Ophthalmology: what does health insurance cover? - Fatima Coeg


Ophthalmology: what does health insurance cover?

   Knowing - the services or benefits of each of the policies will be key to choosing the best health insurance. Consultations, regular eye exams, tests and treatments are usually covered by insurers

Eye insurance

More than 2,200 million people suffer from vision problems or blindness, which represents almost a third of the population, according to the World Health Organization (WHO). However, most of these conditions could be avoided or solved by wearing glasses or undergoing minor surgery. 

The main reasons why these numbers have increased so significantly are related to the current lifestyle. We spend a large part of the day in front of a screen not only for work reasons, but for leisure and fun. We currently live in a world so digitized that, without being aware of it, sitting at the computer, looking at the mobile phone or watching TV can affect your health. We are aware of the importance of eye health and the increase in vision problems of which the World Health Organization alerts, therefore, at Rastreator we offer you all the information you need to know about ophthalmological coverage in health insurance .  

What ophthalmological coverage do insurers offer?

Ophthalmology is one of the most unknown medical specialties and, although most insurers usually offer similar services, it is interesting to know the benefits that we can access as insured to prevent future problems. Knowing the services or benefits of each of the insurance will be key to choosing your health insurance . 

In general, ophthalmic services offer consultations, regular eye exams, tests and treatments . In this way, you can monitor your health and prevent any type of eye disease. This coverage usually includes and treats the most common eye diseases, such as conjunctivitis, keratitis, glaucoma, myopia or strabismus, among others.

Regarding surgeries, insurers usually cover eye surgeries that are necessary and improve your health, such as glaucoma, lacrimal obstruction, retinal pathologies or eye injuries caused by diseases or accidents. Likewise, some insurers (the most comprehensive) also cover other surgeries such as cataract surgery or corneal transplantation. 

Does my insurance cover myopia operation?

More and more people want to undergo a visual surgery operation to end uncomfortable vision problems and, therefore, more operations are performed every day to correct myopia, hyperopia or astigmatism . In recent years, the number of these interventions has skyrocketed, reaching more than 150,000 Spaniards a year who decide to undergo this intervention, known as refractive surgery. It is a set of surgical techniques whose purpose is to eliminate or minimize refractory ocular defects. The four most common refractive errors are myopia, hyperopia, presbyopia and astigmatism, terms known to all and that we usually hear on a daily basis.  

However, refractive surgery is considered an unnecessary surgery , that is, a voluntary surgery. Therefore, as it is a voluntary operation, most insurers do not cover the expenses derived from the intervention . However, although insurance companies do not fully cover these expenses, they offer a large number of discounts and options for their policyholders, as well as coverage of other related services. 

If health insurance doesn't cover refractive surgery, what does it cover?

Although the medical insurance does not cover the expenses derived from this surgery, it does cover the consultations related to it, that is, the pre and postoperative consultations, as well as any emergency visit derived from said intervention . And, although it may not seem like too much, these consultations usually have a high cost of approximately more than 100 euros; quite a considerable saving.  

Optical coverage

The purpose of optical coverage is to help you with the expenses arising from the acquisition of glasses or contact lenses under medical prescription. For this reason, many insurers not only offer ophthalmological coverage, but also significant discounts on the acquisition of optical products such as single vision glasses, progressive glasses, frames, sunglasses or contact lenses. Normally these discounts are usually only valid in establishments set by the insurer.   

However, and here is the crux of the matter, to be able to access the advantages and discounts of the insurers you will have to acquire a complementary optical insurance that will increase the amount of your quota. Also, in order to benefit from this service, companies usually establish a grace period of a minimum of six months.

In short, insurers offer an ophthalmological service that includes the consultations, treatments and required interventions. Although they do not cover voluntary interventions, they do pay for the expenses that these entail, such as pre and postoperative consultations.

The most comprehensive health insurance

Optical coverage can be very useful for those who have vision problems and renew their glasses or contact lenses on a regular basis. These items are often priced quite high, so including this coverage in the policy can mean significant savings. But before hiring health insurance, it is convenient to know that there are different types and that not all insurers can have this guarantee. If you want to know which are the most complete insurances and choose the one that suits you best, Rastreator helps you decide. Your insurance comparator shows you which are the policies that offer the most guarantees, at the most competitive price. Use Rastreator's health insurance comparator and find out which one is the most suitable for you.

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