Which Insurance Companies Cover Lasik Eye Surgery in India?

Does mediclaim cover LASIK surgery? You might ask this question while planning on getting LASIK eye surgery. The health insurance companies in India consider LASIK surgery as elective/cosmetic surgery. The surgery is not performed due to an injury, ailment, or disease that requires treatment. Therefore, it is covered under health insurance only in rare circumstances. The conditions under which LASIK is covered by insurance include:

1. Eye surgery for refracted errors that occurred because of an injury or an accident.
2. LASIK for refractive errors that occurred because of another surgical procedure.
3. Correction of refractive errors equal to or more than 7.5 dioptres.
4. Eye surgery for patients who are unable to wear glasses due to a physical deformity or constant pain.
5. Surgery for patients who cannot wear contact lenses due to a lack of tolerance or a physical limitation.

LASIK surgery is covered by insurance only when the refractive error is equal to or more than 7.5 dioptres. Wondering which insurance companies cover LASIK eye surgery in India? The following are some of the best health insurance companies that include the treatment cost for LASIK eye surgery: 

1. Aditya Birla Health Insurance: With 5700+ network hospitals, all plans under Aditya Birla Health Insurance cover LASIK eye surgery. The waiting period is 30 days from the start of the policy. 
2. Bajaj Allianz Health Insurance: The insurance company has over 6500 network hospitals where policyholders can get cashless LASIK eye surgery. The insured can avail of the benefits after a waiting period of 30 days. All health plans under Bajaj Allianz Health Insurance cover LASIK. 
3. Care Health Insurance: Care health insurance offers comprehensive health plans for individuals and families. All health plans under this insurance company offer LASIK eye surgery in over 11000 network hospitals. The benefit of insurance is provided after 30 day waiting period. 
4. ManipalCigna Health Insurance: The company offers health plans covering a range of diseases to help policyholders get financially protected during emergencies. All health plans under ManipalCigna Health Insurance cover LASIK eye surgery and offer cashless treatment across 6000+ network hospitals. Treatments within the first 30 days of the policy are not covered. 
5. Star Health Insurance: Star Health Insurance is one of the most reputed insurance providers in the country, with a network of more than 11000 hospitals for cashless treatment. All health plans of the company cover LASIK eye surgery. The initial waiting period of the plan is 30 days. 

Other health insurance companies that offer coverage for LASIK surgery under their plans include:

1. Oriental Insurance
2. United India Insurance
3. New India Insurance
4. ICICI Lombard
5. Niva Bupa Health Insurance
6. Universal Sompo Health Insurance
7. TATA AIG Health Insurance 

Note: Insurance providers have their terms and conditions for LASIK surgery covered by insurance. Make sure to read the policy and talk to the provider to check if you qualify for the eligibility criteria to get coverage for refractive surgeries. 

LASIK surgery covered by insurance can vary significantly based on the policy and provider. Some of the key factors that affect the insurance coverage to consider are:

1. Type of insurance policy: One of the main factors that impact insurance coverage is the type of insurance policy. As a result, it is advised that the patients take a look at their requirements and ensure that it aligns with the insurance policy.
2. Medical necessity: One must be wondering, ‘does Mediclaim cover LASIK surgery? The answer is that some insurance policies cover LASIK eye surgery if deemed medically necessary.
   1. This means that the patient must have a vision problem that cannot be corrected through other means, such as glasses or contact lenses.
   2. Coverage also extends to patients who cannot wear contact lenses or glasses due to physical deformity or any other physical limitation. 
3. Age restrictions: Some insurance policies may have age restrictions for LASIK eye surgery coverage. For example, the policy may only cover surgery for patients between 18 and 40 yrs.
4. Refractive error: Most health insurance providers cover LASIK eye surgery if the patient has a refractive error that is equal to or more than 7.5 dioptres.
5. Reason for refractive error: Insurance coverage for LASIK eye surgery is also provided if the refractive error is caused by a serious injury, accident, or another surgery.

The process for claiming LASIK eye surgery under a health insurance policy can either be cashless or reimbursement. Here is an overview of each process:

Cashless Claim Process

1. Patients should check if their insurance provider has a network hospital or clinic that offers LASIK eye surgery. If so, they should choose a hospital or clinic in the network.
2. Patients should show their health insurance card and a valid ID proof at the hospital or clinic to initiate the cashless claim process.
3. The hospital or clinic will verify the patient's policy details and request pre-authorisation from the insurance provider.
4. The insurance provider will review the request and approve or deny the pre-authorisation.
5. If the pre-authorisation is approved, the insurance provider will pay the hospital or clinic directly for the approved amount. The patient will not have to pay anything out of pocket except for any deductible or co-payment as specified in the policy.

Reimbursement Claim Process

1. Patients should choose a hospital or clinic for LASIK eye surgery.
2. After the surgery, patients should collect all the necessary documents, including medical bills, discharge summaries, and diagnostic reports, and submit them to their insurance provider.
3. The insurance provider will review the claim and approve or deny it based on the policy terms and conditions.
4. If the claim is approved, the insurance provider will reimburse the patient for the approved amount, subject to any deductible or co-payment specified in their policy.

It's important to note that the claim process may vary depending on the insurance provider and policy terms and conditions. Patients should carefully review their insurance policy and consult their insurance provider for more information on the claim process.

Health expenses are constantly rising in India. A health insurance policy can help policyholders pay their bills during a medical emergency without losing all their savings. This is especially beneficial for people who are the sole earners in a family. Health insurance can offer medical assistance for several diseases and treatments during the policy lifetime. Moreover, insurance companies offer the advantage of cashless treatment at network hospitals, where they settle the medical bills directly. 

But is LASIK covered by insurance?

1. Yes, almost all health insurance companies offer coverage for LASIK eye surgery under their basic health insurance plan.
2. Earlier, getting LASIK covered by insurance was challenging as several insurance providers considered it cosmetic surgery.
3. However, in September 2019, The Insurance Regulatory and Development Authority (IRDAI) announced that LASIK eye surgery would be covered in all basic health plans as long as the patient’s refractive error is equal to or more than 7.5 dioptres.
4. Thanks to IRDAI’s new guidelines, patients can now undergo LASIK eye surgery and cover the cost using their health insurance plan. 
5. However, it is still important to go through the policy document and check LASIK’s coverage conditions before raising a claim.  

While it was difficult to get LASIK surgery covered by insurance a few years back, it is not anymore! LASIK eye surgery effectively corrects vision problems like myopia, hyperopia, and astigmatism. The treatment is especially beneficial for people who cannot use glasses or contact lenses due to physical limitations. Since LASIK can be expensive, individuals prefer getting the surgery covered under a health insurance plan. All basic health plans cover LASIK surgery subject to certain conditions. It is important to know about these conditions before raising a claim.