Are Lasik Operation Covered Under PMJAY?

What Is PMJAY (Ayushman Bharat)?

The Pradhan Mantri Jan Arogya Yojana—commonly called Ayushman Bharat or the Ayushman Card scheme—is a flagship health insurance programme launched by the Government of India in 2018. It provides cashless treatment of up to ₹5 lakh per family per year at any empanelled hospital, covering over 1,950 medical and surgical procedures across 26 specialities.

The scheme targets economically vulnerable families identified through the Socio-Economic Caste Census (SECC) 2011 data. Eligible beneficiaries receive an Ayushman Bharat Health Account (ABHA) card and can access secondary and tertiary care at both government and private hospitals that are part of the PMJAY network. The programme covers hospitalization expenses, pre- and post-operative care, diagnostics, and medications—but only for procedures on its approved list.

Does PMJAY Cover LASIK Eye Surgery?

No, PMJAY does not cover LASIK eye surgery. LASIK—whether standard, bladeless, or advanced variants like topography-guided or wavefront-optimized—is classified as an elective refractive procedure. This means it corrects a vision problem (myopia, hyperopia, or astigmatism) that can already be managed with glasses or contact lenses. Because spectacles provide a functional alternative, LASIK is not considered medically essential under PMJAY’s framework.

This isn’t unique to Ayushman Bharat. Most government health schemes worldwide treat laser vision correction as elective rather than emergency or life-saving care. The distinction matters because PMJAY was designed to prevent catastrophic health expenditure—meaning it prioritises surgeries that patients cannot reasonably postpone or manage with non-surgical alternatives.

If you’ve been told that your Ayushman card will cover any type of LASIK procedure, it’s worth verifying directly with PMJAY’s helpline (14555) or the hospital’s insurance desk before scheduling surgery. Misinformation on this topic is surprisingly common.

Eye Procedures That PMJAY Does Cover

While LASIK isn’t on the list, PMJAY does cover several medically necessary ophthalmic procedures. These include:

• Cataract surgery – including phacoemulsification with intraocular lens (IOL) implantation, which is one of the most commonly claimed eye procedures under the scheme.
• Pterygium excision – removal of the fleshy growth that can encroach on the cornea and impair vision.
• Glaucoma surgery – trabeculectomy and other procedures to manage intraocular pressure.
• Dacryocystorhinostomy (DCR) – surgery for blocked tear ducts.
• Squint correction surgery – alignment procedures for strabismus.
• Corneal transplant (keratoplasty) – in cases of corneal opacity or severe corneal disease.
• Vitreoretinal surgery – for retinal detachment and related conditions.

All of these address conditions where vision loss is progressive, irreversible without intervention, or where the patient’s daily functioning is significantly impaired—criteria that refractive errors correctable by glasses do not meet under PMJAY guidelines.

Why Is LASIK Not Covered Under PMJAY?

The exclusion comes down to three factors that PMJAY uses to determine coverage eligibility:

1. Medical Necessity

PMJAY covers procedures deemed medically necessary—meaning there’s no effective non-surgical alternative. Since spectacles and contact lenses adequately correct myopia, hyperopia, and astigmatism, LASIK is considered a choice rather than a necessity.

2. Elective vs. Essential Classification

Government health schemes typically categorise procedures as either essential (required to prevent deterioration or death) or elective (desired but not urgent). LASIK falls into the elective category alongside cosmetic procedures, hair transplants, and dental veneers. This classification is consistent across PMJAY, CGHS, and most state-level health insurance programmes.

3. Budget Prioritisation

PMJAY serves over 55 crore beneficiaries. Including elective refractive surgeries for the millions of Indians with spectacle prescriptions would place an unsustainable burden on the scheme’s annual budget. The programme instead channels resources toward surgeries that prevent disability, blindness from disease, and life-threatening conditions.

Other Insurance Schemes That May Cover LASIK

While PMJAY doesn’t cover LASIK, other insurance options in India sometimes do—with conditions. Here’s a realistic overview:

CGHS (Central Government Health Scheme)

CGHS may cover LASIK for central government employees if a medical board certifies that the procedure is necessary for the individual’s professional duties. Coverage limits and approval processes vary, and reimbursement—rather than cashless treatment—is the more common route. Read our detailed breakdown of LASIK coverage under CGHS.

ESIC (Employees’ State Insurance Corporation)

ESIC coverage for LASIK depends on the specific dispensary and medical board recommendation. Some ESIC-empanelled hospitals offer LASIK under their super-speciality care provision, but this is not guaranteed. Learn more about LASIK and ESIC coverage.

Private Health Insurance (Mediclaim)

Most standard mediclaim policies exclude LASIK. However, some premium plans from insurers like Star Health, Care Health Insurance, and others may offer partial coverage if the procedure is recommended by an ophthalmologist and the policy explicitly includes refractive surgery. Always check your policy’s exclusion list before assuming coverage.

Employer-Sponsored Insurance

Some corporate group health policies and IT-sector employer plans include LASIK as a wellness benefit. Companies like TCS, Infosys, and several MNCs have historically offered partial or full reimbursement for laser vision correction. If you’re employed, check with your HR department—it’s often the most overlooked avenue for LASIK funding.

Affordable LASIK Options Without Insurance

If insurance doesn’t cover your procedure, LASIK is still more accessible than many people assume. At Visual Aids Centre, we work with patients to find a path that fits their budget:

• Transparent pricing – Our LASIK costs in Delhi are published upfront with no hidden charges. The package includes pre-operative tests, the procedure, post-operative medications, and follow-up visits.
• EMI and payment plans – We offer flexible EMI options through leading banks and fintech providers, making it possible to spread the cost across 6–24 months with low or zero interest.
• Tax benefits – LASIK is eligible for deduction under Section 80D of the Income Tax Act if paid through health insurance. Even without insurance, you may claim it as a medical expense in certain circumstances—consult your tax advisor for specifics.
• Pre-operative consultation – A thorough LASIK evaluation ensures you only proceed if you’re a suitable candidate, preventing unnecessary expenditure on a procedure that may not deliver optimal results for your eyes.