Complete Guide to Cashless Eye Surgery in Mumbai
Zero upfront payment for your eye surgery. Get treated by Dr. Jignesh Gala (FRCS Glasgow, MRCS Edinburgh) with cashless coverage from 30+ insurance companies, all major TPAs, CGHS, ECHS, Ayushman Bharat & more. World-class eye care is now within everyone’s reach.
What is Cashless Eye Surgery?
Understanding how cashless health insurance works for eye care procedures
Cashless eye surgery is a facility provided by leading eye hospitals where the patient does not need to pay upfront for their surgical procedure. Instead, the hospital settles the medical bill directly with the insurance company or Third Party Administrator (TPA). You walk in for your surgery, receive world-class treatment, and walk out without worrying about arranging large sums of money.
This facility is available for a wide range of eye surgeries including cataract surgery, glaucoma procedures, retina surgeries, corneal transplants, squint correction, oculoplasty, and many more. At Crystal Clear Eye and Topax Eye Care, we have partnered with virtually every major insurance provider in India to ensure no patient delays critical eye care due to financial constraints.
Under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY), eligible families can get free cataract surgery worth up to Rs. 5 lakh per family per year. At our centres, we process PMJAY claims seamlessly with zero out-of-pocket expenses for qualifying patients.
Cashless vs. Reimbursement: What’s the Difference?
| Feature | Cashless Eye Surgery | Reimbursement |
|---|---|---|
| Payment | ✅ Zero upfront payment (except non-admissible charges) | ❌ Patient pays full amount first |
| Process | Hospital bills insurance company directly | Patient submits bills to insurer for refund |
| Timeline | Pre-authorisation: 24-48 hours | Reimbursement: 15-45 days after submission |
| Documentation | Hospital insurance desk handles everything | Patient must collect and submit all documents |
| Financial Stress | Minimal – only co-pay/non-admissible amounts | High – full amount blocked until reimbursement |
| Approval Tracking | Hospital follows up with insurer/TPA | Patient must follow up personally |
As you can see, cashless is the clearly preferred option for most patients. It eliminates the financial burden entirely and allows you to focus on what matters most – your recovery and vision. At both Topax Eye Care (direct cashless) and Crystal Clear Eye (third-party cashless), we have dedicated insurance coordinators who manage the entire process for you from start to finish.
Two-Facility Cashless Network
We are the only eye care provider in Andheri West with dual cashless infrastructure – Topax Eye Care for direct insurance tie-ups AND Crystal Clear Eye for comprehensive TPA coverage. This means we can process cashless claims through virtually any insurance channel available in India.
Need Help Understanding Your Coverage?
Our insurance experts will check your policy coverage, waiting periods, and sub-limits free of charge. Simply share your insurance card details and we’ll tell you exactly what’s covered.
Get Free Coverage CheckWhy Choose Dr. Jignesh Gala for Cashless Eye Surgery?
Mumbai’s most trusted name in advanced ophthalmology with unmatched expertise and dual-facility convenience
Dr. Gala has trained and practised across India, the United Kingdom, and Singapore, bringing international best practices to every procedure. His work as a BMJ Peer Reviewer ensures he stays at the cutting edge of ophthalmic research.
Unmatched Credentials & Experience
Triple International Fellowship
FRCS (Glasgow), MRCS (Edinburgh), FICO (London) – rare triple-board certification held by few ophthalmologists in India
Dual Fellowship from LV Prasad Eye Institute
India’s premier eye institute – specialised training in advanced surgical techniques and complex case management
Ex-Assistant Professor, Nair Hospital
Previously shaped the next generation of eye surgeons at one of Mumbai’s most prestigious government medical colleges
BMJ Peer Reviewer
Selected by the British Medical Journal to peer-review research papers – a recognition of academic excellence
Proven Track Record
1,62,000+ patients treated and 25,780+ surgical procedures performed with excellent outcomes over 12+ years
Why Patients Trust Dr. Gala for Cashless Surgery
Our Two-Facility Advantage
The only eye care group in Andheri with both direct cashless AND TPA cashless processing
Topax Eye Care
DIRECT CASHLESSState-of-the-art eye hospital offering direct cashless surgery through direct tie-ups with insurance companies. No intermediary – faster approvals, smoother processing.
