all health insurance provides coverage for pre- and post-surgery expenses. However, Digit has something more for you. 🙂 At Digit, we cover your pre and post-surgery expenses depending on the policy you have, which includes costs involved in diagnosis, tests, doctor’s consultation, and recovery.
No, cataract surgery cannot be performed on both eyes simultaneously. Doctors suggest keeping a week to one-month gap between the surgeries for both eyes. This is done to ensure that your first eye is healed completely and your vision is stabilized before having another surgery.
No, cataract surgery cannot be performed on both eyes simultaneously. Doctors suggest keeping a week to one-month gap between the surgeries for both eyes. This is done to ensure that your first eye is healed completely and your vision is stabilized before having another surgery.
The document requirement depends on the type of claim you are requesting from your company. For Cashless Claim: You are just required to fill out the form given by TPA at the hospital and don't need to submit any document. For Reimbursement: In this, you need to submit your health invoices, medical bills, doctor’s prescriptions and other relevant receipts.
The document requirement depends on the type of claim you are requesting from your company.
Yes, cataracts can be prevented primarily by maintaining your eye health and overall well-being as well. Some of the ways to prevent cataracts include wearing sunglasses in the sun, having a regular eye checkup, eating healthy food, avoiding smoking, maintaining a healthy weight, etc.
Yes, cataracts can be prevented primarily by maintaining your eye health and overall well-being as well.
Some of the ways to prevent cataracts include wearing sunglasses in the sun, having a regular eye checkup, eating healthy food, avoiding smoking, maintaining a healthy weight, etc.
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Author: Team Digit
Last updated: 21-03-2025
CIN: U66010PN2016PLC167410, IRDAI Reg. No. 158.
Go Digit General Insurance Limited (formerly known as Oben General Insurance Ltd.) - Registered Office Address - 1 to 6 floors, Ananta One (AR One), Pride Hotel Lane, Narveer Tanaji Wadi, City Survey No.1579, Shivaji Nagar, Pune-411005, Maharashtra | Corporate Office Address - Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru-560095, Karnataka | Trade logo of Go Digit General Insurance Ltd. displayed above belongs to Go Digit lnfoworks Services Private Limited and is provided and used by Go Digit General Insurance Ltd. under license.
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