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Health Insurance for Cataract Surgery in India

Cataract disease is one of the leading causes of vision impairment in India, especially among people over 50. While cataract treatment is safe and highly effective, the cost of surgery, lens implants, and hospital charges can be significant. This is where health insurance for cataract surgery becomes important

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What is Cataract Disease?

Cataract disease occurs when the natural lens of the eye becomes cloudy, leading to blurred or dim vision. It develops gradually and can affect daily activities like reading, driving, and recognising faces. Understanding cataract symptoms early can help in timely diagnosis and treatment.

Cataracts Treatment

Cataract treatment involves surgically removing the cloudy lens and replacing it with an artificial intraocular lens (IOL). Cataract surgery is usually a day-care procedure, meaning hospitalisation for 24 hours may not be required. This makes cataract surgery medical insurance extremely valuable. The cost of cataract surgery in India may vary depending on:

  • Type of lens selected
  • Hospital and city
  • Surgeon’s expertise
  • Pre- and post-operative care

Look for the Best Health plan that suits your Needs!

Explore our top health insurance policies in India that provide financial protection against unexpected medical emergencies:

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  • Cover Amount₹5 lakh
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Is Cataract Surgery Covered by Health Insurance?

Yes, health insurance plans cover the costs of cataract treatment, subject to the policy terms and conditions. Under our family health insurance plans, the coverage for cataract includes:

  • Surgeon’s fees
  • Operation theatre charges
  • Day-care hospital expenses
  • Pre-hospitalisation tests
  • Post-hospitalisation follow-up

Optional Benefits You Can Consider

When purchasing health insurance for cataract surgery, you may consider the following optional benefits available with Care Health Insurance plans:

  • Unlimited Care: This add-on allows a single, large claim during the policy's lifetime to be paid, regardless of the coverage amount.
  • OPD Care: Physical consultations with general physicians and specialist doctors.
  • Grace Period Coverage: Policy coverage is extended to include the grace period during the policy term.
  • Claim Shield Plus: Coverage for non-payable items under Annexure-I.

These benefits enhance overall protection beyond basic hospitalisation coverage.

>> Read more: Why You Can’t Afford to Skip Cataract Surgery Health Insurance

What is Covered and Not Covered under Health Insurance for Cataract Surgery?

Before purchasing health insurance for cataract surgery, it is important to review the coverage and the standard exclusions applicable under the policy:

  • Coverage
  • Exclusions
  • In-patient Hospitalisation: Hospital expenses such as room rent, ICU charges, doctor’s fees, and other medical costs during hospitalisation.
  • Pre-hospitalisation Expenses: Consultations, diagnostic tests, and medicines incurred within 60 days prior to hospitalisation.
  • Post-hospitalisation Expenses: Follow-up consultations, medicines, and diagnostic tests for up to 90 days after discharge.
  • Modern Treatments: Specialised procedures, including robotic surgeries, and other advanced treatments as per policy terms.
  • Domiciliary Hospitalisation: Covers medical treatment taken at home when the patient cannot be moved to a hospital.
  • AYUSH Treatments: Ayurveda, Naturopathy, Unani, Siddha, and Homoeopathy, in accordance with policy terms.
  • Waiting Period: Cataract treatment during the initial waiting period specified in the policy.
  • Sub-limits: Expenses exceeding the specified sub-limit per eye as mentioned in the policy schedule.
  • Premium Lenses: Cost of premium or specialised intraocular lenses beyond the base policy coverage.
  • Elective Procedures: Non-medically necessary treatments or elective procedures are not covered.
  • Non-Network Limitations: Treatment undertaken at non-network hospitals (specifically for cashless claims, unless filed for reimbursement).
  • Non-Disclosure: Any pre-existing cataract condition not declared at the time of policy purchase.

Note: Policy exclusions may vary depending on the insurer and plan selected. Always review the policy wording carefully.

