LASIK surgery is covered by Vidal Health Insurance, but only if your refractive error is 7.5 dioptres or higher, or if you meet specific medical criteria.
If you’re considering LASIK and want to know if your Vidal Health policy will help with the costs, understanding the eligibility rules, inclusions, and claims process is essential.
This blog will guide you through everything you need to know about LASIK coverage with Vidal Health Insurance, including who qualifies, what’s included, and how to make your claim as smooth as possible.
Understanding LASIK Coverage: The Basics
LASIK (Laser-Assisted In Situ Keratomileusis) is a widely used vision correction procedure that can treat myopia, hyperopia, and astigmatism. While many people seek LASIK for convenience, insurance companies—including Vidal Health—typically consider it elective or cosmetic unless certain medical conditions are met.
Thanks to updated guidelines from the Insurance Regulatory and Development Authority of India (IRDAI), LASIK is now included in basic health insurance plans, but only for patients with a refractive error of 7.5 dioptres or more. This threshold ensures that only those with severe vision problems, who cannot be adequately corrected with glasses or contacts, are eligible for coverage.
Who Is Eligible for LASIK Coverage Under Vidal Health Insurance?
You may be eligible for LASIK coverage if:
- Your refractive error is equal to or greater than 7.5 dioptres (in either eye).
- You require eye surgery due to a refractive error caused by injury, accident, or another surgery.
- You cannot wear glasses due to a physical deformity or constant discomfort.
- You are unable to use contact lenses due to physical limitations or intolerance.
Coverage is not available if:
- You want LASIK solely for cosmetic reasons or to eliminate the need for glasses or contacts for convenience.
- Your refractive error is less than 7.5 dioptres and you do not meet any of the medical necessity criteria.
What Does Vidal Health Insurance Cover for LASIK Surgery?
If you qualify, your policy may cover:
- Hospital-related expenses (including ICU charges, consumables, and nursing fees)
- Pre- and post-surgery hospitalisation, including consultations and follow-ups
- Surgeon’s consultation and operating fees
- Anesthesia fees
- Diagnostic tests and evaluations before and after surgery
Note: Always check your specific policy document, as coverage details and exclusions can vary by plan and insurer.
When Is the Best Time to Get LASIK Surgery?
Most doctors recommend LASIK between the ages of 18 and 40, once your prescription has been stable for at least one year. However, people over 40 may also be eligible depending on their health and vision needs. Eligibility criteria may change as technology and guidelines evolve, so consult your ophthalmologist and insurance provider for the latest advice.
How Does Vidal Health Insurance Process LASIK Claims?
Vidal Health Insurance TPA (Third-Party Administrator) is a leading health services management firm in India, partnering with 12,000+ hospitals and handling claims for over 180 million lives nationwide. Here’s how the process works:
1. Pre-Authorisation
- Contact Vidal Health or your hospital’s insurance desk before your surgery.
- Submit your ophthalmologist’s medical evaluation and proof of refractive error (≥7.5 dioptres).
- Provide all required documents, including your policy details and ID.
2. Cashless or Reimbursement Claim
- Cashless: If your hospital is in Vidal Health’s network, your bill can be settled directly by the insurer.
- Reimbursement: If you use a non-network hospital, pay the bill and submit all documents for reimbursement later.
3. Documentation
- Medical reports and diagnostic test results
- Surgeon’s notes and hospital bills
- Pre-authorisation approval (for cashless claims)
- Completed claim forms (available on the Vidal Health website)
4. Claim Settlement
- Vidal Health reviews your claim as per policy terms.
- Approved claims are settled directly with the hospital (cashless) or reimbursed to you (within policy timelines).
What Are the Common Inclusions and Exclusions?
Inclusions:
- LASIK for refractive error ≥7.5 dioptres
- LASIK required due to injury, accident, or post-surgical complications
- LASIK when glasses/contact lenses cannot be used for medical reasons
Exclusions:
- LASIK for cosmetic reasons or mild vision correction
- Claims without proper documentation or outside policy terms
- Expenses not related to the surgery (e.g., travel, non-medical costs)
Vidal Health’s Network and Support
Vidal Health Insurance TPA partners with all major health insurers in India and maintains a robust network of over 12,000 hospitals and diagnostic centres in 800+ cities. Members can:
- Browse hospital profiles and package costs
- Schedule appointments
- Manage medical information securely online
- Access 24/7 helplines and hospital-based assistance
Vidal Health Insurance: A Trusted Partner for Your Vision
Vidal Health is one of India’s largest and most established TPAs, managing claims for millions of policyholders and supporting government health schemes. Their focus on customer service, technology, and a vast hospital network makes them a reliable partner for your LASIK and other medical needs.
Making the Most of Your LASIK Coverage
LASIK surgery can be covered by Vidal Health Insurance if your refractive error is 7.5 dioptres or higher, or if you meet certain medical criteria.
Before scheduling surgery, review your policy, consult your ophthalmologist, and contact Vidal Health for pre-authorisation. With the right preparation and documentation, you can access coverage for LASIK and enjoy clearer vision without the financial burden. If you have questions, Vidal Health’s customer support team is ready to help you every step of the way.
Frequently Asked Questions
Does every Vidal Health policy cover LASIK?
No, coverage varies based on your refractive error and the details of your insurance policy. Always check your policy document or contact Vidal Health for confirmation.
Is there a waiting period for LASIK coverage?
Some policies may have a waiting period before elective surgeries are covered. Review your policy or ask Vidal Health directly.
Does LASIK insurance coverage require hospitalisation?
No. LASIK is considered a day-care procedure and is eligible for coverage even without a 24-hour hospital stay.
Can I claim LASIK for both eyes?
Yes, if both eyes meet the refractive error criteria and your policy allows, you can claim for both.
What if my claim is rejected?
If your claim is denied, Vidal Health will inform you and the hospital. You may need to pay the difference or appeal with additional documentation.