Health insurance rules for cataract surgery
Waiting periods, sub-limits on lens costs, and the cashless claim process — explained.
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*Corporate/Group insurance covers it from Day 1 in most cases.
Sub-limits (the catch)
Even if you have a ₹10 Lakh cover, the insurer usually caps cataract surgery. Common caps are:
- ₹24,000 - ₹30,000 per eye for basic policies.
- ₹40,000 - ₹50,000 per eye for premium policies.
If you choose a Premium Multifocal Lens costing ₹80,000, and your limit is ₹40,000, you must pay the remaining ₹40,000 + proportionate deductions out of pocket.
Documents for cashless
- Health card / E-card
- Aadhaar card / PAN card
- Past 2 years policy copies (to prove waiting period completion)
- Doctor's first consultation paper
Check your cataract insurance coverage
Insurance coverage check
We'll verify your insurer, TPA, or government scheme — usually within 48 hours.