Does ICICI Lombard Health Insurance Cover Cataract Surgery?

Cataract Surgery is a common surgical procedure needed to restore vision for those suffering from cataracts. Though the procedure is simple and painless, it can be very expensive, with costs starting from ₹15,000 and going up to ₹1,00,000. 

Because the surgery deals with a delicate body part, such as the eye lens, it costs more than any other regular surgery. 

But we have good news! 

If you have a health insurance policy, you might get covered for the cataract surgery costs. But it depends on certain scenarios, like the 

• Chosen insurance company, 
• Chosen health insurance plan and coverage terms, etc.   

Today, we’ll see if ICICI Lombard health insurance covers cataract surgery. 

Continue reading if you want to learn about the types of cataract surgery covered and how to verify the cataract surgery coverage with ICICI Lombard. 

Why Is Cataract Surgery Coverage Essential?

About 1.8 to 3.8 million new cataract cases are added to the backlog every year. Plus, cataract is the major cause of blindness in Asia. 

The reason? High surgery cost! 

That's why cataract surgery coverage in health insurance is essential; everyone might be unable to afford the surgery. For people having bilateral surgeries or comorbidities, the cost is even higher. 

Along with the cost of the surgery, the health insurance also covers the pre-and post-operative changes, such as medications and follow-up visits to the doctor. In short, it is essential to reduce the financial burden. 

Knowing that your insurance covers cataract surgery gives you peace of mind. You don't have to stress about how you will pay for the surgery if and when you need it.

Does ICICI Lombard Cover Cataract Surgery?

Yes! ICICI Lombard offers different health insurance plans (names are discussed in the next section) that cover cataract surgery. But there are some terms and conditions. Read on to find out! 

Every health insurance policy has a waiting period for coverage of certain expenses. In the timeline, the policyholder can not raise a claim. 

The waiting period for cataract surgery depends on the particular insurance company. For ICICI Lombard, it is between 12 to 24 months. (depending on the health insurance plan)

The cost of cataract surgery depends on several factors, such as location, type of lens needed, and the surgical procedure. The cost of operating one eye usually starts from ₹10,000, but in metropolitan cities, the cost can go up to ₹60,000 for one eye as well. 

Further, it is worth remembering that the insurer might not bear the whole surgery cost. For instance, some companies only cover 80%, and the rest 20% needs to be covered by the insured. 

Health Insurance Plans Offered By ICICI Lombard For Cataract Surgery

Now, let’s explore the different health insurance plans offered by ICICI Lombard that cover cataract surgery. 

• Health Care Plus: This particular policy of ICICI Lombard covers cataract surgery after 24 months of the commencement of the policy.
• Max Protect: It covers any cataract and age-related eye treatments of the policyholder or their family members.
• Complete Health Insurance: This insurance policy of ICICI Lombard also provides financial benefits for the cataract surgery of the policyholder after the waiting period of 24 months.
• MaxProtect 1 Crore Health Insurance Policy: The MaxProtect 1 crore health insurance policy of ICICI Lombard provides financial benefits for treatments such as cataract, hernia, and varicose veins
• iHealth Plus: iHealth Plus is a product of ICICI Lombard Complete Health Insurance and provides financial help of up to ₹20,000 per eye to the policyholder. 

Who is Eligible for ICICI Lombard Health Insurance Cataract Surgery Coverage?

One must follow the eligibility criteria below to get ICICI Lombard health insurance coverage for cataract surgery. 

• You must have an active ICICI Lombard health insurance policy that covers cataract surgery.  Make sure the waiting period is completed. 
• The insurance policy must be active and renewed on time without any breaks.
• You might need to provide medical records, doctor's notes, and other documents to show that the surgery is necessary and to make a claim.
• Some insurance plans have age limits for coverage. Check if there are any age-related rules in your policy.
• If you had cataracts before buying the insurance, you might need to wait longer. 

Pre-Existing Conditions and Their Impact on Coverage

Let’s find out the impact of the pre-existing condition on coverage of cataract surgery.