Led by Dr. Jignesh Gala & Dr. Namrata Bhuta
Co-Directors at Topax Eye Care
- ✓ Direct insurance company tie-ups
- ✓ Faster claim processing (24-48 hrs)
- ✓ World’s fastest LASIK laser (AMARIS)
- ✓ Premium IOLs & advanced diagnostics
- ✓ Dedicated insurance helpdesk
Crystal Clear Eye
THIRD-PARTY CASHLESS (TPA)Comprehensive eye clinic offering third-party cashless surgery through a vast network of TPAs (Third Party Administrators). Accepts virtually every mediclaim policy in India.
Led by Dr. Jignesh Gala
Founder & Director
- ✓ All major TPAs accepted (25+ TPAs)
- ✓ PSU insurance processing (GIPSA)
- ✓ CGHS, ECHS, Ayushman Bharat
- ✓ Complete TPA coordination
- ✓ Follow-ups covered under cashless
Thousands of happy patients who trusted us with their vision – now living glasses-free!
When you visit us, our insurance coordinators first determine the best processing route for your specific policy. If your insurer has a direct tie-up with Topax Eye Care, we process through the direct channel for faster approval. If your policy is managed through a TPA, we route it through Crystal Clear Eye’s comprehensive TPA network. In either case, you receive the same world-class surgical care from Dr. Jignesh Gala and his team. The only difference is the administrative processing route – and we handle all of that for you.
Comprehensive Eye Surgeries Covered Under Cashless
From paediatric to senior care, we offer cashless processing for the widest range of eye surgical procedures in Mumbai
At Crystal Clear Eye and Topax Eye Care, we perform and process cashless claims for virtually every type of eye surgery covered under health insurance in India. Below is the complete list of procedures we offer with typical insurance coverage details.
👶 Paediatric Eye Surgeries (1 month – 18 years)
| Surgery/Procedure | Description | Typical Coverage | Cashless Eligible |
|---|---|---|---|
| ROP Screening & Laser | Retinopathy of Prematurity screening and laser treatment for premature babies | Rs. 15,000-25,000/session | ✓ Yes |
| Paediatric Cataract Surgery | Cataract removal with specialised IOL implantation in children | Rs. 30,000-50,000 | ✓ Yes |
| Congenital Glaucoma Surgery | Surgical treatment for glaucoma present at birth or early childhood | Rs. 25,000-40,000 | ✓ Yes |
| Squint/Strabismus Surgery | Correction of eye muscle alignment in children | Rs. 20,000-35,000 | ✓ Yes |
| Lazy Eye (Amblyopia) Treatment | Comprehensive therapy including patching, vision therapy, and atropine | OPD coverage only | △ Partial |
| Paediatric Retina Surgery | Vitrectomy and other retinal procedures for children | Rs. 40,000-80,000 | ✓ Yes |
| NLDO Surgery | Nasolacrimal Duct Obstruction correction (blocked tear ducts) | Rs. 15,000-25,000 | ✓ Yes |
| Congenital Ptosis Correction | Drooping eyelid correction in children | Rs. 20,000-35,000 | ✓ Yes |
| Paediatric Trauma Management | Emergency surgical repair of eye injuries in children | Up to full SI | ✓ Yes (Emergency) |
* Coverage varies by insurance company and policy terms. Pre-authorisation required for all surgical procedures.
🧑 Adult Eye Surgeries (18 – 60 years)
| Surgery/Procedure | Description | Typical Coverage | Cashless Eligible |
|---|---|---|---|
| LASIK/Refractive Surgery | Laser vision correction for myopia, hyperopia, astigmatism | Generally NOT covered | ✗ No* |
| SMILE | Small Incision Lenticule Extraction – flapless laser procedure | Generally NOT covered | ✗ No* |
| Contoura Vision | Topography-guided LASIK for superior visual outcomes | Generally NOT covered | ✗ No* |
| ICL Surgery | Implantable Collamer Lens for high myopia correction | Generally NOT covered | ✗ No |
| ✨ Cataract Surgery (Phaco/MICS) | Advanced cataract removal with foldable IOL implantation | Rs. 25,000-50,000/eye | ✓ Yes |
| Femto Laser Cataract | Bladeless cataract surgery using femtosecond laser | Restricted to MICS rates | △ Partial |
