The exclusion of a treatment package which covered the treatment of age-related macular degeneration (AMD) from the Medisep 2 health insurance scheme, which came into effect on February 1, is likely to put thousands of pensioners in Kerala at the risk of irreversible loss of vision.
Ophthalmologists say the AMD is a leading cause for loss of vision in those above 50 years.
Expressing grave concern over the exclusion, Devin Prabhakar, Thiruvananthapuram-based ophthalmologist and the State president of Qualified Private Medical Practitioners Association (QPMPA), said that Medisep 2’s exclusion of Intra-vitreal anti-VEGF injections, the timely administration of which is essential for preserving eyesight in those suffering from the AMD, was “devastating” for the elderly.
He said that the issue was noticed when one of his patient’s treatment claim was not accepted by the Medisep.2 software.
The AMD happens when the centre of the retina (macula) is damaged. Excess production of vascular endothelial growth factor (VEGF), a protein produced by cells in the body, can lead to the abnormal growth of blood vessels under the macula. These vessels may leak blood or other fluids, causing swelling and bleeding of the macula, affecting vision.
Intravitreal anti-VEGF drugs are medications injected directly into the eye’s vitreous cavity to block VEGF, so that fluid leakage and abnormal blood vessel growth are reduced. “These are standard, sight-saving treatments for retinal diseases such as wet AMD. The drugs are patented and hence expensive, making the treatment unaffordable to many without insurance cover. Under Medisep.1, up to six anti-VEGF injections a year (amounting to approximately ₹1 lakh) was covered and thousands of pensioners were benefiting from this,” said Dr. Prabhakar.
‘Irreversible blindness’
“Without access to Intravitreal anti-VGEF injections, patients face a high risk of irreversible blindness, affecting their independence and well-being. Pensioners might delay their treatment, if they do not get Medisep cover and this can be dangerous,” Dr. Prabhakar said.
He said that every insurance claim for intravitreal anti-VGEF injections were accompanied by photographs of the retina and OCT scans and that there was no room for any malpractice.
The QPMPA has appealed to authorities to prioritise the welfare of pensioners and to include intravitreal anti-VGEF drugs in the Medisep.2 treatment packages like earlier.
Published – February 04, 2026 05:45 pm IST
