What Is Day Care Treatment in Health Insurance? Complete Guide (2025)
Health insurance was originally designed to help people with rising costs and modern-day health care needs. As technology advanced, many treatments and procedures could be done quickly without keeping patients in the hospital overnight. Health insurers recognized this change and started offering coverage for day care treatment. In this article, readers will learn about its meaning, importance, benefits and more.
Key Highlights
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Day care treatment in health insurance requires less than 24 hours of hospitalization for multiple treatments/surgeries such as cataract surgery, chemotherapy, and endoscopy.
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These treatments are usually covered under most basic health insurance policies and offer cashless claim facilities at network hospitals.
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Coverage reduces out-of-pocket expenses for costly short-term treatments to ease the financial burden on policyholders.
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The claim process is simple and quick with minimal paperwork.
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Policyholders also apply for deductions under Section 80D of the Income Tax Act, 1961.
Day Care Procedure in Health Insurance: What is it?
In simple words, any treatment that doesn’t require an overnight stay or allows patients to get discharged within 24 hours is a part of a day care procedure. Cataract surgery, chemotherapy, and dialysis are a few examples of the same.
While such treatments are often labled as ‘minor surgeries’, people should never underestimate how expensive they can be. Take Rahul’s story, for instance. He had the habit of working long hours, skipping meals and fighting the concept of ‘I’m not that old’. When he turned 62 last year, he started having trouble reading documents and driving at night. He visited the doctor and had to undergo cataract surgery. Fortunately, his health insurance offered coverage against it and he could save money he had planned to invest in building an asset.
Why Should You Avail Health Insurance With Day Care Treatments Covered?
Here’s a brief look at its key benefits.
Cashless Treatment
Imagine a scenario where you get a treatment without paying a single penny. That’s the beauty of a cashless facility. If you choose a hospital that’s part of your insurer’s network, the treatment cost is settled directly between the hospital and the insurance company. Thus, you can walk in for a procedure, get treated, and leave without opening your wallet.
Ease the Financial Burden
Medical expenses in India are rising by the day, and a short visit to the hospital can put a dent in your wallet. This applies to minor day care procedures like cataract surgeries. Having good health insurance by your side can cover its expenses and empower you to focus on the recovery you deserve.
Hassle-Free Claim Settlement
Making a claim for a day care treatment is usually fast and straightforward. The paperwork and approval process are quicker as treatments don’t require a long hospital stay.
Tax Savings
When you buy health insurance with day care treatment, you can protect your health and save on taxes by claiming tax deductions under Section 80D of the Income Tax Act, 1961.
List of Day Care Treatments Covered
Health insurance companies now have a day care treatment list that allows patients to get treated, avail coverage and return to their normal lives within 24 hours. Here’s a detailed look.
|
Body Part |
Day Care Treatments/Surgeries Covered |
|
Eyes |
Cataract surgery, Glaucoma surgery, and Corneal incision |
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Ears |
Tympanoplasty (eardrum repair), Mastoidectomy, and Ear wax removal |
|
Nose & Throat |
Sinus surgery, Tonsillectomy, Septoplasty, and Nasal polyp removal |
|
Teeth & Mouth |
Root canal, Tooth extraction (if medically necessary), and Dental abscess drainage |
|
Heart |
Angiography, and Pacemaker-related minor procedures |
|
Bones & Joints |
Arthroscopy, Joint injections, Fracture treatment, and Ligament repair |
|
Digestive System |
Endoscopy, Colonoscopy, Piles treatment, and Fistula surgery |
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Skin |
Abscess drainage, Minor skin grafting, Mole or wart removal |
|
Cancer Treatment |
Chemotherapy and Radiotherapy |
Note: The actual list of day care procedures may vary based on the choice of insurer and health plan. Always check your policy document for the full list.
What Makes Day Care Treatment Different From OPD Treatment?
People often confuse day care treatment with OPD (Outpatient Department) treatments. They are different in terms of coverage, process and other parameters listed below.
|
Parameter |
Day care Treatment |
OPD Treatment |
|
Definition |
Medical procedures that require hospital admission less than 24 hours. |
Medical consultations or minor treatments without getting admitted to the hospital. |
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Examples |
Cataract surgery, dialysis, chemotherapy, and tonsil removal. |
Doctor consultation, blood tests, dental checkups, and X-rays. |
|
Covered Under Base Policy |
Usually included in most health insurance plans. |
Not always included. May require an add-on. |
|
Claim Process |
Cashless or reimbursement via the hospitalization section. |
Generally, requires reimbursement with proper bills and prescriptions. |
|
Documentation Needed |
Hospital admission, discharge summary, and treatment bills. |
Prescription, consultation bill, and test reports. |
No one likes to spend more time in hospitals than needed. That’s why health insurance with day care coverage is a great choice. It ensures quick recovery with quality care and saves your hard-earned money. Just remember to review the day care treatment list and benefits before purchasing a plan to make the most out of your coverage.