| Glaucoma Surgery (Trabeculectomy) | Filtering surgery to reduce intraocular pressure | Rs. 25,000-40,000 | ✓ Yes |
| Glaucoma Valve Implant | Tube shunt surgery for advanced glaucoma cases | Rs. 35,000-60,000 | ✓ Yes |
| Vitrectomy | Surgical removal of vitreous gel for retinal conditions | Rs. 40,000-80,000 | ✓ Yes |
| Retinal Detachment Repair | Urgent surgical reattachment of detached retina | Rs. 50,000-1,00,000 | ✓ Yes |
| Macular Hole Surgery | Vitrectomy with membrane peel for macular holes | Rs. 45,000-75,000 | ✓ Yes |
| Diabetic Retinopathy Treatment | Laser photocoagulation, intravitreal injections | Rs. 15,000-40,000 | ✓ Yes |
| Cornea Transplant (PK/DSEK/DMEK) | Penetrating or lamellar keratoplasty for corneal diseases | Rs. 50,000-1,00,000 | ✓ Yes |
| Corneal Cross-Linking (C3R) | Strengthening cornea for keratoconus progression | Rs. 25,000-40,000 | ✓ Yes |
| Squint Surgery (Adult) | Strabismus correction in adults for functional/cosmetic reasons | Rs. 20,000-35,000 | ✓ Yes |
| Oculoplasty (Ptosis, Entropion, Ectropion) | Eyelid and surrounding structure corrective surgeries | Rs. 20,000-35,000 | ✓ Yes |
| DCR Surgery | Dacryocystorhinostomy for blocked nasolacrimal duct | Rs. 25,000-40,000 | ✓ Yes |
| Pterygium Surgery | Removal of fleshy growth on the cornea with graft | Rs. 15,000-25,000 | ✓ Yes |
| Uveitis Treatment | Medical and immunosuppressive therapy for uveitis | OPD + IPD coverage | △ Partial |
* LASIK/SMILE/Contoura may be covered if refractive power > -7.0D or for post-keratoconus correction. ICL is generally excluded. Please check your specific policy terms.
👴 Senior Eye Surgeries (60 – 100 years)
| Surgery/Procedure | Description | Typical Coverage | Cashless Eligible |
|---|---|---|---|
| ✨ Advanced Cataract Surgery | Phaco/MICS with Premium IOLs – Multifocal, Toric, EDOF | Rs. 25,000-50,000 (upgrade cost extra) | ✓ Yes |
| AMD Treatment | Age-related Macular Degeneration – injections, laser | Rs. 20,000-40,000/injection | ✓ Yes |
| Glaucoma Management | Medical, laser (SLT), and surgical management | Rs. 8,000-60,000 | ✓ Yes |
| Retinal Vein Occlusion Treatment | Intravitreal injections and laser for RVO | Rs. 20,000-40,000 | ✓ Yes |
| Diabetic Eye Disease Management | Comprehensive care including laser, injections, surgery | Rs. 15,000-80,000 | ✓ Yes |
| Low Vision Aids | Specialised devices and rehabilitation for low vision | Limited/Exclusion | △ Check Policy |
| Second Opinion for Complex Cases | Expert evaluation and treatment planning | OPD consultation covered | △ Partial |
* Senior citizen policies often have reduced waiting periods (1-2 years) for cataract surgery. Premium IOL upgrades (Multifocal/Toric/EDOF) may require additional out-of-pocket payment beyond insurance coverage.
⚡ Laser Procedures
| Laser Type | Purpose/Condition Treated | Typical Coverage | Cashless Eligible |
|---|---|---|---|
| LASIK Laser | Refractive error correction (myopia, hyperopia, astigmatism) | Generally excluded | ✗ No* |
| PRK Laser | Surface ablation for thin corneas | Generally excluded | ✗ No* |
| Femto Laser (Bladeless Cataract) | Computer-guided bladeless cataract surgery | Up to MICS rate | △ Partial |
| YAG Laser (Capsulotomy) | After-cataract/PCO treatment post cataract surgery | Rs. 5,000-10,000 | ✓ Yes |
| SLT Laser | Selective Laser Trabeculoplasty for glaucoma | Rs. 8,000-15,000 | ✓ Yes |
| Green Laser (Retina) | Pan-retinal photocoagulation for diabetic retinopathy | Rs. 10,000-20,000 | ✓ Yes |
| Barrage Laser | Preventive laser for retinal holes and tears | Rs. 8,000-15,000/session | ✓ Yes |
| IRIDEX Laser | Advanced retinal laser therapy | Rs. 10,000-20,000 | ✓ Yes |
| PASCAL Laser | Pattern Scanning Laser for faster retinal treatment | Rs. 10,000-20,000 | ✓ Yes |
* LASIK/PRK may be covered in exceptional cases: (a) refractive power > -7.0 dioptres, (b) post-keratoconus after C3R, or (c) anisometropia causing vision disability. Please verify with your insurer.
