Here’s All That You Need to Know About Cataract & Its Health Insurance Coverage

One of the most frequent eye procedures performed in India is cataract surgery. A survey shows over 74% of Indian seniors over 60 have cataracts or have undergone cataract surgery.

A cataract operation typically costs between Rs. 15,000 and Rs. 65,000. In India, several health insurance providers offer coverage for cataract procedures at competitive premium rates. Cataract insurance provides a minimum of Rs. 20,000 in coverage per eye and a maximum of Rs. 35,000. After a two-year waiting period, cataract coverage is available.

In the prime of your life, a health insurance plan with cataract coverage can help you save significant money. Instead of purchasing at the last minute, be ready with enough coverage to guarantee a smooth ride through the medical emergency. Most health insurance providers offer health insurance plans that include coverage for cataract procedures.

However, bear in mind the following terms and conditions related to the coverage before purchasing a health insurance policy:

  1. The waiting period: Most health insurance policies covering cataract surgery have a two-year waiting period. To ensure that policyholders don’t purchase a health insurance policy solely to cover the costs of their cataract surgery, insurers put this clause in the policy terms. However, if you purchase a health insurance policy with cataract coverage when you’re still young, you can claim the coverage as needed as you age.
  2. Limit on claim amount: The amount that policyholders may be reimbursed for cataract surgery under their health insurance coverage is subject to a maximum limit for it as defined in the policy. Over and above the designated sub-limit, the policyholders are responsible for covering any excess costs.

However, different insurers have different maximum claim amounts. You may not be able to use the entire sum covered for your cataract surgery when you have purchased your policy from some insurers. So, choose a health insurance coverage with no specific sub-limits if you want your insurer to pay the entire cost of your cataract treatment.

  1. Preoperative and postoperative care are not covered: Cataract health insurance policies do not cover the expense of postoperative treatment, such as the price of speciality glasses, eye drops, prescriptions, etc. This indicates that you would be responsible for paying these costs out of pocket rather than having the insurance company cover them.
  2. Range of coverage: A person with a cataract in one eye is likelier to get a cataract in the other. However, the health insurance plan you intend to buy may not cover cataract surgery for both eyes. Therefore, confirming the level of cataract coverage in a specific health insurance policy is critical before committing to it. Additionally, it would be best if you looked into the alternative options for treating both eyes.


Before narrowing your search to a particular policy, use a health insurance premium calculator to estimate the premium cost for a specific health insurance plan. Select a plan with the highest sub-limit for cataract treatment. Keep in mind that if you have a health plan with extended coverage, you can get your vision back without paying thousands of rupees out of pocket. Apart from focusing on cataract, you should also consider other requirements, especially if you are looking to provide overall coverage to your family under the same policy.

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.