Does Health Insurance Cover LASIK Surgery?

Posted on: Jan 17, 2022 | 3 mins | Written by: HDFC ERGO Team

Does Health Insurance Cover LASIK Surgery?

Deciding to undergo LASIK isn’t just about clearer vision; it’s about the financial and practical decisions that come with it. For many, the question isn’t just “Can I have the surgery?” but “Can I afford it without stretching my budget?” Understanding how health insurance fits into the picture can ease the uncertainty and help you plan effectively. This blog will guide you through what to look for in your policy, common coverage pitfalls and how to make an informed choice for your eyes and finances.

What is Lasik Eye Surgery?

Lasik (short for Laser-assisted in Situ Keratomileusis) is a well-known and commonly performed surgery to correct vision problems. It is an alternative to glasses and contact lenses. During the surgery, a special type of cutting laser is used to change the shape of the dome-shaped clear tissue in the front of your eye (cornea).

This precise surgery done with the help of technological advancements improves vision. Unlike in eyes with normal vision, the cornea bends (refracts) light incorrectly onto the retina at the back of the eye in case of nearsightedness (myopia), farsightedness (hyperopia) or astigmatism.

The blurry or cloudy vision is then corrected by wearing glasses or contact lenses. Lasik surgery corrects your vision by reshaping the cornea itself. The process begins with a medical inspection of the eye by an expert. Before you opt for the surgical process, ensure that you meet all the criteria to be operated on. This surgery takes around 30 minutes and instantly improves your quality of life.

Is Lasik Eye Surgery Covered in Health Insurance?

Many people considering LASIK often ask: “Does health insurance cover laser eye surgery?” The cost of Lasik eye surgery can be huge in private hospitals. The cost can be as much as INR 1 lakh, excluding post-surgery expenses. If your income is limited, this can mean a big blow to your annual budget. Therefore, a few health insurance providers include the cost of Lasik surgery in their health plans. You just need to look for such a plan and must carefully go through the policy's terms and conditions before purchasing it.

How Does a Health Insurance Plan Help with LASIK Surgery?

LASIK surgery can be expensive in India, often costing INR 1 lakh or more depending on the city, hospital and doctor’s experience. Health insurance can help ease this financial burden if your plan includes LASIK coverage.

Key points to keep in mind:

• Most basic health insurance plans cover LASIK only if your refractive error is 7.5 dioptres or higher.

• Many insurers offer cashless treatment, where the hospital bills are paid directly by the insurance company.

• Always read your policy carefully and check the rules for LASIK coverage before filing a claim.

When is LASIK Eye Surgery Covered by Health Insurance?

LASIK eye surgery may be covered by health insurance in the following cases:

• When the refractive error is 7.5 dioptres or higher.

• When a refractive error is caused by an injury or accident.

• When a refractive error happens as a result of another surgery.

• When the person cannot use contact lenses because of a physical limitation or intolerance.

• When the person cannot wear glasses due to a physical deformity or ongoing discomfort.

When is the Best Time to Get a LASIK Eye Surgery?

The best age for LASIK or laser vision correction is usually between 18 and 40 years. Doctors often suggest waiting at least a year after you start wearing glasses before getting the surgery.

However, people over 40 can also have LASIK, depending on their health and vision. Even older adults, like your parents, may be eligible for the procedure.

Inclusions in Health Insurance Coverage for Lasik Eye Surgery

You can get health insurance cover for Lasik eye surgery if:

• The refractive error is caused by an injury or accident.

• The refractive error is caused by another surgery.

• It's a case of severe refractive error.

• You fall in the age bracket mentioned by the policy.

• The surgery is inevitable because you can't wear glasses or use contact lenses due to some physical deformity or intolerance.

Also, be aware of the exclusions so that there is no confusion during the claim settlement process.

Conclusion

Deciding to undergo LASIK is not just about vision; it’s also a financial decision. While coverage is limited, understanding your health insurance policy can help you avoid unexpected costs and make the procedure more affordable if you qualify. Take the time to review your policy, clarify doubts with your insurer and explore options that could reduce your out-of-pocket expense. Being informed ensures that your choice for clearer vision is both safe for your eyes and smart for your budget.

FAQs

1. Does Health Insurance cover LASIK Surgery?

Yes, some health insurance plans may cover LASIK surgery if the patient has a high refractive error (often 7.5 dioptres or higher) or a medical necessity. Always confirm with your insurer before planning the surgery.

2. Can LASIK Surgery be claimed on insurance?

Yes, claims are possible if your policy includes LASIK coverage and you meet the eligibility criteria. Ensure you follow your insurer’s procedures and submit the required documents.

3. Are post-surgery expenses like medications and follow-ups covered?

Generally, post-surgery costs such as eye drops, protective eyewear and follow-up consultations are not covered. Some plans may offer partial coverage, so check your policy carefully.

4. Is LASIK covered for all ages?

Coverage depends on the policy. Typically, LASIK is recommended for people aged 18-40, but eligibility for insurance coverage may vary based on age and medical history.

5. What conditions make LASIK medically necessary for insurance coverage?

Coverage may be considered if a refractive error is extremely high, caused by an accident or injury or if glasses or contact lenses cannot be used due to physical limitations.

6. Do all insurance plans offer cashless LASIK treatment?

Not all. Some insurers provide cashless facility where the hospital bills are paid directly, while others require upfront payment with later reimbursement. Confirm with your insurer beforehand.

7. Can LASIK be partially covered under critical illness or vision-specific add- ons?

In some cases, insurers offer add-on plans or rider benefits that cover LASIK partially. Check your policy options to see if such riders are available.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.

How Much Does LASIK Eye Surgery Cost in India?

10 Simple Ways to Take Care of Your Eyes

Everything you need to know about cataract surgery

Know Everything About Laser Eye Surgery

Debunking Myths & Facts About Eye Care