- Cataract surgery is covered by ALL health insurance policies in India (subject to waiting period)
- Retina, glaucoma, and cornea surgeries are covered by most comprehensive health policies
- LASIK/SMILE/Contoura/ICL are generally NOT covered as they are considered cosmetic
- All laser procedures for medical conditions (YAG, SLT, Green, Barrage) are typically covered
- Paediatric and senior surgeries follow the same coverage as adult procedures
- Government schemes (CGHS, ECHS, Ayushman, ESIC) cover most procedures with minimal exclusions
Not sure about your specific case? WhatsApp us your insurance card and we’ll tell you exactly what’s covered within minutes.
Insurance Companies & TPAs We Work With
The most comprehensive cashless network in Andheri West – we accept ALL major insurers that our competitors do, and more
Our competitors – Aggarwal Eye Hospital, Arohi Eye Hospital, Global Eye Clinic, Mumbai Eye Care, Orbit Eye Hospital, Envision Eye Hospital, Doctor Eye Institute, and ASG Eye Hospital – accept various combinations of insurers. At Crystal Clear Eye and Topax Eye Care, we provide cashless processing through ALL the same companies they accept, ensuring you never need to compromise on surgeon choice due to insurance constraints.
🏢 Private Insurance Companies
🇮🇳 PSU (Government) Insurance Companies
🔄 Third Party Administrators (TPAs)
🏛️ Government Health Schemes
CGHS
Central Government Health Scheme for central government employees, pensioners & MPs
FULL CASHLESSECHS
Ex-Servicemen Contributory Health Scheme for armed forces veterans & dependents
FULL CASHLESSAyushman Bharat PMJAY
Pradhan Mantri Jan Arogya Yojana – up to Rs. 5 lakh/family/year for eligible families
FULL CASHLESSESIC
Employees’ State Insurance Corporation for organised sector workers & families
FULL CASHLESSMJPJAY
Mahatma Jyotiba Phule Jan Arogya Yojana – Maharashtra state health scheme
FULL CASHLESSAnd counting – we are continuously adding new insurance partners to serve you better.
Mediclaim Policies Explained
Understanding your policy type, coverage limits, and waiting periods for eye surgery
Policy Types & Eye Surgery Coverage
| Policy Type | Eye Surgery Coverage | Typical Limit | Waiting Period |
|---|---|---|---|
| Individual Health Insurance | Cataract, Retina, Glaucoma, Cornea | 10% of SI, max Rs. 25K-50K/eye | 2-4 years |
| Family Floater | All covered eye surgeries | Shared sum insured | 2-4 years |
| Senior Citizen Mediclaim | Cataract with foldable IOL | Rs. 10,000-25,000/eye | 1-2 years |
| Group/Employer Insurance | Most eye surgeries | As per company policy | 0-1 year |
| Personal Accident | Trauma-related eye surgery | Up to full SI | None |
| Critical Illness | Covers blindness, retinal detachment | Lump sum payout | 90 days |
| CGHS (Central Govt) | All eye surgeries | Full cashless | None |
| ECHS (Ex-Servicemen) | All eye surgeries | Full cashless | None |
| Ayushman Bharat | Cataract, glaucoma, retina | Up to Rs. 5 lakh/family | None |
| ESIC (Employees) | All eye surgeries | Full cashless | None |
- LASIK/SMILE/Contoura – considered cosmetic (except in specific medical conditions)
- ICL Surgery – generally excluded from all policies
- Premium IOL upgrades – insurance covers standard foldable IOL; multifocal/toric/EDOF upgrades are payable
- Femto laser cataract – restricted to MICS rates by most insurers
- Non-medical consumables – gloves, gowns, cotton (some policies exclude)
- Room rent above capping – differential payable by patient
- Registration/admission charges – may not be admissible
- Diet charges, attendant charges – generally excluded
Specific Procedure Coverage Limits
| Procedure | Coverage Range |
|---|---|
| Cataract Surgery | Rs. 25,000 – 50,000/eye |
| MICS/Phaco | Rs. 30,000 including IOL |
| Femto Laser Cataract | Restricted to MICS rates |
| LASIK | Generally NOT covered |
| Vitrectomy (Retina) | Rs. 40,000 – 80,000 |
| Retinal Detachment | Rs. 50,000 – 1,00,000 |
| Trabeculectomy (Glaucoma) | Rs. 25,000 – 40,000 |
| Glaucoma Valve | Rs. 35,000 – 60,000 |
| Squint Surgery | Rs. 20,000 – 35,000 |
| Cornea Transplant (PK/DSEK) | Rs. 50,000 – 1,00,000 |
| Oculoplasty (Ptosis, Entropion) | Rs. 20,000 – 35,000 |
| Pterygium Surgery | Rs. 15,000 – 25,000 |
| ROP Laser (Paediatric) | Rs. 15,000 – 25,000/session |
| Barrage Laser | Rs. 8,000 – 15,000/session |
| YAG Laser Capsulotomy | Rs. 5,000 – 10,000 |
| SLT Laser (Glaucoma) | Rs. 8,000 – 15,000 |
| ICL Surgery | Generally NOT covered |
Pro Tips for Maximum Coverage
- Check waiting period completion before scheduling surgery
- Use group/employer insurance if available – shorter/no waiting period
- Port your policy to carry forward waiting period credits
- Get pre-authorisation BEFORE surgery for smooth cashless processing
- Understand sub-limits – cataract has 10% of SI cap in most policies
- Consider super top-up plans for higher coverage at low premium
- CGHS/ECHS/ESIC beneficiaries – utilise government schemes for zero-cost surgery
Most senior citizen policies and some standard policies have a co-pay clause (typically 10-20%), meaning you pay a percentage of the admissible amount. Some policies also have room rent capping (1-2% of SI per day) – choosing a room within this limit ensures full coverage. Our insurance coordinators will calculate your exact out-of-pocket amount before surgery so there are no surprises.
