Health Insurance: Here’s all you need to know about Day Care procedures

The procedures that require medical care and are completed within 24 hours are called daycare procedures.

health insurance
As a policyholder, you must thoroughly read the policy documents to know the day care procedures included in your policy. Representative image

Any illness and/or injury can become a huge obstacle in achieving life goals. While there are times when these cannot be prevented, the only hope in such a situation is faster recovery through proper medicine. The crucial factor here is getting the right treatment at the right time. Thankfully now, the healthcare industry has advanced so much so that procedures that required several days in the hospital are now being treated in a day’s time or less. Health insurance policies also provide cover for several daycare procedures. The procedures that require medical care and are completed within 24 hours are called daycare procedures.

Nikhil Chopra, Chief Business Officer, Medi Assist Healthcare Services, said that these procedures require advanced treatments and are expensive. Previously, health insurance policies covered inpatient hospitalizations and treatments that went beyond 24-hours only.

“Choosing the right health insurance cover for yourself and your loved ones can help you secure your finances against enormous medical bills. There are various benefits for opting for a daycare policy, whether it is a planned treatment or an emergency,” Chopra told FE Online.

What are daycare procedures/treatments?

According to Chopra, daycare treatments refer to medical treatments and/or Surgical Procedures that –

  1. Have to be undertaken under General or Local Anesthesia in a Hospital/Day Care Centre in less than 24 hours because of technological advancement
  2. Otherwise required a Hospitalization of more than 24 hours.

These treatments can be undergone in ‘AYUSH’ daycare centres as well. Every health insurance policy typically has a list of procedures considered a part of daycare procedures and mentions the scope of them very clearly.

Common daycare procedures/treatments

Chopra said that choosing the right policy will enable you to avail for a better cover for various day care procedures. The coverage is available for a wide range of surgical procedures noted below:

  • Eyes: Cataract, Excision and destruction of infected tissue of the eyelid, Incision of tear glands, Incision of the cornea, Retinal detachment surgery, Procedures on the epicanthus and canthus, Foreign body removal from the cornea, conjunctiva, eye lens, etc
  • Nose: Procedures on the turbinates, Excision and destruction of infected tissue of the nose, Nasal sinus aspiration
  • Heart: Coronary Angiography
  • Tongue: Incision, excision, destruction of diseased tissue of the tongue, glossectomy, reconstruction of the tongue, and other surgical procedures
  • Cancer Treatment: Radiotherapy and chemotherapy
  • Other surgeries: Haemodialysis, colonoscopy, lesion removal, piles appendicectomy, hydrocele treatment, lithotripsy, sclerotherapy, thoracoscopy, skin surgeries
  • Orthopaedics: Arthroscopic knee aspiration, Osteosynthesis, Incision on bone – aseptic and septic, Suture and other procedures on tendons/tendon sheath

“There are some of the daycare procedures that many health insurance policies cover. As a policyholder, you must thoroughly read the policy documents to know the daycare procedures included in your policy,” said Chopra.

It is important that you go through and understand the surgical procedures included in the daycare procedures before purchasing your policy. Further, also evaluate the number of procedures included within each category as listed above. This can help you avoid any kind of confusion going forward.

Benefits of daycare procedures

  • Avail Cashless treatment: Daycare procedures are mostly planned in advance which means that you can avail seamless cashless treatment at any of the network hospitals.
  • Seamless Claims procedure: The claims process for daycare procedures is the same as your regular cashless or reimbursement claims making it easy and convenient.
  • Efficient medical care: Day is a much more hassle-free treatment process that can help you undergo treatment and start your recovery journey immediately.

What is the difference between OPD and Daycare procedures?

The primary difference between OPD and daycare procedures is the nature of the procedures covered. While OPD includes minor medical expenses, the latter relates to costlier procedures that otherwise would have entailed at least 24-hour hospitalization, if not for medical technology advancements. Dental treatments fall in the OPD category, while cataract surgery comes under daycare procedures

Things to Keep in Mind

According to Chopra, Day care procedures are covered subject to them being in the by the particular insurance company. When looking for policies that cover day care procedures, it is advisable to look for policies that cover a broad range of categories instead of ones that list specific procedures as the broad categories generally cover a lot more surgeries and procedures.

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