Day Care Treatment - Coverage, Advantages and List of Treatments

• Written by Ritika Malik

  Reviewed by Munmi Sharma

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Daycare treatment is a clinical procedure or surgery that doesn't require hospitalisation for more than 24 hours. Medical advancements nowadays enable the patient to receive quick medical intervention and recovery, unlike conventional hospitalisation methods, in which patients must spend overnight or longer. Healthcare experts usually carry out daycare treatment using minimally invasive technology that guarantees fewer recovery periods and minimises the possibility of complications.

Day Care Treatments in Health Insurance

A health insurance policy with day care treatment cover offers coverage for listed procedures that require less than 24 hours of hospitalisation. Under this feature, the insurer will bear the policyholder's medical expenses through reimbursement or a cashless facility.

Day care treatment offers a range of clinical interventions. Here are some of the common day care treatment options:

• Minor surgeries
• Diagnostic tests
• Chemotherapy and dialysis
• Infusion therapies for several medical conditions

Advantages of Buying Day Care Health Insurance

Daycare health insurance several benefits and some of them are:

• 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.

List of Day Care Procedures Covered

Choosing the best health insurance policy enables you to avail of coverage for various day care treatments. Under a health insurance policy, the day care treatment list includes:

• 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 a health policy. Policyholders must thoroughly read the policy documents to understand day care procedures covered.

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. However, you must keep the following things in mind when opting for day care treatments cover:

• 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

By following the right steps, you can ensure smooth and hasslefree claim filing for day care treatment under health insurance policy. Here are the straightforward steps for filing health insurance with daycare treatments:

Step 1: Inform Your Insurer

Notify your insurance service provider about the procedure before treatment. You must inform your insurer of planned treatments to obtain pre-authorisation and cashless benefits. According to the policy details, you must notify them instantly of an emergency procedure or therapy within definite periods.

Step 2: Submit Required Documents

Collect all crucial documents to begin the claim, such as duly filled claim form (provided by your insurer), physician's prescription detailing the treatment, clinical records and diagnostic reports, hospital bills, discharge summary, and receipts, and ensure you retain copies of all documents for the future.

Step 3: Claim Evaluation

After you submit the documents to the insurer, they will assess your claim to confirm its eligibility under your policy. Insurers contact the hospital for more details or to verify the information. The approval request usually depends on the clarity of the submitted documents and all policy information.

Step 4: Payment Approval

Once the insurer verifies the information, they approve the claim request instantly:

• For cashless claims: the insurer instantly settles the bills.
• For reimbursement claims: the insurer settles the bill by transferring the approved amount to the account after treatment.

It is essential to submit the documents on time to settle claims quickly, enabling you to focus on healing.

Tips to File Day Care Claim

File daycare claim might seem confusing for some people, so here are the tips that can help you move forward with the process smoothly:

• Ensure you read the policy cautiously and determine the treatment or conditions covered.
• Notify your insurer about the treatment in advance to maintain timely communication.
• Submit all the necessary documents.
• Opt for a network hospital to prevent delays in the reimbursement process and leverage cashless benefits.

>> Also Read: What is a Claim Form in Health Insurance?

Secure Your Health with the Right Coverage

Don’t let clinical costs interfere with your mental peace. Choose daycare health insurance and enjoy the usefulness of advanced healthcare treatments. If you are looking for insuring yourself or your family, you can consider our comprehensive family health policy, offering coverage for in-patient, pre and post hospitalisation expenses. With Care Health Insurance, avail quality healthcare at more than 24800+ healthcare providers.

Disclaimer: The health insurance benefits are subject to policy terms and conditions. Refer to your policy documents for more information. Also, consult your general physician for verified medical advice.