Competitor Comparison: We Accept Everything They Do
Why travel far when the best cashless eye surgery network is right here in Andheri West?
Below is a transparent comparison of cashless insurance acceptance between Dr. Jignesh Gala’s facilities and other eye hospitals within a 75km radius. As you can see, we provide cashless through ALL the same insurance companies that our competitors accept – often with the added advantage of dual-facility processing.
| Hospital | Location | Contact | Cashless Providers Accepted | Our Match |
|---|---|---|---|---|
| Aggarwal Eye Hospital | Andheri East | +91 98211 11116 | Bajaj Allianz, Star Health, ICICI Lombard, New India, GIPSA, Care Health, HDFC ERGO, Niva Bupa, Universal Sompo, Liberty, Reliance, Digit, Chola, Acko, Navi, Manipal Cigna | ✓ Full Match |
| Arohi Eye Hospital | Andheri West/Versova | +91 98201 11315 | 50+ Insurance Providers, NABH, Medi Assist, MDIndia, Paramount, Heritage, FHPL, Raksha, Vidal, Volo | ✓ Full Match |
| Global Eye Clinic | Ghatkopar West | +91 95008 59570 | 15+ insurers, Liberty, ICICI Lombard, Star Health, Chola, Future Generali, HDFC ERGO, Reliance, Universal Sompo, Royal Sundaram, Bharti AXA, Apollo Munich | ✓ Full Match |
| Mumbai Eye Care | Ghatkopar | +91 84510 45934 | New India, National, Oriental, United India, Aditya Birla, Bajaj Allianz, Chola, Future Generali, HDFC ERGO, Liberty, Reliance, Care Health, SBI General, Star Health, Universal Sompo + 22 TPAs | ✓ Full Match |
| Orbit Eye Hospital | Jogeshwari West | Not listed | Acko, Aditya Birla, Bajaj Allianz, Bharti AXA | ✓ Full Match + More |
| Envision Eye Hospital | Jogeshwari West | Not listed | NABH certified, 7500+ surgeries/year | ✓ Equivalent |
| Doctor Eye Institute | Andheri West | Not listed | 60+ years, CGHS, NABH | ✓ CGHS + All |
| ASG Eye Hospital | Multiple locations | Not listed | Multiple TPAs and insurers across Mumbai | ✓ Full Match |
| Dr. Agarwal’s Eye Hospital | Vashi, Girgaon | Not listed | Major TPAs and private insurers | ✓ Full Match |
| Surya Eye Hospital | Multiple locations | Not listed | Multiple TPAs, 5 lakh+ cataract surgeries | ✓ Full Match |
| 🔷 Crystal Clear Eye + Topax Eye Care (Dr. Jignesh Gala) | Andheri West | 077188 85245 | ALL of the above + 30+ private insurers, 4 PSU insurers, 25+ TPAs, CGHS, ECHS, Ayushman Bharat, ESIC, MJPJAY. Direct + Third-party cashless through dual facilities. | ✓✓ Best Coverage |
✨ Why Choose Dr. Gala Over Competitors?
