Daycare Treatments Are Covered Under Health Insurance

Considering the circumstances, experts have opined that maintaining at least one health insurance policy is the only way out for efficient finance management. A couple of days' hospitalisation is enough to deplete a considerable amount of your hard-earned money. Even a daycare treatment also attacks your money pretty hard.

This article will shed light on the types of daycare treatments that are covered under health insurance policy coverage.

What is meant by daycare treatment procedure?

Daycare treatment is termed as those treatments that require less than 24 hours of hospitalisation. Some of the common types of daycare treatments include cataract surgery, chemotherapy, angiography, radiotherapy, appendectomy, etc.

Daycare treatments never really require any more than 24 hours of hospitalisation. It has become possible because of medical technological advancements. You must not confuse small OPD consultations related to fractures, sprains, etc. with daycare treatments.

Which daycare procedures are covered by health insurance?

Nearly all standard health plans offer daycare treatment coverage. However, the types of ailments covered may vary from one insurer to another.

List of daycare treatments covered under health insurance

Some of the common types of daycare procedures that are covered under health insurance include:

Benefits of having daycare treatment coverage in health insurance

Some of the major benefits of having health insurance with daycare coverage include the following:

• Convenience: A daycare coverage facility allows you easy access to quality medical facilities without much financial strain or tension.

• Easy claim settlement: The health insurance daycare claim settlement procedure is comparatively much simpler and quicker.

• Wide network: Policyholders become eligible to access a wide network of quality healthcare facilities with the help of health insurance coverage protection.

• Tax savings: Premiums paid towards health insurance are liable for tax benefits under section 80D of the IT Act.

What is covered?

Any medical treatment or procedure that requires less than 24 hours of hospitalisation qualifies for daycare coverage under health insurance. Some plausible daycare coverage examples include dialysis, chemotherapy, angiography, radiotherapy, appendectomy, cataracts, etc.

What is not covered?

Any treatment procedure that is done under OPD does not fall under the category of daycare coverage. For example, if you require medical consultation for seasonal ailments or minor sprains that do not involve any surgical intervention, it will not be covered by daycare protection.

Daycare coverage eligibility

The following are the conditions that qualify a medical process as a daycare facility:

• The treatment procedure must be medically essential

• The process must require hospital admission of the concerned individual

• The hospitalisation duration must remain within 24 hours due to advanced medical treatment progress.

• The patient must require general or local anesthesia to complete the procedure

Factors to consider while opting for daycare treatment coverage

Some of the major factors that you need to consider before choosing a health plan with daycare coverage include:

• Sum insured: The influence of medical inflation is true and undeniable. You must consider it while deciding the sum insured amount. The coverage value must be enough to meet your requirements.

• Policy type: Be it a family floater plan or an individual health cover, the chosen health plan must offer comprehensive coverage against medical costs, including daycare protection.

• Exclusions: The policy document mentions every single detail involved in the plan concerned. You must read the document well to be aware of all the relevant details to decide your suitability before purchasing.

• Co-payment: Before buying, check out the co-payment option to keep yourself prepared to share a certain percentage of expenses incurred during hospitalisation or undergoing any form of medical treatment.

• Network hospitals: It is desirable that the list of network hospitals must be wider to ensure easy availability of cashless treatment facilities.

Daycare claim filing

You can file for claim settlement for daycare treatments using both cashless and reimbursement options:

Cashless

• Since most daycare procedures are pre-determined, inform your respective insurance provider prior to the procedure and choose a network hospital.

• The hospital authorities will also forward similar information once you get admitted, confirming the insurance coverage.

• Once everything is confirmed to be authentic, the claim is automatically settled by the insurance company directly with the hospital authorities.

Reimbursement

• Select any non-network hospital of your choice and inform your respective insurance company about the same.

• Settle all the dues out of your pocket once the treatment is over, but keep all the bills and documents intact.

• Apply for claim settlement after discharge by submitting all the relevant details and documents.

• Once all are verified to be genuine, you will receive the claim amount directly to your bank account, provided you raise the claim within the stipulated time.

Differences between daycare treatments and OPD coverage

Some of the major differences between daycare treatment and OPD treatment include:

Conclusion

We have aptly established how daycare treatments differ from OPD treatments to avoid any confusion and ensure a better understanding. Nearly all standard health plans offer daycare treatment coverage, but the types of procedures covered may differ according to the insurance provider. You must read the policy documents well to know if it will suit your needs or not and then proceed to buy.

FAQ's On Day Care Treatments

Ans: Hospital daycare is the practice of planned admission to treat certain ailments that would not require more than a days’ hospitalisation. This reduces hospital care cost and reduces surgical waiting time, thereby minimally disrupting a patient’s lifestyle.

Ans: Yes, certain daycare treatments that would require a day’s attendance are covered under insurance.

Ans: Yes, some treatments that require less than 24 hours of hospitalisation can be covered under certain plans in insurance.

Ans: Day Care Procedure Benefit is the ease of treatment an ailment within 24 hours, thereby requiring hospitalisation of less than a day. This has proved to be beneficial for patients as they can now be treated and discharged within a day.

Ans: There are a number of factors an individual must consider before zeroing in on a Day Care Health insurance plan. Some of them are provision of cashless facility, age limit, sub limit, co-payment etc.

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