One common question when considering cataract surgery is whether a hospital plan will cover the procedure. This article sheds light on this aspect and provides useful information for anyone contemplating cataract surgery.
Hospital Plans Generally Do Cover It
Good news! If you’re on a hospital plan, there’s a high likelihood that cataract surgery will be covered. This is because cataract surgery is typically performed in a hospital theatre, a setting that hospital plans are designed to cover.
Cataracts are a Prescribed Minimum Benefit
It’s important to note that cataract treatment falls under the category of Prescribed Minimum Benefits (PMBs) in South Africa. This means that all registered medical aid plans, including hospital plans, are required by law to provide coverage for cataract surgery.
Pre-Authorisation Is Important
Even if you are on a hospital plan, it’s advisable to go through the pre-authorisation process. This ensures that you understand the specifics of your coverage and that you won’t face any surprise bills after the procedure.
Conclusion
If you are on a hospital plan, you can generally expect coverage for cataract surgery. However, it’s always a good idea to check the specifics with your healthcare provider and to go through the pre-authorisation process for a clearer understanding of your coverage.
Disclaimer: This article is for informational purposes only and should not be considered medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your ophthalmologist or other qualified health professional with any questions or concerns you may have about your eyesight. The most reliable advice is obtained through a consultation and inspection from a medical specialist
