Use your health insurance here.
When surgery is needed, it is carried out at a partner hospital, and cashless approval depends on that hospital's insurer network and your policy's terms. If you have a health policy, our team at Aadithya Eye Care will guide you through the claim process from your first consultation to discharge, so the paperwork does not become more stressful than the treatment.
Aadithya Eye Care does not have an in-house operating theatre. Consultation, diagnosis and follow-up happen here in Perambur, and when surgery is needed, it is arranged at a partner hospital. Cashless approval depends on whether that specific partner hospital is on your insurer's network, so it varies by hospital, insurer and policy, not just by procedure. We will confirm this with you before your surgery is scheduled.
Your policy should work for you, not against you.
Eye surgery can be expensive when paid entirely out of pocket. Cataract surgery with a basic monofocal lens, glaucoma drainage procedures, vitreoretinal surgery, and paediatric squint correction are all procedures commonly covered under health insurance policies in India.
The challenge patients face is navigating the pre-authorisation process, understanding what is covered under their specific policy, and confirming the partner hospital for their surgery is on their insurer's network. Our administrative team at Aadithya Eye Care has experience handling cashless claims and will walk you through each step, coordinating directly with the partner hospital on your behalf.
The best time to ask about insurance is before your surgery is scheduled. Call us or come in with your policy document and we can advise on likely coverage, the pre-auth timeline with the partner hospital, and what to expect.
Procedures typically covered
- Cataract surgery (phacoemulsification)
- Glaucoma drainage and filtration procedures
- Vitreoretinal surgery and laser retinal procedures
- Squint correction surgery in children
- Corneal procedures depending on policy
Coverage depends on your specific policy terms, your TPA, and whether the partner hospital used for your surgery is on your insurer's network. Always confirm with your insurer before scheduling.
From policy to procedure in five steps
The cashless claim process is more straightforward than most patients expect. Here is what happens between your first consultation and your surgery date.
Bring your policy details
At your initial consultation, bring your insurance card, policy number, and TPA card if you have one. Tell the front desk you intend to claim, we will note it from the start.
Clinical assessment and surgical plan
Dr Vasantha Gowri will examine you, confirm the diagnosis, and recommend treatment. The clinical records generated here form the basis of your pre-authorisation application.
Pre-authorisation request
Once we know which partner hospital your surgery will take place at, our team submits the pre-auth to your insurer or TPA through that hospital. This typically takes 1 to 3 working days. Some insurers require additional clinical documents, which we prepare and forward directly.
Approval and scheduling
Once approval comes through, your surgery or procedure is scheduled. We will confirm the approved amount, the co-payment required if any, and what you need to bring on the day.
Discharge and final claim
After your procedure, our administrative team handles the final claim paperwork and submits the discharge summary and billing to your insurer. You pay only the non-covered portion, if any, on discharge.
We coordinate cashless claims with all major health insurers
Our partner hospitals are commonly empanelled with the following insurance companies and government schemes for cashless surgery. Empanelment varies by partner hospital, so we confirm this for your specific case before scheduling. If your insurer is not listed, call us first, as the list is updated regularly.
This list is indicative and depends on which partner hospital your surgery is arranged at. Policy terms and covered procedures vary between insurers, plan types and hospitals. Always confirm directly with your TPA or insurer before scheduling a procedure.
Insurance questions we hear most
Is LASIK surgery covered by health insurance?
Most standard health insurance policies in India exclude refractive surgery such as LASIK and SMILE, as these are considered elective rather than medically necessary procedures. There are exceptions, particularly in high myopia above a threshold of minus 6 or minus 7 dioptres, where some policies provide partial cover.
Always check your specific policy document and speak to your TPA before assuming coverage is available. If LASIK is not covered, we can discuss payment plans and transparent pricing.
Is cataract surgery always covered?
Most health policies do cover cataract surgery, but there are important details to check. Basic phacoemulsification with a standard monofocal lens is almost always covered. Premium lens implants such as multifocal or toric lenses are typically not covered, and the cost difference between the standard and premium lens falls on the patient.
Some policies have a waiting period of two years before cataract surgery can be claimed. If your policy is new, check whether you are past this waiting period before scheduling.
What is the difference between cashless and reimbursement claims?
In a cashless claim, your insurer settles the approved amount directly with the hospital where your surgery takes place. You do not pay the covered portion upfront. In a reimbursement claim, you pay the full amount and then apply to your insurer for repayment.
Cashless claims require that hospital to be on your insurer's network panel, which involves a formal empanelment process. Since your surgery is carried out at a partner hospital rather than at Aadithya Eye Care itself, cashless eligibility depends on which partner hospital is used and whether it is empanelled with your specific insurer. We confirm this with you before scheduling, as reimbursement can take weeks and requires meticulous documentation.
What documents should I bring for a cashless admission?
Bring your health insurance card, TPA card, photo ID (Aadhaar, PAN card, or passport), and a copy of your policy document. If you have had prior authorisation issued, bring that letter as well.
On the day of surgery, arrive at least one hour before the scheduled time to allow for admission paperwork. Our team will help complete any forms that require hospital information.
Can I get a second opinion and still use my insurance?
Yes. A consultation and second opinion at Aadithya Eye Care is paid for directly, since diagnosis and consultation happen in-house. If you then proceed with surgery, it will be arranged at a partner hospital, and the surgical claim can be processed through insurance provided that hospital is on your insurer's network.
Many patients come for a comprehensive examination first, and then decide on surgery after a proper conversation about the findings, the options, and the likely outcome. That is the right sequence regardless of how you plan to pay.
Call us before you book. We will tell you exactly what to expect.
Our team handles insurance queries every day. A five-minute call before your appointment can save you a great deal of uncertainty on the day of your procedure.