- ✓ Dual-facility processing – no competitor offers both direct AND TPA cashless
- ✓ FRCS + MRCS + FICO triple international qualification
- ✓ 162,000+ patients treated with excellent outcomes
- ✓ 25,780+ surgeries performed with precision
- ✓ BMJ Peer Reviewer – academic excellence recognised globally
- ✓ Convenient Andheri West location – easy access from all Mumbai
🚗 Save Time & Travel
- 📍 Located in Andheri West – heart of Mumbai’s western suburbs
- 🚆 Near Railway Station and Metro
- 🚌 Easy bus and auto connectivity
- 🅿️ Parking available nearby
- ⏰ Open until 9 PM – convenient for working professionals
- 📱 WhatsApp booking for hassle-free appointments
Step-by-Step Cashless Process
Your journey from consultation to surgery – completely hassle-free
At Crystal Clear Eye and Topax Eye Care, we have simplified the cashless process to ensure a seamless experience. Our dedicated insurance desk handles all the paperwork so you can focus on your treatment.
Visit Clinic
Walk in with your insurance card + ID proof. Our reception will guide you to the insurance desk.
OPD Consultation
Dr. Gala examines your eyes and recommends the appropriate surgical procedure.
Insurance Verification
We check policy validity, coverage, waiting period, and sub-limits instantly.
Pre-Authorisation
We fill and submit the pre-auth form to TPA/Insurance company.
Approval Received
Approval comes in 24-48 hours. Surgery is then scheduled at your convenience.
Surgery Performed
Cashless, zero payment from patient for admissible charges. Surgery by Dr. Gala.
Discharge
Final bills sent directly to the insurer. You only pay non-admissible amounts (if any).
Post-Op Follow-ups
Covered for 60-90 days post-surgery as per policy terms.
Typical Timeline
Documents Required Checklist
In case of emergency eye surgery (trauma, retinal detachment, acute glaucoma), the cashless approval process is expedited. We can obtain:
- Emergency approval within 6-12 hours
- Retroactive authorisation for admission
- 24/7 insurance coordination support
For eye emergencies, call us immediately at 077188 85245
Reimbursement (If Cashless is Denied)
In rare cases where cashless is not available, you can:
- Pay for the surgery upfront
- Submit bills to your insurer within the stipulated time
- Receive reimbursement in 15-45 days
Our insurance desk will help you with all reimbursement documentation to ensure maximum recovery.
Frequently Asked Questions
Everything you need to know about cashless eye surgery at our centres
Cashless eye surgery is a facility where you do not need to pay upfront for your surgical procedure. The hospital (Crystal Clear Eye or Topax Eye Care) settles the bill directly with your insurance company or TPA. You simply show your insurance card, get treated by Dr. Jignesh Gala, and the hospital handles all the financial processing. You only pay any non-admissible charges (like premium IOL upgrades, extra room rent, or co-pay amounts as per your policy) at discharge.
Yes, all health insurance policies in India cover cataract surgery. Coverage typically ranges from Rs. 25,000 to Rs. 50,000 per eye (usually 10% of your sum insured), subject to a waiting period of 2-4 years for individual policies. Group/employer policies often have shorter waiting periods (0-1 year), while government schemes like CGHS, Ayushman Bharat, and ESIC cover cataract surgery with no waiting period.
Generally, LASIK is NOT covered by most insurance companies as it is considered a cosmetic or elective procedure. However, some insurers may cover LASIK in exceptional cases: (a) if the refractive power is greater than -7.0 dioptres, (b) if performed as treatment for keratoconus after cross-linking, or (c) in cases of anisometropia causing functional vision disability. SMILE, Contoura Vision, and ICL surgery are also typically not covered. For LASIK at competitive self-pay rates, visit Topax Eye Care – The LASIK Hub.
Dr. Jignesh Gala accepts cashless eye surgery through virtually every major insurance provider in India. This includes 30+ private insurers (Star Health, HDFC ERGO, ICICI Lombard, Bajaj Allianz, Care Health, Niva Bupa, Aditya Birla Health, Manipal Cigna, Tata AIG, Acko, and many more), 4 PSU insurers (New India Assurance, National Insurance, Oriental Insurance, United India), 25+ TPAs, and 5 government schemes (CGHS, ECHS, Ayushman Bharat PMJAY, MJPJAY, ESIC). If you don’t see your insurer listed, please call us – we likely accept it.
You need to bring: (1) Health Insurance Card (original + photocopy), (2) Government ID Proof (Aadhaar/PAN/Passport), (3) Two passport-size photographs, (4) Previous medical records if any, (5) Bank account details (for reimbursement backup if needed), (6) Employer ID (for corporate policies), (7) Cashless card (if provided by your insurer), (8) Filled TPA pre-authorisation form (our insurance desk fills this for you), and (9) Doctor’s prescription recommending surgery. Our team will guide you through every document needed.
