Comprehensive Guide to Day Care Treatment, Coverage and Advantages

What is Day Care Treatment in Health Insurance?

An illness or injury is usually an obstacle in pursuing our life goals. Suddenly, health becomes our only priority. In our fast-paced life, getting prompt medical treatment is a blessing. 

Thanks to medical advancements, several medical procedures do not require hospitalisation for more than a day. Some medical procedures are completed within 24 hours and are known as Day Care Treatment or Day Care Procedures. This benefit will allow you to get coverage if you have day care insurance claim facility available under your plan.

Investing in a health cover secures your finances against enormous medical treatment expenses. It also gives you the advantage of availing of the day care treatments cover. Before choosing a health policy, you must check the number of treatments included in the day care list with other features in the policy. Day care treatments in health insurance benefit a person significantly, during any planned treatment or an emergency, compared to a few years ago when it was not available. So, always consider a plan that has day care treatment in health insurance.

Advantages of Buying Day Care Health Insurance

Cashless treatment: Usually, most day care  surgeries or medical  procedures would be planned in advance. The patients can easily avail of the cashless treatment facility at any network hospital by notifying their insurer at the specified time. 

Easy claims procedure: A policyholder can apply for a cashless or reimbursement claim. The claim procedure is usually the same as applicable for in-patient hospitalisation.  

Convenience: Health policy's day care treatments feature ensures access to timely and quality medical care without any hassle. As we will work to settle the expenses, the policyholders can simply focus on their recovery without worrying about the medical bills. 

Savings: Tax benefit is among the key advantages of having a health policy with several features, including day care treatment coverage. The policyholder can claim tax deductions on the premium paid, per Section 80D of the Income Tax Act, 1961. 

Day Care Treatments  in Health Insurance

Day Care Treatments refers to a medical or surgical procedure carried out under general or local anaesthesia and requires hospitalisation of less than 24 hours. A health insurance policy with coverage for day care treatments is beneficial. Under this feature, the insurer will bear the policyholder's medical expenses through reimbursement or a cashless facility.

Day Care Procedures Covered Under  Health Insurance

Choosing the best health insurance policy enables you to avail of coverage for various day care treatments. Day care treatment list includes treatments such as- 

• Heart: Coronary Angiography
• Eyes: Cataract surgery, removal of foreign body, operations on tear duct, and corrective surgeries
• ENT: Foreign body removal, Septoplasty, Nasal Sinus Aspiration, Tonsillectomy, Myringotomy with Grommet Insertion, Tympanoplasty, and other operations of the middle and inner ear
• Tongue: Incision, excision, and destruction of diseased tissue of the tongue, Glossectomy, Reconstruction of the tongue, and other surgeries
• Cancer treatment: Radiotherapy and Chemotherapy 
• Other surgeries: Haemodialysis, Colonoscopy, Lesion removal, piles, Appendicectomy, Hydrocele treatment, Lithotripsy, Sclerotherapy, Thoracoscopy, skin surgeries, bone fracture, and joint-related surgeries, operations on mouth and face, certain injury-related dental surgeries, etc.

Note: The abovementioned procedures are some of the many day care procedures covered in health policy. Policyholders must thoroughly read the policy documents to know the various day care procedures covered. 

Before opting for it, one should understand the definition or meaning of day care treatments in health insurance. Moreover, an individual must consider the number of procedures covered under one category. At the same time, they should also pay attention to the definition of such medical procedures to avoid any confusion. The broader the definition or category is, the more beneficial it is for a policyholder.

Things to Consider When Opting for Day Care Treatments Cover

Day Care Treatments coverage in health insurance plans is a key feature that saves a person from financial loss due to expensive medical treatment that does not require an extended hospital stay. The coverage is usually up to the sum insured.

If you have a mediclaim policy, you can rest assured as the policy will cover the medical expenses you incur for a day care procedure. In mediclaim, it is a vital factor you should consider. It would be helpful if you keep the following in mind:

• Sum insured: It is logical to consider the medical inflation factor that has made day care treatments expensive. Opt for a coverage amount that will meet your healthcare needs.
• Type of policy: Whether an individual policy or a family floater option, choose a health cover that best suits your requirements and provides comprehensive cover for medical expenses, including day care procedures.
• Exclusions: Read the policy documents to understand the cases where you are not eligible to get a claim under the policy.
• Co-payment: Check the co-payment clause in the policy document to prepare to bear a certain percentage of your treatment expenses.
• Network hospitals: Review the network hospitals list and find the hospitals nearest to your location for immediate access to medical care.

Process of Filing Day Care Claims in Health Insurance 

Among the foremost things to do when opting for a health insurance policy is to determine to  the procedures to notify the insurer and file a claim. Also, it is vital to inform the insurer about the hospitalisation as per the stipulated time. All these steps will help prevent any last-minute hassles. 

To avail of the day care treatments in health insurance, you must follow the same claim process for in-patient hospitalisation cover available in a regular health plan. One can avail of the cashless facility at a network hospital for any planned or emergency treatment. It is convenient, and you need not make any upfront payment. One can approach a network hospital empanelled with us. The initial steps include contacting the insurance desk, submitting a pre-authorization form, presenting the health card, and the required ID proof to get admission. 

Suppose a person chooses a non-network hospital for treatment. In that case, he/she can apply for a reimbursement claim by submitting the mandatory documents, including the medical practitioner's referral letter advising hospitalisation.

Secure your health with ‘Care’, a comprehensive family health policy by Care Health Insurance, offering cover for over 540 day care treatments. Avail of cashless treatment facility at any of the 21100+ cashless healthcare providers.

*Please read the policy T & C, brochure, and prospectus to know more about our health insurance plans. Underwriting of claims is subject to policy terms and conditions.