What's inside? 🧐
- Introduction
- What Is A Day Care Treatment?
- How Is A Day Care Treatment Different From OPD Treatment?
- Why Are Day Care Treatments Important In A Health Insurance Policy?
- List Of Day Care Procedures Included Under Health Insurance
Introduction
The field of healthcare is progressing at a never-seen-before pace. Now, treatments that require extended hospital stay are as convenient as a swift, one-day road trip, leaving you with minimal disruption to your daily life. Offering you the gift of speedy recovery and a chance to swiftly resume your routine.
However, beneath this silver lining lies a challenge - as medical miracles unfold, insurance providers have hesitated to adapt to the changing landscape. And therefore, many find themselves grappling with financial burdens, unable to access the benefits of these expedited treatments.
But fret not, as the Insurance Regulatory and Development Authority of India (IRDAI) has offered a game-changing solution. It has urged insurance companies to incorporate an essential feature in their policies - the coverage of day care treatments - an advanced way of getting you treated without spending the night at the hospital.
In this article, let us delve into the world of day care treatments.
What Is A Day Care Treatment?
In the past, health insurance mainly covered treatments that required staying in the hospital for more than 24 hours. However, thanks to remarkable technological advancements, the landscape has evolved significantly.
Today, some medical procedures can be efficiently performed under either general or local anaesthesia, allowing patients to undergo treatment and return home within a 24-hour timeframe. These are categorised as day care treatments. For such treatments to be covered by a health insurance policy, it is imperative that they are deemed medically necessary, and a written prescription from a qualified medical professional is required.
Some of the common procedures that fall under day care treatments include -
- Piles / Fistula
- Angiography
- Dialysis
- Cataract
- Chemotherapy
- Colonoscopy
- Sinusitis
- Eye surgery
- Hydrocele
- Appendectomy
- Lithotripsy
- Liver aspiration
- Prostate
- Radiotherapy
- Sclerotherapy
Note: Besides these, many other procedures can be covered under day care treatments. The specific procedures that are covered by your policy depend on the type of policy you choose. Therefore, it is essential to review the policy details to pick the one that best aligns with your specific needs and preferences.
Now, you may be wondering, “What is the difference between day care treatments and OPD treatments - since both these have shorter treatment duration?” Let’s find out…
How Is A Day Care Treatment Different From OPD Treatment?
While Day Care and OPD treatments may seem alike due to their shorter treatment durations, a subtle yet significant distinction sets them apart. The key difference between the two lies in the aspect of how long you stay in the hospital.
👉Day Care Treatments
A day care treatment specifically pertains to medical surgeries, operations, or treatments that necessitate no more than a 24-hour hospital stay, thanks to advancements in modern medical technology. Take cataract surgery, for example. Just a few decades ago, patients undergoing this procedure had to stay in the hospital for several days. However, technological progress has streamlined the surgery to the point where patients can now be discharged on the same day.
👉OPD Treatments
An Out Patient Department (OPD) treatment is a convenient way to consult with a doctor about your health concerns - without the need for hospitalisation. This means you can simply visit a medical facility like a diagnostic centre, consultation room, or pharmacy in the hospital to seek advice from the doctor and initiate treatment. For example, if you have a stomach ache or any minor health issue, and you want a doctor's expert advice, you can reach out to the OPD.
So, day care treatments require you to get hospitalised even if they consume less time. On the flip side, OPD consultations are more about seeking advice and getting minor procedures done without the need for hospitalisation. So, you must not consider sprains, fractures and other minor procedures as day care treatments.
Why Are Day Care Treatments Important In A Health Insurance Policy?
In the realm of health insurance, day care treatments play a pivotal role by offering coverage for medical procedures that demand specialised medical attention but no overnight hospital stay. Even though these treatments allow you to go back home the same day, they can still be costly. This is where health insurance with day care coverage comes to the rescue, ensuring you are shielded from the burden of hefty medical expenses.
In medical conditions like cancer and kidney failures, day care procedures such as chemotherapy and dialysis play a major role in the overall treatment process. And they often account for a substantial chunk of healthcare expenses. Being insured for such procedures can make a huge difference, easing the financial strain and allowing you to focus on healing.
So, day care procedures reduce the disruption caused to your daily routines and enable you to recover in the comfort of your home, surrounded by your dear ones. Basically, you can stay protected against hospital-acquired infections by being at home, ensuring a safer and more effective recovery process!
