All You Need to Know about Care Advantage Day Care Benefit up to Sum Insured


All You Need to Know about Care Advantage Day Care Benefit up to Sum Insured

The awareness of health insurance plans has been rising due to their readiness and effectiveness to cover medical expenses. Care Advantage is one of the most talked about health  insurance plans in India offered by Care Health Insurance. With medical inflation at a whopping 14%, covering yourself and your loved ones is indeed the need of the hour. Where only getting a health plan is not enough but availing the comprehensive yet round-the-clock coverage is, Care Advantage makes its entry by offering wide-ranging sum insured of up to ₹6 crore with other alluring features. Let’s know deeper.

What is  Care Advantage Plan?

A one-stop solution for all your medical emergencies, the plan offers you extensive coverage for all your expensive medical expenses such as pre and post-hospitalisation bills, daycare treatment, in-patient care, maternity care , ICU charges, OPD treatment, AYUSH treatment, and ambulance charges. Often called the ‘faultless health plan’, Care Insurance thus allows a long list of features and benefits. However, the coverage of almost all day care treatment procedures that too up to the sum insured make it a true good-to-be-true plan.

Daycare treatment coverage in health insurance is vital, encompassing minor surgeries, therapies, and medical procedures that do not require an overnight hospital stay. It eases financial burdens, encourages timely medical care, and supports families with comprehensive healthcare, ensuring efficient treatment and recovery for various health conditions in a cost-effective manner. Read on to understand the day care treatment meaning , daycare treatment health insurance, and how to make the most of it.

Why is Day Care Treatment Insurance Important?

With the advancement of medical science and technology, surgical procedures have become quite convenient and easy for patients. There are a number of surgeries and critical medical treatments which require shorter or even no hospitalisation. These treatments are called day care treatments. Simply put, all day care treatments mean hospitalisation for 24 hours or less.

So, does shorter hospitalisation mean reduced medical bills? Unfortunately no! Day care treatment can be very expensive, making it difficult to afford. Procedures like dialysis, cataract and other corrective surgeries, radiotherapy, piles, bone fractures, etc. can put a dent in your savings.

Don’t bother about it. Thankfully, you can choose plan like  Care Advantage  in which day care treatment covered in health insurance.   It will provide you with a cashless treatment facility or reimbursement  for the money you spend on medical bills.

What Makes Care Advantage the Better Option?

Investing in Care Advantage health insurance can significantly reduce the financial burden of medical emergencies. It is a comprehensive yet affordable health cover that you can purchase to secure your and your loved ones’ health. The policy will bear all your medical expenses for hospitalisation as well as on all day care treatment.

Read on to learn about the benefits of day care treatment health insurance that you can enjoy with Care Advantage:

Particulars OPD Treatment Day-care Treatment
Treatment Outpatient consultation for a health check-up, fever, and medical advice Inpatient treatment
HospitalisationHospitalisation Doesn’t require hospitalisation Hospitalisation of less than 24 hours
Basis of rejection No rejection of reimbursement if all medical bills are authorised Rejection is possible if treatment is given on an outpatient basis without any hospitalisation for even a few hours
Insurance coverage Only selected policies cover OPD treatment Day care treatments are covered by most of the health insurance policies
Sum insured Only a particular amount or percentage of the sum insured is covered under OPD treatment With care Advantage, you can claim daycare treatment of up to your sum of insured money

1. Long list of day care procedures

Check out the day care treatment list covered by health insurance: 

  • Eye Surgery: Cataract surgery, removal of foreign body, eye-related corrective surgeries, and tear duct operations
  • Heart Surgery: Coronary angiography
  • ENT surgery: Septoplasty, nasal sinus aspiration, myringotomy, grommet insertion, tympanoplasty, tonsillectomy, nasal sinus operation, and operations of the inner or middle ear
  • Dental surgery: Dental surgery or dental injury treatment 
  • Tongue surgery: Incision and excision, glossectomy, and reconstruction of tongue
  • Cancer treatment: Chemotherapy and Radiotherapy
  • Other common treatments: Appendix removal, lithotripsy, sclerotherapy, skin surgery, colonoscopy, removal of the lesion, piles, dialysis, tympanoplasty, and hydrocele  treatment.

2. Wide Coverage

Care Advantage policy offers coverage of up to ₹6 crore. From ₹25 lakhs to ₹6 crore, you can choose a sum insured option based on your requirements and budget. A big advantage that the plan offers is that you can claim daycare treatment up to the sum insured limit. This is a useful feature as there are a number of daycare treatments that otherwise will burn a big hole in your pocket. Let us take a look at the estimated costs of some common day care treatment:

  • Kidney dialysis can be between ₹1,500 to ₹5,000
  • Angiography can be between ₹12,000 to ₹50,000
  • Nasal sinus operation can be between ₹45,000 to ₹570,000
  • Reconstruction of tongue can go from ₹1 lakh to ₹1.8 lakhs
  • Colonoscopy can range from ₹5,000 to ₹50,000.

3. AYUSH Care

As per the norms of IRDA (Insurance  Regulatory and Development Authority of India), your health insurance company provides you with insurance coverage for AYUSH treatments. You are entitled to claim a total sum of insured money for your AYUSH medical treatments. Furthermore, you can also avail of the benefits of the company’s cashless medical facility.

4. Cashless Treatment

The first and foremost advantage of buying day care treatment insurance is that you will get the facility of cashless treatment. You don’t need to bother about arranging funds in times of emergency. You simply need to get in touch with us when you get admitted to an empanelled network hospital. You will get the best possible medical treatment based on your chosen plan option.

5. Easy Reimbursement

Could you not get the day care treatment in a network hospital? Worry not, you can still make a claim.  Under your Care Advantage plan, you will be able to get a reimbursement for your day care treatment in mediclaim. You would have to pay the bill upfront and then submit all the medical bills for the same. As soon as the verification is complete, you will receive the reimbursement amount.

6. Tax Savings

Apart from these numerous benefits, you also get the advantage of tax savings when you invest in a health insurance policy. As a policyholder, you become eligible to avail of tax benefits on the premium of up to ₹1.5 lakhs that  you pay towards your Care Advantage under Section 80D of the Income Tax Act, 1961.

Difference between OPD and Day Care Treatments

A lot of people may consider OPD and daycare treatments to be synonymous. However, there are some differences between them. Go through the following table that shows the difference between OPD and Day Care Treatments:

Things to Know about Day Care Treatments

When you opt for the Care Advantage insurance plan, you should also make sure that your day care treatment meets the following criteria:

  • You should be given local or general anaesthesia for one-day hospitalisation .
  • The hospitalisation period should not exceed 24 hours
  • Out-patient treatment is exempted from insurance coverage.

Bottom Line

Care Advantage is an extensive health insurance plan that can make day care treatment hassle-free. Your investment in this plan will help you safeguard your and your family’s well-being.

Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.

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