Eye-Care Expenses You Can’t Insure - And How To Plan for Them

From an insurer’s lens, eye care is still seen as a predictable and recurring expense rather than a sudden medical risk. Glasses, contact lenses, and routine eye check-ups are costs most people incur regularly, much like dental care.

“Health insurance in India is primarily designed to protect against high, unexpected hospitalization expenses, not everyday medical needs. While screen-related vision problems are rising, insurers haven’t fully reworked product designs to reflect this lifestyle shift yet, so eye care continues to sit on the margins,” says Sarita Joshi, head of health and life insurance, Probus.

What Is Covered, What Is Not 

Coverage is usually limited. Cataract surgery is typically included, but often with caps, waiting periods, or co-payments. So, there may be a limit on the coverage ( like up to Rs 50,000), and also basic surgery with standard lenses may only be covered.

Routine eye check-ups, spectacles, contact lenses, and vision correction procedures like Laser-Assisted In Situ Keratomileusis (LASIK) are commonly excluded. “For correction, usually anything beyond 7.5 diopters (the unit for measuring a lens's optical power) is considered medically necessary, and LASIK surgery is approved for such cases. Below 7.5 is considered cosmetic eye treatment and not covered,” says Hari Radhakrishnan, expert, Insurance Brokers Association of India (IBAI).

Having said that, some insurers consider lower than 7.5, and some also say below 6.5. Eyewear reimbursement plans can be purchased on a group basis separately, but they come at an additional cost.

“These exclusions are not always obvious upfront and are often buried in policy wordings, which can lead to confusion at the time of claim,” says Arun Ramamurthy, co-founder, Staywell.Health.

How To Plan For Eyecare Expenses 

Since most eye-care expenses are foreseeable, many people plan for them separately from insurance. “This can involve budgeting annually for eye exams and eyewear, using employer-provided health or wellness allowances, or choosing bundled hospital packages for procedures if needed,” says Ramamurthy.

Setting aside a small annual health budget for eye check-ups, glasses, or lenses can go a long way. Some employers offer OPD or vision benefits, which can help offset these costs. “The key is awareness, knowing what your policy does not cover helps you avoid surprises and manage eye-care expenses without financial stress,” says Joshi.

Reading policy details carefully and treating eye care as a regular health expense can help individuals avoid unexpected financial pressure.