Explained: Day Care Treatment Cover vs OPD Treatment Cover


Explained: Day Care Treatment Cover vs OPD Treatment Cover

Health is a vital aspect of our lives that demands maximum attention. Getting quality health care is crucial as it helps us get back to good health and routine that got affected due to an ailment, injury, or medical condition. A health insurance policy is a necessity as it covers hospital expenses and reduces the need to spend money from our reserves. A good health cover offers more than just in-patient hospitalisation benefits. It also includes day care procedures that do not require an extended stay at the hospital. Coverage for day care treatment in health insurance is a beneficial feature.

Day care treatment and OPD treatment are two terms in the health insurance domain that often confuses people. Hone your knowledge on such technical jargon so that you do not face any hassle at the time of applying for a health insurance claim.

Day care treatment is different from the feature of OPD cover in health insurance plans. We shall discuss them in this article.

Understanding Day Care Treatment Cover

If you think that hospitalisation is necessary to be eligible to get the benefits of your health cover, it is not so. You can avail of day care treatment that may not require you to stay for more than 24 hours in the hospital. Several medical or surgical procedures that once required an extended hospital stay for the patient are now done quickly, thanks to medical advancements. These procedures are called Day Care Treatment or day care procedures, which require less than 24 hours of hospitalisation.

Think of a time when surgeries for cataract removal would require a patient to admit in the hospital for a few days. Now, with day care procedures, a patient can get back home the same day and can focus on faster recovery.

Under Day care treatment in health insurance policies, the insurer will bear the medical expenses, through reimbursement or cashless facility, subject to the policy terms and conditions. At the time of buying a policy, one should take a detailed view of the policy documents to know the specified day care procedures covered in the policy.

Given below are some of the medical procedures mentioned in the Day Care Treatment list of Care Health Insurance:

  • Coronary Angiography
  • Cataract Surgery
  • Radiotherapy and Chemotherapy
  • Haemodialysis
  • Tonsillectomy
  • Bone fracture and joint-related surgeries
  • Certain injury-related dental surgeries

Know the Difference between Day Care Treatment and OPD Cover

Outpatient Department or OPD treatment is available in many hospitals wherein a patient can visit the doctor’s clinic, or consultation room, for getting medical services including consultation, diagnosis of ailments, minor medical procedures, pharmacy, etc. without getting admitted in the hospital. 

The OPD cover includes in the policy on a reimbursement basis. There are terms and conditions in Health Insurance which Covers OPD expenses. For instance, there is a limit on the number of times one can make a claim for OPD costs. It is advisable to read the policy documents when one opts for a health cover. 

The need for hospitalisation of a minimum duration in day care treatment makes it different from OPD treatment where the patient does not require to be hospitalised. However, one should note that surgery done as an outpatient procedure is not considered as a day care treatment. 

Let us understand the differences:

Factors Day Care Treatment OPD Cover
1. Hospitalisation Hospitalisation of minimum duration, which is less than 24 hours, is compulsory For OPD treatment, the insured person does not require hospitalisation
2. Coverage Coverage for daycare treatment is up to sum insured. It is available as a main feature in many health insurance policies. Some health policies include OPD cover as an optional benefit. The coverage is up to a specified limit.
3. Claim Settlement The facility of Cashless treatment is available under daycare treatment cover. However, one can also apply for reimbursement claim if the treatment is taken at a non-network hospital. The cover for OPD expenses is provided only through reimbursement facility. The policyholder should submit relevant documents to get the claim.

To Summarise

By opting for health insurance with day care treatment cover, you can be free from any worry as your policy will cover your hospitalisation expenses, thereby saving you from a financial burden. For the claim settlement for day care cover, all you need to do is follow the same procedure as mentioned for in-patient hospitalisation. By availing the cashless medical treatment facility at a network hospital, you would have easy access to quality medical care and stay relaxed about payment of hospital bills.

Stay knowledgeable and embrace a healthier life by accessing the best medical treatment. Make the most of the various benefits of your health insurance policy. The benefits include coverage for 541+ day care treatments procedures and surgeries. Visit our official website to find the best health cover and get the cashless treatment facility at any of the 21,100+ cashless healthcare providers. 

Disclaimer: Plan features, benefits, coverage, and underwriting of claims are subject to policy terms and conditions. Please refer to the brochure, sales prospectus, and policy documents carefully.

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