Mediclaim for Cataract
  • Why Cataract Surgery Coverage Important?
  • Waiting Period For Cataract Surgery
  • Claim Limit & Procedure
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Is Cataract Surgery Covered In Health Insurance?

Eyes are the window to the world and its beauties. Any mishap to the eyes can lead to loss of vision. A cataract is the term famous worldwide. There is no corner in the world left untouched by cataracts.

What Is Cataract?

A cataract is a disorder concerning human eyes. In cataracts, clouding occurs on the natural eye lens. It can lead to impaired vision or loss of vision. It has three variants:

  • Subcapsular Cataract
  • Nuclear cataract
  • Cortical cataract

Cataracts can even lead to blindness if not treated in time. In case of hazy vision or any doubt, the doctor should be consulted at the earliest to control the disorder at the initial stage.

Which Age Group Is More Affected?

Earlier cataract was common among people above 60 years of age. At present, it is found among people in the 40s. There can be several reasons for the occurrence of cataracts. It might be because of smoking, obesity, diabetes, high blood pressure, excessive alcohol intake, etc. People who have undergone eye surgery or having an eye condition are more vulnerable to this disease. Aging people are prone to the disorder.

Is There Health Insurance For Cataract Surgery?

Yes, there is provision for the inclusion of cataract treatment in the health insurance policy. There might be a possibility, that few of the health insurance policy does not include cataract treatment. So, it must be checked properly in the policy details at the time of purchasing the policy. In case you already withhold a health insurance policy then you can check in the policy documents and the inclusions of the policy.

Waiting Period For Cataract Surgery

The insured needs to serve the waiting period to utilize cataract treatment coverage. Generally, the waiting period in most of the health insurance companies is for 2 years for treatment-related cataracts. But, it should be confirmed with the concerned insurance company if they provide the facility.

What Would Be The Claim Limit?

The claim limit is completely in the hands of the insurance companies providing a cataract health insurance facility. All that is to be done is to check the inclusions and exclusions of the policy properly.

Few insurers might have set claim limits under the cataract health insurance whereas few companies might not have set any such claim limit. The claim limit for cataract treatment is finalized by the health insurance company based on the sum insured and in some cases, it can also be on the percentage basis. For example, 10% of the sum insured up to INR 25000(Maximum).

Which Plans Comes With Cataract Health Insurance Cover?

Here is the name of a few of the health insurance company and the names of their plans which provides cataract health insurance cover. One thing common in all of the plans mentioned below is that they all have a waiting period of 2 years. The other details have been mentioned below:

Health Insurance CompanyHealth PlansCataract Surgery Claim Limit
ICICI LombardComplete Health InsuranceOffers a claim limit up to Rs.20,000 for each eye.
Care Health Insurance(formerly known as Religare Health Insurance)Care freedom (Senior Citizens)They do not have any sub-limits relating to cataract treatment insurance cover.
Star Health InsuranceSenior Citizen Red Carpet PolicyThey offer maximum claim limit up to Rs.25,000 and it also depends on the insures sum.
Oriental InsuranceHappy Family Floater PolicyThere are no cub limits relating to the cataract treatment under the health insurance cover.
SBI General Health InsuranceThe claim limit is dependable on the sum insured and the maximum limit is up to Rs.25,000.
Apollo Munich Health InsuranceOptima SeniorApollo Munich has not set any claim limit for the cataract treatment insurance.
Bajaj Allianz Health InsuranceHealth-GuardThe claim limit is 10% of the sum insured and the amount can go higher to Rs.35,000.
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What Is The Cataract Surgery Cost In India?

In India cataract is common impairedness in the people who are 40 years and above in age. The chances of the disorder increase with the increase in age. In the treatment of cataracts, the average expense may range from Rs.15,000 to Rs.35000 in India.

Insurance companies have several procedures and plans for cataract health insurance. All that is required to be done is research and buy a best health insurance Plan covering cataracts.

Is Cataract Covered Under Group Health Plan?

There might be a probability that the group health insurance provided by the employer includes insurance for cataracts. But, it always depends on the insurance company providing group health insurance. There might not be a waiting period in this case.


Eyes are the most precious part of the human body and it should be procured in any of the challenging conditions. Health insurance for cataracts is a ray of hope for the sufferers. Surgery is the only way out for cataracts and the fund can easily be sponsored by the health insurance companies. So, take the initiative at the earliest if you are having the cataract symptoms.

Written By : Naval Goel

Last Updated : November, 2019

Naval Goel is the CEO & founder of Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of Insurance Web Aggregator.

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