Pre-existing conditions, such as:

• Diabetic retinopathy, 
• Macular degeneration, 
• Glaucoma, 
• Uncontrolled diabetes, 
• Hypertension, 
• Previous laser eye treatments and 
• Retinal surgeries lead to higher premiums and longer waiting periods. 

The insurer will need a detailed record of these previous treatments to decide the coverage for cataract surgery.

If you have any of these or related pre-existing conditions, read all the terms and conditions of the policy to have a clear idea about the coverage. Consult with your insurance relationship manager if you have any questions. You can do so by emailing us your query on support@insurancedekho.com 

Types of Cataract Surgery Covered

Let’s explore the types of cataract surgery covered by ICICI Lombard.

• Incision of tear glands and operations on the tear ducts
• Incision of diseased eyelids and operations on the canthus and epicanthus
• Excision of diseased tissue of the eyelid
• Surgery for entropion, ectropion, and blepharoptosis
• Removing a foreign body from the conjunctiva and cornea
• Incision and other operations of the cornea
• Removal of a foreign body from the lens of the eye, posterior chamber of the eye, and orbit and eyeball
• Operations of pterygium
• Operation of cataract

What is Covered by ICICI Lombard?

Let’s understand the particulars that the ICICI Lombard covers.

• In-patient treatment covers hospital admission expenses of more than 24 hours.
• Pre- and post-hospitalization costs, such as medical expenses, will be up to 60 to 90 days after the treatment.
• Daycare treatment coverage means the reimbursement for treatment that takes less than 24 hours.
• Domestic road emergency ambulance covers the ambulance expenses to the hospital of the insured person.
• Donor expenses cover the expenses of any organ transplant surgery. 

How to Verify Your Cataract Surgery Coverage with ICICI Lombard

There are a few ways you can follow to verify your cataract surgery coverage with ICICI Lombard. 

• Read The Policy Document: The best way is by reading the policy document thoroughly as it includes all the details about plan inclusions, and exclusions along with waiting period details.
• Contact Customer Service Team: Contact the ICICI Lombard customer care team at 1800 266 9725 or you can email them at customersupport@icicilombard.com to get your queries answered. 
• Online: You can also learn about the cataract surgery coverage details by logging into your ICICI Lombard account. 

Conclusion

Cataract surgery is a very small but vital operation. Having a health insurance policy that covers the expenses of this operation is a great relief. If you have a medical history of conditions that might lead to cataract surgery in the future, then you must opt for an insurance policy that covers this surgery. 

ICICI Lombard has many health insurance plans that cover it, but before you buy any of them, make sure to read all the terms and conditions of the policy thoroughly. We hope this guide has been helpful for you in learning all about the cataract surgery coverage of ICICI Lombard. 

Frequently Asked Questions (FAQs)

Ques 1. What is cataract surgery?

Ans. Cataract surgery is a medical procedure that replaces a cloudy lens of your eye with an artificial lens. A certain cataract makes the lens of your eye cloudy and eventually makes your vision blurred. The surgery is done by an ophthalmologist, and it is an outpatient treatment, which means you don’t have to stay at the hospital after the surgery. 

Ques 2. What is the waiting period for ICICI Lombard health insurance coverage for cataract surgery?

Ans. The waiting period generally varies from policy to policy, but it is usually between 12 to 24 months. This means that you must have an active policy at least from 1 to 2 years, before getting coverage for cataract surgery expenses. 

Ques 3. Is ICICI Lombard a good health insurance company?

Ans. The claim settlement ratio of the ICICI Lombard health insurance is 99.7%, which is an exceptionally good number. The number suggests how efficient the company is in settling their claims.   

Ques 4. Why should I purchase health insurance?

Ans. Health insurance gives you financial comfort in times when unexpected medical expenses arise. The future is uncertain, so it is always better to be prepared for it and getting health insurance helps in this preparation. 

Ques 5. Does ICICI Lombard give cashless facilities?

Ans. Yes. The ICICI Lombard health insurance provides cashless facilities at any of their network hospitals or even any hospitals in your locality. This facility helps you ensure to get fast treatment for you and your family members without worrying about the hospital bills.