Does National Health Insurance Cover Cataract Surgery?

Cataracts are a common eye condition that affects millions of people worldwide. Cataracts affect the eyesight of people by clouding the lens of the eye and impairing their vision. The only remedy for cataracts is surgery. However, the costs associated with cataract surgery can be concerning. For many individuals, the financial burden of this procedure can be a bit overwhelming.

Understanding Cataracts

Cataracts mostly occur in people aged 50 and older. As we age, the lens of the eye becomes less flexible and transparent. Proteins and fibres within the lens break down and group together. This is the reason for the clouding of the lens. Individuals notice a slight blur in their vision or sensitivity to light in the early stages. Over time, as the cataract develops, the clouding of the lens grows and becomes more prominent. Eyesight diminishes steadily as the vision continues to blur. Even routine activities like reading, driving, and recognising faces become increasingly challenging.

Causes of Cataract

There are several reasons for cataracts. They include the following:

• Increased production of antioxidants – Also called free radicals, antioxidants can cause damage to the lens's protein fibres, leading to gradual clouding,

• Exposure to UV rays – Exposure to ultraviolet radiation is a leading contributor to the onset of cataracts. UV rays severely damage the lens of the eye.

• Smoking – Smoking increases oxidation, which, as mentioned above, leads to clouding

• Trauma – Physical trauma, either through injury or surgery, increases the possibility of cataracts

• Radiation therapy - Individuals who have undergone radiation therapy, especially near the head or neck area, are susceptible to cataracts in future

• Steroids – High levels of steroid intake can affect the protein fibres.

Symptoms of Cataracts

The symptoms of cataracts are as follows:

• Clouded, blurred or dim vision

• Sensitivity to light and glare

• Increasing difficulty with vision at night

• Need for brighter light for reading and other activities

• Frequent changes in eyeglass or contact lens prescription

• Seeing "halos" around lights

• Fading or yellowing of colours

• Double vision in a single eye

Cataract Surgery

Cataracts can be treated with cataract removal surgery, also called lens removal surgery. The process involves the removal of the cloudy lens and its replacement with an artificial intraocular lens. The cloudy lens is broken down into smaller pieces using a high-frequency ultrasound device. The fragmented pieces are then suctioned out of the eye. The intraocular lenses are then placed in the eye. Cataract surgery is known for its high safety record and quick recovery of patients. The cost of cataract surgery varies based on factors such as geographical location, healthcare facility, and the specific type of intraocular lens chosen. On average, cataract surgery costs between Rs 30000 and Rs 50000.

Things to do after cataract surgery

Despite the minimal care required and quick recovery of patients, there are certain things to be done after cataract surgery to ensure a smooth transition to a normal routine.

• Avoid straining your eye by activities such as driving, watching TV or reading. It's best to take rest.

• Wear protective eyewear for a week post-surgery.

• Avoid unclean water from entering the eye for the first 2-3 weeks. It's best to take a body bath below the chin. Just apply a wet cloth to wipe your face.

• Eye drops need to be applied as prescribed.

• Avoid touching or rubbing the eye for a month after surgery.

• Avoid doing any heavy lifting.

• Avoid wearing eye makeup.

About National Insurance Company

Found in 1906 and nationalised in 1972, the National Insurance Company is one of the oldest insurance companies in India. Headquartered in Kolkata, the company has a strong presence with over 1730 offices, 13,000 skilled employees, and 50,000 agents all over the country. National Insurance Company Ltd. offers its customers a wide range of insurance services, with around 300 products, including health insurance.

Cataract Surgery Cover in National Health Insurance

National Insurance company includes cataracts in the list of ailments covered under its health insurance policy. However, there are certain factors to be considered before purchasing insurance.

• Waiting period: The waiting period is the time period needed for premium holders to wait before performing cataract surgery and raising a claim. Usually, the waiting period provided by most insurance companies is around 24 months. Insurers use a waiting period to prevent customers from buying health insurance just to perform cataract surgery.

• Sublimit: A sublimit is a limit set within the insurance policy, set on the maximum amount of coverage that will be provided for a particular category of expenses. In the case of cataract surgery, most insurance companies set specific sublimits. Additional expenses need to be paid by the policyholders themselves.

Conclusion

To answer the question, yes, national health insurance does offer coverage for cataract surgery. This helps people make up for the expenses of one of the most common vision loss problems around the world. 

Frequently asked questions

Q1. Is cataract covered in a group plan?

There is scope for covering cataract surgery in a group plan. But this depends on the insurance provider.

Q2. What are the types of cataract surgery?

There are three types of cataract surgery. They include:

• Phacoemulsification.
• Femtosecond laser-assisted cataract surgery (FLACS).
• Extracapsular cataract extraction (ECCE).

Q3. What is an IOL?

IOL stands for Intraocular lens. An intraocular lens is an artificial lens used as a replacement for the removed lens during cataract surgery. IOL is also used for correcting other sight problems, such as short-sightedness or long-sightedness. 

Q4. What are the foods that help prevent cataracts?

Foods packed with antioxidants, vitamins, minerals, omega fatty acids, and other nutrients help prevent cataracts. Some effective foods are carrots, broccoli, avocados, walnuts, bilberries, eggs, salmon, green tea, and orange juice.

Q5. What are the measures to be taken while having cataracts?

• Wearing polarised sunglasses to reduce glare in strong sunlight.
• Adding brighter lightbulbs to your lamps to help you see better when reading.
• Using a magnifying glass to help you read.
• Trying to avoid driving at night if the headlights bother you or cause glare.
• Managing any underlying medical conditions, like diabetes.
• Seeing your eye care provider according to the schedule they provide and updating your eyeglasses prescription as needed.