For planned surgeries, the pre-authorisation process typically takes 24-48 hours after submission. For emergency surgeries (trauma, retinal detachment, acute glaucoma), approval can be obtained within 6-12 hours. At Topax Eye Care and Crystal Clear Eye, our dedicated insurance desk proactively follows up with TPAs and insurers to ensure the fastest possible approval. We recommend scheduling your consultation at least 3-5 days before your preferred surgery date.
Direct cashless means the hospital has a direct agreement with the insurance company, bypassing intermediaries. This results in faster claims processing, fewer documentation requirements, and smoother coordination. TPA (Third Party Administrator) cashless involves an intermediary company that processes claims on behalf of the insurer. While equally reliable, it may involve slightly more paperwork and processing time. At our facilities, Topax Eye Care offers direct cashless with major insurers, while Crystal Clear Eye provides comprehensive TPA cashless coverage. We automatically route your claim through the optimal channel.
For cashless surgery, you typically do NOT pay the main surgical charges. However, you may need to pay: (1) Co-pay amount – a percentage of the bill (usually 10-20%) as per your policy terms, common in senior citizen policies, (2) Non-admissible charges – items not covered by insurance like registration fees, diet charges, or certain consumables, (3) Premium upgrades – if you choose a premium IOL (multifocal/toric/EDOF) or a room above your policy’s capping, (4) Non-medical items – some policies exclude gloves, gowns, etc. Our insurance coordinator will give you an exact estimate of out-of-pocket expenses before surgery.
Yes, most policies have waiting periods: Individual/Family Floater policies: 2-4 years for cataract, 2-4 years for other eye surgeries. Senior Citizen policies: 1-2 years for cataract. Group/Employer policies: 0-1 year (often no waiting period). Government schemes (CGHS, ECHS, ESIC, Ayushman Bharat): No waiting period. If you’ve ported your policy from another insurer, your waiting period credit transfers. We can check your specific policy’s waiting period status during your consultation.
Yes! Eligible families under Ayushman Bharat PMJAY can get completely free cataract surgery, glaucoma surgery, and retinal procedures at our centres. The scheme provides up to Rs. 5 lakh per family per year for secondary and tertiary care hospitalisation. To check your eligibility, visit the PMJAY website or call us. We have processed hundreds of PMJAY claims successfully.
Absolutely. We are empaneled for CGHS (Central Government Health Scheme) and accept ECHS (Ex-Servicemen Contributory Health Scheme) cards. Both schemes offer 100% cashless coverage for all eye surgeries including cataract, retina, glaucoma, and corneal procedures with no waiting period and no co-pay. Central government employees, pensioners, MPs, and ex-servicemen can avail world-class eye surgery at zero cost.
Cashless rejection is rare when proper verification is done beforehand. However, if it occurs: (1) We immediately initiate the reimbursement route – you pay and claim later, (2) Our insurance team appeals the decision with additional documentation if applicable, (3) We help you file a complaint with the Insurance Regulatory and Development Authority (IRDAI) if the rejection is unjustified. In our experience, with proper pre-authorisation, cashless approval rates exceed 95%.
Yes, in most cases. The initial cashless pre-authorisation typically covers post-operative follow-ups for 60-90 days from the date of surgery. This includes OPD consultations, medications, and any necessary post-operative procedures. The exact duration depends on your policy terms and the type of surgery. Our insurance desk will inform you of your specific follow-up coverage period at the time of discharge.
Insurance covers the cost of a standard foldable IOL for cataract surgery. If you want a premium IOL (multifocal, toric, EDOF/extended depth of focus), you will need to pay the difference in cost between the standard and premium lens. For example, if insurance covers Rs. 3,000 for a standard IOL and your chosen multifocal IOL costs Rs. 35,000, you pay the Rs. 32,000 difference. Dr. Gala will explain the benefits of each IOL type and help you make the best choice for your vision goals and budget.
Absolutely not. At Crystal Clear Eye and Topax Eye Care, every patient receives the same world-class surgical care regardless of payment method. Dr. Jignesh Gala personally performs or oversees all surgeries with the same precision, using the same advanced technology and equipment. The only difference is the administrative billing route – cashless claims are processed through insurance, while cash payments are settled directly. Your surgical outcome and experience are identical.