Looking for Cataract Surgery? Read How Much Does It Cost in India

Why You Need Cataract Surgery Medical Insurance

Having the right health insurance for cataract surgery ensures financial protection and access to quality treatment without delay. Without cataract surgery medical insurance, expenses may include:

  • Diagnostic tests (eye scans, vision tests)
  • Surgery charges
  • Lens implantation cost
  • Follow-up consultations

Things to Check Before Buying Cataract Surgery Health Insurance

Buying early ensures coverage before diagnosis, as new policies may not provide immediate benefits for pre-existing conditions. Before choosing a policy, review:

  • Waiting period for cataract disease
  • Sub-limit per eye
  • Co-payment (especially for senior citizens)
  • Network hospitals in your city
  • Coverage for advanced lenses

Documents Required to Purchase Health Insurance for Cataract Surgery

Submission requirements may vary based on age, sum insured, and underwriting guidelines. Below is the standard list of documents required to purchase a health insurance policy covering cataract surgery:

  • Identity Proof: Aadhaar Card, Passport, Voter ID, PAN Card
  • Address Proof: Utility bills, Passport, Aadhaar Card
  • Medical History Documents: Past medical records, especially related to cataract disease or other eye conditions (if applicable)
  • Recent Medical Reports: As requested by the insurer during underwriting

How to File a Claim for Cataract Surgery

If your family member gets hospitalised due to a cataract, there are two types of claims you can make:

Basis Cashless Claim Reimbursement Claim
When to Use When treatment is taken at a network hospital When treatment is taken at a non-network hospital
Step 1 Choose a network hospital Pay hospital bills upfront
Step 2 Inform the insurer before admission Collect all original documents
Step 3 Get approval from the insurer Submit the claim form and documents to the insurer
Step 4 Insurer settles eligible bills directly with the hospital Get reimbursed as per policy terms

Choosing Care Health Insurance for Cataract  Surgery

Selecting the right health insurance plan ensures financial protection for cataract surgery and other medical emergencies. Care Health Insurance offers:

  • Wide network of cashless hospitals across India
  • Coverage for day-care procedures, like cataract surgery
  • Flexible sum insured options
  • Easy digital policy purchase and renewal
  • Dedicated claim support assistance
  • Plans tailored for individuals, families, and senior citizens

Disclaimer: Plan features, benefits, coverage, and underwriting of claims are subject to policy terms and conditions. Please refer to the brochure, sales prospectus, and policy documents carefully.

Why Choose Care for Cataract Surgery

22100+

Cashless Healthcare Provider^^

74.5 Lakh+

Insurance Claim Settled

96.95%

Claim Settlement Ratio

15 Crore+

Lives Covered Since Inception

24 X 7

Claim Support

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I ported my healthcare plan last year; it is the wisest decision I made by choosing Care Health Insurance. I recently got admitted due to a viral infection, and all my expenses got covered under my plan.

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Soubhagya K Kulkarni

Everything went very smooth

Thank you for helping me when I needed help the most, being in the hospital. Buying Care’s health insurance plan is my best decision so far.

Soubhagya K Kulkarni

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Vaibhav Rai

Really helpful explaining the process in advance

Thank you for helping me with your fastest claim settlement process. I didn’t have to wait much for the approval. Everything was quick and seamless.

Vaibhav Rai

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FAQs

Q. Is cataract surgery covered by health insurance in India?

Yes, most comprehensive health insurance plans in India cover cataract surgery. However, coverage is subject to waiting periods, sub-limits per eye, and policy terms and conditions. It is advisable to review the policy document before purchase.

Q. What is the waiting period for cataract surgery under health insurance?

Health insurance policies typically have a 24-month waiting period for cataract surgery. Claims made during the waiting period are generally not admissible unless the policy specifies otherwise.

Q. Can I buy health insurance after being diagnosed with cataract disease?

If cataract disease has already been diagnosed, new health insurance policies may impose waiting periods or underwriting conditions before providing coverage. Buying health insurance early ensures uninterrupted protection.

Q. Does senior citizen health insurance cover cataract surgery?

Yes, most senior citizen health insurance plans cover cataract surgery. However, policies may include sub-limits, co-payment clauses, and waiting periods that should be carefully reviewed.

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Disclaimer : Information above is just for reference. Kindly read T & C of policy thoroughly, Do refer IRDAI guidelines for tax exemption conditions.

~Tax benefit is subject to changes in tax laws. Standard T&C Apply

^^Number of Cashless Healthcare Providers as of Dec 2025

**Number of Claims Settled as of Dec 2025

^Get exclusive 5% off on Total premium on purchasing the plan from website

#The premium is calculated for an insured individual (18) who opts for a sum insured of 5 lakh in a zone 3 city.