Daycare Procedures in Health Insurance

Posted on: Mar 27, 2023 | | Written by: HDFC ERGO Team

Daycare Procedures in Health Insurance

Imagine that you've been experiencing persistent pain in your knee, limiting your mobility and interfering with your daily activities. You visit a doctor who recommends a diagnostic procedure and a follow-up surgery to treat the underlying condition. However, the thought of hospitalisation for an extended period and the high cost of the procedure is daunting. In such a situation, daycare treatments can offer a viable solution. Daycare treatments are medical procedures that do not require overnight hospitalisation and can be completed within a few hours or a day. The cost of daycare treatments can be high. Fortunately, many healthcare plans, including individual health insurance policies, cover daycare treatments, making it easier for individuals to access necessary medical procedures.

What are Daycare treatments in health insurance?

Due to advancements in science and technology, many medical treatments and procedures today do not require prolonged hospitalisation. Such procedures and treatments can be completed in the span ofa few hours. Such procedures, surgeries, and treatments require hospitalisation, but the patient is discharged on the same day. Your health insurance policy includes daycare procedures; hence, you don’t have to buy it separately as an add-on cover.

Daycare treatments should not be confused with OPD (Out-Patient Department) consultation. In OPD, you consult a doctor for issues or minor medical treatments which do not require hospitalisation.

List of coverages

Here are some common daycare procedures covered under insurance:

• Chemotherapy

• Radiotherapy

• Angiography

• Dialysis

• Cataract surgeries

• Colonoscopy

• Sinusitis

• Appendectomy

• Liver aspiration

• Piles/Fistula

• Septoplasty

Benefits of Daycare Procedures Covered under Health Insurance Plans

The benefits of daycare procedures covered under insurance are:

1. Daycare procedures are generally planned in advance, so you can notify the insurer and easily avail of cashless claims at any of the network hospitals of the insurance provider.

2. Due to technological advancements, daycare treatments are much easier and hassle-free. You can also avail timely and quality medical care without worrying about expenses.

3. Whether you opt for a cashless or reimbursement claim, the process is seamless and usually similar to inpatient hospitalisation claims.

4. As per Section 80D, you can avail of a tax deduction on the premium paid towards your health insurance policy having features like Daycare procedures.

How to opt for the Best Daycare Health Insurance Policy?

Now that you know what is daycare treatment, the next step is to understand how to buy the best daycare health insurance policy. Daycare expenses are covered in your Mediclaim policy, so you need to keep the following factors in mind while purchasing the plan:

1. Type of policy:

Whether you are buying individual health insurance or a family healthcare plan, ensure the policy also has comprehensive coverage for daycare procedures. The policy should meet your requirements.

2. Sum insured:

This is an important factor. Considering the number of family members and health conditions, the sum insured should be sufficient to financially protect you in case of emergencies. Never settle for a low sum insured because of a lower premium.

3. Network hospitals:

Opt for an insurance provider with a wide network of hospitals. Keep a list of the hospitals which are near your location for immediate access in an emergency.

4. Exclusions:

Some procedures may not come under the purview of daycare procedures covered under insurance. Check the policy exclusions and other terms and conditions before buying the policy, whether individual health insurance, family floater, or senior citizen health insurance.

5. Co-payment:

A co-payment clause in a policy is a certain percentage of the claim amount you have to bear while the insurer pays the rest. Be aware of the co-payment amount so that you are financially prepared.

Conclusion

Today, several medical procedures have become daycare procedures, thanks to medical advancements. The financial burden is reduced as daycare surgeries are done within 24 hours and do not require prolonged hospitalisation. As per the IRDAI, the non-hospitalisation expenses are almost twice the hospitalisation costs. They also help you get cashless claims without any hassles since these surgeries are planned in advance. So, while choosing the best health insurance in India, it is important to understand what is daycare treatment in health insurance and opt for the one which covers a wide range of daycare treatments.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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