It may be considered a disability if you have cataract. Because you cannot see clearly, it will also be a cause of accidents and therefore injuries. In most cases, surgery is necessary to bring back your vision. Find out if HMO covers cataract surgery needs of members.
HMO Coverage for Cataract Surgery
Major HMOs will cover cataract extraction even for outpatient procedures. However, the limit of coverage will depend on your MBL (maximum benefit limit). In one example, the HMO coverage for cataract surgery in the Philippines reached up to Php 120,000 for both eyes.
List of Health Cards
In our research, we found that major HMOs have cataract coverage including Maxicare, Valucare and Medicard. The coverage may vary but the most common ones include phacoemulsiciation and the cost of lens.
Cataract Overview
Cataract is a medical condition wherein a part of the eyes’ lens become cloudy. PNA reports that cataract is one of the major causes of vision impairment among Filipinos. The cloudy part of the lens may be removed through cataract extraction and then replaced with an artificial one.
Types of Surgery
There are various types of surgeries for cataracts. These are all covered by a health card. Some of the most common ones include:
- Phacoemulsification
- Extracapsular surgery
- Laser surgery
Do Prepaid Health Cards Cover Eye Surgery?
Since prepaid health cards are usually useful only for emergency room treatment, do not expect it to cover cataract surgery. The coverage is only applicable to comprehensive health plans available through employment or individual accounts. Prepaid health cards do not cover cataract surgery in general.
Post Operation Expenses
While the surgery itself is covered, post-op expenses may not be included in the benefits anymore if you have consumed up the benefit limit. However, you may still consult with an accredited ophthalmologist and use your health card account.
Leave a Reply