The rising costs of present-day medical treatments have made it indispensable to maintain a proper health insurance plan, with enough coverage. Even for domiciliary treatment or day care, health Insurance aids a lot. In this article, we will be highlighting the different aspects of day care treatment processes.
Technically day care treatment processes are referred to as those medical treatment processes that require hospitalisation for less than one day or 24 hours. Some prominent examples of day care treatments include dialysis, cataract surgery, chemotherapy, radiotherapy, appendectomy, angiography, etc. However, no OPD consultations related to any fracture, sprain, or any other minor medical treatment procedures cannot be included as day care treatments.
Some of the common day care procedures that are generally covered by health insurance policies include cataract (eyes), adenoidectomy (throat), appendectomy (gastro), fistula/piles (rectal), septoplasty (nasal), and other processes include radiotherapy, chemotherapy, angiography, etc. However, every individual health insurance plan differs in its list of day care processes included. You must carefully read and understand the policy documents to know the full details of the particular plan.
Read More: Day Care Treatments Covered Under Health Insurance
Not all health insurance plans cover day care treatment processes. The ones that provide it are highly beneficial, especially for those who require it regularly, and might eventually cost a fortune. Some of the most significant benefits of day care coverage include:
Any medical procedure that requires the concerned policyholder to get admitted to the hospital for less than 24 hours falls under the coverage category of day care treatment inclusions. It can be any surgery or operation or any other medical treatment process, but it is compulsory to get admitted to the hospital for a few hours to qualify for this claim. Some plausible examples of this sort of procedure include cataract surgery, dialysis, etc.
The option of day care coverage comes with its limitations and naturally never includes each and every short-term medical treatment procedure. Any treatment procedure that is dealt with by the OPD never qualifies for day care treatment procedures. Therefore, any medical consultation for minor injuries, regular health check-ups, etc. is not included in this category.
As mentioned above, not all minor medical treatment processes qualify for day care treatment. You need to fulfil certain pre-defined criteria to qualify for the same:
The claim settlement procedure for day care treatment is similar to in-patient claims only. You can opt for either reimbursement or a cashless claim only depending on the circumstances or the nature of the treatment and the hospital chosen to fulfil the procedure.
Firstly, to avail of the facility of a cashless claim, you have to choose a network hospital and duly inform the concerned insurance provider before the onset of hospitalisation
The insurer will also receive the same information from the hospital authorities too, confirming and approving that the day care treatment process comes within the purview of the chosen plan
Depending on the terms and conditions of the plan and the provisions of day care coverage, the concerned insurance company will settle all the dues with the hospital authorities.
There exist certain basic differences between OPD coverage and day care treatment cover:
| FACTORS OF DIFFERENCE | DAY CARE TREATMENT | OPD COVER |
|---|---|---|
Before you buy health insurance with day care cover, you need to carefully consider certain crucial factors for the best experience:
This article is a comprehensive discussion of the crucial aspects of day care treatment processes. As per the existing pattern of health insurance in India, you do not need to opt for it separately, day care remains included within the standard coverage of a health plan. However, depending on your plan choice, the extent of this coverage may differ.
