Which Insurance Companies Cover LASIK Eye Surgery in India?
Here we are listing some companies that provide ample coverage for LASIK surgery in India.
| Company Name |
LASIK Surgery Coverage Eligibility Criteria |
Network Hospitals |
| Star Health Insurance |
Covered if power is 7.5 D or more |
6500+ |
| Manipal Cigna Health Insurance |
Covered if power is 7.5 D or more |
6000+ |
| Aditya Birla Health Insurance |
Covered if power is 7.5 D or more |
5700+ |
| Care Health Insurance |
Covered if power is 7.5 D or more |
11000+ |
| Bajaj Allianz Health Insurance |
Covered if power is 7.5 D or more |
6500+ |
In all plans offered by these health insurance providers, LASIK surgery is now covered as long as the patient meets the eligibility criteria.
Insurance Claim Process for LASIK Surgery
There are two methods to claim an insurance policy for LASIK surgery- a Cashless claim and a Reimbursement claim. The claim process for each method varies slightly.
Cashless Claim
A cashless claim allows the patient to pay the hospital bill upfront. In this type of claim, the insurance company pays directly to the hospital authorities with minimal involvement of the patient. However, there is a prerequisite to get a cashless claim, i.e., the patient is obliged to choose a network hospital for LASIK surgery.
The steps to get a cashless claim are explained below-
- Inform the insurance provider 3 days prior to the surgery.
- Get the cashless claim form and fill in the required information.
- Provide the necessary documentation and clinical evidence verified by a certified ophthalmologist.
- Wait for approval.
Meanwhile, the insurance company will coordinate with the hospital authorities (TPA or third-party administrator) to validate the documents. The patient is informed about the claim approval through an email and/or message stating the amount of coverage.
Note– If the approved claim amount is less than requested, the patient can always submit the claim request again to ask for more coverage.
Reimbursement Claim
A reimbursement claim is the compensation paid by the health insurance provider to the patient for the treatment expenses that are already paid. In this process, the patient himself/herself pays the hospital bills and asks the insurance company for compensation later. It doesn’t require the patient to choose a network hospital.
The claim process involves the following steps-
- Choose a hospital and undergo surgery as scheduled.
- Let the insurance company know about the surgery 2 days before the surgery or on the day of surgery.
- The insurance agent will provide a reimbursement claim form.
- Fill out the form and submit the documentation required, including discharge summary, pre and post-surgery evaluations, and other bills.
- Once the documents are submitted, the insurance company will validate and verify their authenticity.
- After approval, the total amount of the surgery that can be claimed is credited in the patient’s account at the earliest.
The patient is also notified through a message or email regarding the claim approval or denial. One thing that should be kept in mind is that a patient can only file a reimbursement claim for a particular treatment for a limited period. In most cases, the duration is 30 days after surgery.
Undergo LASIK Surgery at Pristyn Care with/without Health Insurance
Being one of the leading healthcare providers in India, Pristyn Care provides comprehensive care and assistance to patients throughout the treatment journey. We accept all health insurance policies for LASIK surgery and also accept other modes of payment which are convenient for the patients.
Our care coordinators assist the patients with the insurance paperwork, claim request, approval process, and payment confirmation. This allows the patients to focus on their health instead of worrying about the payment. Besides the assistance with insurance claims, we also provide other services that reduce the expenses of LASIK surgery for the patients-
- Free initial consultations with the best LASIK surgeons in India.
- Free cab service on the day of surgery.
- Multiple follow-up consultations without additional charges.
- Flexible payment options, including cheques, credit cards, etc.
- No-Cost EMI service to divide the treatment expenses into small installments.
Whether the patient has insurance or not, he/she can get optimal care at Pristyn Care and undergo LASIK eye surgery at the best prices.
How Does a Basic Health Insurance Plan Help in LASIK Surgery?
A basic health insurance plan may provide coverage for LASIK eye surgery, but it depends on the specific terms and conditions of the plan. Here’s how a basic health insurance plan can potentially help with LASIK surgery:
- Coverage for medical complications: Basic health insurance plans typically cover medical procedures that are necessary to address health conditions or complications. If there are any medical complications associated with your vision that require LASIK surgery for treatment, your health insurance plan may provide coverage for the procedure.
- Pre-authorization and consultation coverage: Some health insurance plans may cover pre-authorization and consultation costs related to LASIK surgery. This coverage can help with the initial evaluation and assessment by an ophthalmologist or refractive surgeon to determine the need for LASIK and to obtain necessary approvals from the insurance company.
- Partial coverage for the procedure: In some cases, a basic health insurance plan may offer partial coverage for LASIK surgery. This means that the insurance plan may cover a portion of the procedure’s cost, while the remaining portion would need to be paid out of pocket by the insured individual.
- Coverage for associated medications and follow-up visits: Basic health insurance plans may cover the cost of prescribed medications, such as eye drops or post-operative medications, as well as follow-up visits with the surgeon or ophthalmologist after LASIK eye surgery.
It’s important to note that the extent of coverage for LASIK eye surgery can vary greatly between different insurance plans. Some plans may have specific exclusions or limitations for elective procedures like LASIK. It’s crucial to review the terms and conditions of your specific health insurance plan or contact your insurance provider directly to understand the coverage, limitations, and associated costs for LASIK eye surgery under your insurance coverage plan.
When is the Best Time to Get a LASIK Eye Surgery?
| Factors to Consider |
Description |
| Stable vision |
The prescription for glasses or contact lenses should have remained consistent for 1-2 years |
| Age |
Typically suitable for individuals who are at least 18 years old with a stable eye prescription |
| Eye Health |
Ensure that your eyes are healthy and free from any underlying eye conditions or diseases |
| Lifestyle factors |
Consider your activities and commitments, especially if they involve a high risk of eye injury |
| Recovery and downtime |
Account for the short recovery period and any upcoming commitments or events during that time |
Inclusions under Health Insurance Policy offering LASIK Eye Surgery
It’s important to consult with an ophthalmologist or refractive surgeon for personalized advice based on your specific circumstances. They will evaluate your eye health, the stability of your prescription, and your individual lifestyle to determine the optimal timing for LASIK eye surgery.
Inclusions under a health insurance policy that offers coverage for LASIK eye surgery can vary depending on the specific policy and insurance provider. Here are some common inclusions that may be covered:
- Pre-authorization: Prior approval from the insurance company may be required before undergoing LASIK surgery. This ensures that the procedure meets the necessary criteria for coverage.
- Surgical fees: The policy may cover the surgical fees associated with LASIK eye surgery, including the cost of the procedure, the use of laser technology, and other surgical supplies.
- Consultation and evaluations: Coverage for pre-operative consultations, evaluations, and assessments performed by an ophthalmologist or refractive surgeon.
- Medications: Some policies may cover the cost of prescribed medications related to the LASIK procedure, such as eye drops or post-operative medications.
- Follow-up visits: Coverage for post-operative follow-up visits with the surgeon or ophthalmologist to monitor the healing process and ensure the desired outcomes.
It’s important to carefully review the terms and conditions of your specific health insurance policy to understand the exact inclusions, coverage limits, and any associated requirements for LASIK eye surgery. Different policies may have different coverage levels and criteria, so it’s best to contact your insurance provider directly or refer to your policy documents for accurate and up-to-date information.
