Cataract Surgery Eligibility, Medical Conditions, and Insurance Coverage
2 months ago
My mother had a basic eye surgery about 4 years ago. She has been diagnosed with cataract in both eyes, and although it was detected around 2 years ago, surgery was postponed. We have been doing regular check-ups, and now the doctor has said she has recovered and is fit for surgery. She also has high blood pressure and diabetes, but we have not yet checked her current sugar levels. She takes regular medicines, but we are not sure about blood thinners. we have a corporate health insurance policy. Could you please guide us about the best location for surgery, the cost per eye, and how insurance coverage and co-payment work for cataract surgery?
Answers (1)
Thank you for sharing the detailed history. Since your mother has cataract in both eyes and has now been declared fit for surgery, the procedure can be safely planned after completing a few pre-surgery tests, especially blood sugar and blood pressure levels.
These are important to ensure safe surgery. Regarding medicines, the doctor will review whether she is taking any blood thinners and guide you accordingly before surgery.
As for insurance, cataract surgery usually has a fixed limit under most policies. In many corporate policies (such as PCS), the limit is around ₹40,000 per eye, with a co-payment of approximately 17.5%.
For example, if the hospital bill is ₹50,000, the co-payment amount will be deducted first, and the remaining amount will be processed by the insurance company.
Please note that insurance approval depends on your exact policy terms and designation, so the final coverage may vary.
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