The easiest way is to WhatsApp us a photo of your insurance card at 077188 85245. Our insurance coordinator will: (1) Verify your policy status and sum insured, (2) Check waiting period completion, (3) Confirm coverage for your specific procedure, (4) Explain sub-limits and co-pay, (5) Give you an estimate of out-of-pocket expenses. This service is completely free and takes just a few minutes.
Yes, we process cashless claims for all GIPSA-affiliated PSU insurance companies (New India Assurance, National Insurance, Oriental Insurance, United India Insurance). GIPSA has standardised package rates for common procedures including cataract surgery. We follow GIPSA guidelines for billing and claim processing, ensuring smooth cashless settlement for PSU policyholders.
We are open Monday through Saturday (and Sunday by appointment for emergencies). Our regular hours are from 10:00 AM to 9:00 PM. The insurance desk operates during all working hours. For cashless surgery consultations, we recommend visiting between 11:00 AM and 7:00 PM when our senior insurance coordinator is present. You can also book your appointment on WhatsApp to avoid waiting.
Crystal Clear Eye: Laram Centre CHS, A1-202, Swami Vivekanand Road, above Sunil Jewellers, near NADCO Shopping Centre, Railway Colony, Andheri West, Mumbai, Maharashtra 400058. Phone: 077188 85245. Topax Eye Care: Visit topaxeyecare.com for directions. Both facilities are easily accessible by road, rail, and metro.
Yes, Dr. Jignesh Gala offers second opinion consultations for complex eye conditions. Many patients come to us for a second opinion after visiting other hospitals. OPD consultation charges may apply unless covered under your policy’s OPD benefit. If surgery is recommended and you choose to proceed with us, the consultation may be adjusted against your surgical package. Book a second opinion consultation today.
What Our Patients Say
Real stories from patients who trusted us with their vision
Hundreds of patients celebrating their new vision at Topax Eye Care – “I DID IT!”
I got my mother’s cataract surgery done through cashless at Crystal Clear Eye. The entire process was so smooth – from insurance verification to surgery to discharge. Dr. Gala explained everything in detail. My mother can see clearly now without glasses. Highly recommended!
After my retinal detachment diagnosis, I was worried about both the surgery and the cost. The insurance desk at Topax Eye Care handled my ICICI Lombard cashless claim within 24 hours. Dr. Gala performed the vitrectomy and saved my vision. Forever grateful!
My father is a central government pensioner with CGHS. We got 100% cashless cataract surgery with a premium multifocal IOL. The staff was courteous, Dr. Gala was excellent, and we didn’t pay a single rupee for the surgery. Best eye hospital in Andheri!
My daughter needed squint surgery and we have a family floater policy with HDFC ERGO. The cashless approval came in just one day. Dr. Gala was so patient with our daughter. The surgery was successful and her eyes are perfectly aligned now.
I was eligible for Ayushman Bharat and got completely free glaucoma surgery at Crystal Clear Eye. The staff helped me with all the documentation. Dr. Gala’s expertise is remarkable – my eye pressure is now under control. Thank you for this wonderful service!
Being an ex-serviceman with ECHS, I was looking for a good eye hospital that accepts ECHS. Found Crystal Clear Eye through a friend. Got cashless cataract surgery with zero hassles. Dr. Gala has golden hands. Jai Hind!
Why We Are The Best Choice for Cashless Eye Surgery in Mumbai
Combining surgical excellence with the most comprehensive cashless network in the region
Most Qualified Surgeon
Dr. Jignesh Gala: FRCS Glasgow, MRCS Edinburgh, FICO London, dual LV Prasad fellowship. BMJ Peer Reviewer. Ex-Assistant Professor, Nair Hospital.
Dual-Facility Advantage
The ONLY eye care group in Andheri with both direct cashless (Topax) AND third-party cashless (Crystal Clear) – maximum insurance coverage.
Widest Insurance Network
30+ private insurers, 4 PSU insurers, 25+ TPAs, CGHS, ECHS, Ayushman Bharat, ESIC, MJPJAY – all under one roof.
Proven Track Record
1,62,000+ patients treated. 25,780+ surgical procedures. 12+ years of excellence. Numbers that speak for themselves.
Fastest Approvals
24-48 hour pre-authorisation for planned surgery. 6-12 hours for emergencies. Dedicated insurance desk for proactive follow-ups.
Prime Location
Andheri West – heart of Mumbai’s western suburbs. Easy access by road, rail, and metro. Open until 9 PM for working professionals.
📥 Download Your Free Cashless Eye Surgery Guide
Get a comprehensive PDF guide with insurance company-wise coverage details, document checklists, and step-by-step process flow. Sent instantly to your WhatsApp.
Send Guide to My WhatsApp