Not All Treatments Require Hospitalisation. Know About the Day-care Treatments Covered By Your Insurance Policy

Thanks to advancements in technology, many surgeries—both complex and straightforward—may now be successfully conducted in a single day, and patients can leave the hospital within 24 hours. Day care procedures are those medical procedures that do not require you to stay in the hospital for longer than 24 hours. 

The following actions typically fall under the heading of daycare actions:

• Cataract
• Radiotherapy
• Chemotherapy
• Septoplasty
• Dialysis
• Angiography
• Tonsillectomy
• Lithotripsy
• Hydrocele
• Piles / Fistula
• Prostate
• Sinusitis
• Liver aspiration
• Colonoscopy
• Appendectomy

One common misconception about daycare procedures is that they are not protected by health insurance. The majority of you mistakenly think that your health insurance plans only pay for longer hospital stays, but this is not always the case. The length of treatment has greatly lowered because to advancements in medical techniques. As a result, short-term inpatient procedures have been included in health insurance policies. 

The benefits of having daycare services covered by health insurance include the following: 

• Peace of Mind: Even a day spent being hospitalised might be stressful. And the high cost of the treatment might undoubtedly contribute to this. But you may reduce your worry and obtain the necessary peace of mind by knowing that your insurance provider will cover your day care costs. 

• Cashless Service: If you know ahead of time that you or a family member will need surgery (a day care procedure), you can check with your health insurance provider if you qualify for the benefit of cashless health insurance claim settlement for the day care procedures that are listed in your health insurance policy. 

• Tax Saving Benefit: In India, paying a premium for your health insurance coverage qualifies you for a tax exemption under Section 80D of the Income Tax Act. Therefore, an insurance that covers you and your family for daycare expenses might also help you save on taxes. Tax benefit is subject to change in prevalent tax laws.

• Best Medical Care: You can receive treatment for day care procedures in the network hospitals, where you can also benefit from cashless service while receiving the best medical care. Even if your hospital stay is brief, receiving care in a network hospital can guarantee that you and your family members receive high-quality care under your family health insurance. 

Procedures used in daycare that may be excluded

Dental cleanings are an example of an OPD (Out-Patient Department) procedure that is not covered by day care procedures and will not be reimbursed by your health insurance provider. It is crucial to read over exclusions in health insurance plans to make sure you do not submit claims for treatments that are not covered. The majority of plans cover day care procedures but not OPD.

The steps involved in making a health insurance claim for day care:

• Due to the fact that day care procedure coverage is a built-in policy element, the method for filing day care claims is comparable to that of a standard health insurance policy. The cashless option is available for planned procedures, while some businesses require advance notification. 

• In other situations, insurers pay out after receiving the necessary paperwork. Pre- and post-hospitalization benefits are still covered under the same terms; the insurance provider pays the policyholder’s hospitalisation costs. 

• It is advisable that you carefully examine the policy wordings to determine which daycare operations are covered by your health insurance plan. In order to avoid any problems while submitting a claim for day care operations under your health insurance policy, please speak with your insurer.

• Coverage for day care operations in health insurance is essential in decreasing the unwarranted cost burden in light of the rising medical inflation. Choose the types of health insurance that offers a wide array of daycare services.

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