Are multifocal lenses covered by ECHS and what are the charges?

Hello,

Under ECHS, cataract treatment at an empanelled hospital is covered according to the applicable ECHS/CGHS package and rates. The standard eligible lens is covered as per the applicable entitlement.

If you want a multifocal or other higher-cost premium IOL, ECHS allows you to opt for the costlier lens, but you have to pay the difference between the approved ECHS/CGHS ceiling and the cost of the selected lens. The official ECHS FAQ confirms that beneficiaries can opt for a costlier IOL by paying the difference.

How much do you have to pay?

There is no single fixed amount. Your out-of-pocket amount depends on:

• The type and brand of multifocal lens

• The hospital's current price

• The applicable ECHS/CGHS lens ceiling

• The cataract package applicable to you

Before the operation, ask the hospital billing desk for a written breakup:

Cost of selected multifocal lens − ECHS/CGHS approved lens amount = Amount payable by you

What should you do?

1. Get the ECHS referral for cataract treatment.

2. Visit an ECHS-empanelled eye hospital.

3. Ask the ophthalmologist about the available lens options.

4. If you prefer a multifocal lens, ask for its total price.

5. Ask the billing department for the exact ECHS-covered amount and your additional payment before giving consent.

6. Pay only the confirmed difference for the premium lens, as applicable.

The exact amount should therefore be confirmed with the ECHS-empanelled hospital before surgery.

Wishing you and your family good health always.
Warm regards,
Team HexaHealth