List Of Day Care Procedures Included Under Health Insurance
You can find all the day care treatments covered by leading health insurance policies in the below table -
Health Insurance Plans | Day Care Treatments Covered | Limit Of Day Care Procedures Acko (Health Insurance) | All day care treatments covered | Up to the sum insured Aditya Birla - Activ Fit (Preferred) | All day care treatments covered | Up to the sum insured Aditya Birla (Active Assure) | 586 procedures | Up to the sum insured Aditya Birla Activ Health Platinum - Enhanced | 586 procedures | Up to the sum insured Aditya Birla Activ Health Platinum -Premiere | 586 procedures | Up to the sum insured Bajaj Allianz - Health Guard (Gold Plan) | 399 day care procedures are covered | Up to the sum insured Bajaj Allianz - Health Guard (Platinum Plan) | 399 day care procedures are covered | Up to the sum insured Care Insurance (Care Supreme) | All day care treatments covered | Up to the sum insured Care Insurance (Care) | 541 day care procedures are covered | Up to the sum insured Chola MS - Flexi Health | 539 procedures | Up to the sum insured Zuno General - Health Insurance | all procedures | Up to the sum insured Future Generali - Health Total Vital | 409 procedures | Up to the sum insured GoDigit - Health Insurance (Double Wallet Plan) | All day care treatments covered | Up to the sum insured GoDigit - Health Insurance (Infinity Wallet Plan) | All day care treatments covered | Up to the sum insured GoDigit - Health Insurance (Worldwide Treatment Plan) | All day care treatments covered | Up to the sum insured HDFC Ergo (Optima Restore) | All day care treatments covered | Up to the sum insured HDFC Ergo (Optima Secure) | all procedures | Up to the sum insured ICICI Lombard (Health AdvantEdge) | All day care treatments covered | Up to the sum insured IFFCO Tokio Family Health Protector | 161 procedures | Up to the sum insured IFFCO Tokio Individual Health Protector | 161 procedures | Up to the sum insured Kotak Health Premier - Advantage | 405 procedures | Up to the sum insured Kotak Health Premier - Edge | 405 procedures | Up to the sum insured Kotak Health Premier - Elite | 405 procedures | Up to the sum insured Liberty Health Connect- Basic | 140 procedures | 10% of the sum insured Liberty Health Connect - Elite | 140 procedures | 10% of the sum insured Liberty Health Connect - Supreme | 140 procedures | 10% of the sum insured Manipal Cigna - ProHealth (Accumulate) | 546 day care procedures are covered | Up to the sum insured Manipal Cigna - ProHealth (Plus) | 546 day care procedures are covered | Up to the sum insured Manipal Cigna - ProHealth (Protect) | 546 day care procedures are covered | Up to the sum insured Manipal Cigna - ProHealth Prime (Advantage) | All day care treatments covered | Up to the sum insured Manipal Cigna - ProHealth Prime (Protect) | All day care treatments covered | Up to the sum insured Max Bupa (Health Companion) | All day care treatments covered | Up to the sum insured National Insurance
(Parivar Mediclaim Plus Policy) | 140 procedures | Up to the sum insured National Insurance (Mediclaim Plus Policy) | 140 day care procedures are covered | Up to the sum insured New India - Mediclaim Policy | 138 procedures | Up to the sum insured Niva Bupa - ReAssure 2.0 (Platinum+) | All day care treatments covered | Up to the sum insured Niva Bupa - ReAssure 2.0 (Titanium+) | all day care treatments covered | Up to the sum insured Oriental (Happy Family Floater - Gold) | 116 day care procedures are covered | Up to the sum insured Oriental (Mediclaim Insurance Policy -Individual) | 116 procedures | Up to the sum insured Raheja QBE- A La Carte | 140 procedures | Up to the sum insured Raheja QBE- Basic | 140 procedures | Up to the sum insured Raheja QBE- Comprehensive | 140 procedures | Up to the sum insured Raheja QBE- Super Saver | 140 procedures | Up to the sum insured Reliance General - Health Gain (Power) | All day care treatments covered | Up to the sum insured Reliance General - Health Infinity | All procedures | Up to the sum insured Royal Sundaram - Lifeline (Supreme Plan) | All day care treatments covered | Up to the sum insured Royal Sundaram - Multiplier | All day care treatments covered | Up to the sum insured SBI General - Arogya Supreme | 537 procedures | Up to the sum insured SBI General - Health Edge | All day care treatments covered | Up to the sum insured Star Health (Assure) | All day care treatments covered | Up to the sum insured Star Health (Comprehensive) | All day care treatments covered | Up to the sum insured Star Health (Family Health Optima) | All day care treatments covered | Up to the sum insured TATA AIG - MediCare | 541 procedures | Up to the sum insured TATA AIG - MediCare Premier | 541 procedures | Up to the sum insured United India (Family Medicare Policy) | All day care treatments covered | Up to the sum insured Universal Sompo Complet health Care (Privilege) | 514 procedures | Up to the sum insured
Every health insurance policy has a number of day care treatments they cover. But that number alone might not tell you the whole story. Some insurers use general terms for procedures related to specific organs, while others provide more detailed descriptions of the diseases and treatments covered. Put simply, some insurers provide you with the big picture, while others zoom in on the tiniest details.
Now, going through these lists and comparing them with other insurance companies can be tough if you are not familiar with all those medical terms. But here's some good news - nowadays, many leading insurers offer plans without any list of day care procedures. This means that they promise to cover all the necessary hospitalisations - without saying NO to any particular treatment. That means you don't have to worry about checking long lists or missing out on something important.
And, as per MyInsureBuddy’s expert opinion, going for such a company that covers ALL day care procedures is the best choice. This way, you can ensure that you are always covered, no matter what storms your weather!
Need more clarity on the day care procedures and whether your preferred plan covers them? Go for MyInsureBuddy's Free 1-To-1 Consultation to get expert answers!