Mar 25, 2013
Mediclaim & Cataract Operation:
//Post based on Email Query.
I think low vision is the common problem in the older age & since now a days cataract operation has become very much simple most of the peoples are inclined towards it rather than avoiding.
Cataract is a simple operation where clouded original lense is replaced by artificial intraocular lense(IOL).
Most of the insurance companies pay cataract reimbursement & we will take view of the same:
- Hospitalization is not required for cataract operation.Its day care process & condition of compulsory 24 hrs hospitalization do not apply for cataract.
- Most of the health insurance companies pay claim only after completion of two policy years.Its mostly excluded for first 2 policy years & its considered as pre-existing if policy holder is operated within first two years.Its policy holders duty to know the exclusion period.
- Cataract reimbursement is mostly settled in lumpsum way…most of insurers pay limited reimbursement in between Rs.15,000 – Rs.20,000 depending on nature of policy.
- Cashless facility can be availed for cataract if hospital is network hospital.
- One need to seek reimbursement if hospital is non-network hospital.
- Please inform customer care of company at least 48 hours prior to the operation date.
- Following documents are generally required to claim the cataract reimbursement:
- Claim settlement form:
- IOL Specification Report in original:Before going for cataract surgery its important for eye surgeon to draw lense specifications.This report contains all specifications of artificial intraocular lenses (IOLs) which needs to be submitted in original.
- IOL Sticker: sticker comes alongwith the lenses & its important to stick this IOL sticker while submitting the claim form.
- Discharge Summary : Discharge summary in original which have details like patients name,date of operation,type of operation etc.
- Hospital Bill: Hospital bill in original.
- Medical certificate by treating doctor with details like name / registration number.
Cataract operation is common now a days..if we aware of the process for mediclaim reimbursement then I think we will able to organise the documents from initiation & it will surely reduce our headache afterwards..isn’t it?
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