What Is The Difference Between Day Care And Outpatient Therapy?
Updated On Apr 26, 2022
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When it comes to buying a health insurance policy, many people tend to make a hasty decision. As a result, they ignore the important features of the policy. While buying a health cover, you must consider several factors, including the claim amount, the claim settlement process, policy inclusions and exclusions, coverage for daycare and OPD treatment, etc.
What Is OPD Treatment?
OPD is an acronym for the Outpatient Department. In OPD treatment, the patient does get hospitalized. Generally, the patients who visit the OPD to seek consultation from the doctor and avail treatment for a specific disease/illness. If your health insurance policy includes OPD coverage, it pays for doctor’s consultation fees, pathological tests (if prescribed by the doctor for detailed assessment for the condition), and medicines. Depending on the type of health care plan you hold, it may also include maternity treatment coverage.
What Is A Daycare Procedure Or Treatment?
As the name suggests, the daycare treatment is completed within a few hours on the same day as the patient's visit to the hospital/clinic. Like the OPD treatment, the patients visit the doctor’s office for a consultation and do not require hospitalisation. An example of daycare treatments includes cataract surgery, dental procedures, chemotherapy, and many others.
Day Care Treatment and OPD Treatment – Knowing the Differences
While at the outset, both daycare treatment and OPD treatment may look the same, there are many differences, and knowing the fine line would help get the most of your health insurance policy.
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Hospitalisation
In the case of daycare treatment, depending on your health condition, the doctor may advise you to get admitted to the hospital (usually for a few hours) for treatment. But, in OPD treatment, hospitalisation is not required; the doctors only provide consultation.
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Scope of coverage
One of the significant differences between daycare treatment and OPD treatment is that most insurance companies provide coverage for daycare procedures. Whereas the latter is generally excluded unless it is specifically mentioned in the policy documents. The coverage for daycare treatment may vary from policy to policy.
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Coverage amount
Generally, for daycare procedures, you are entitled to get compensation to the limit of the plan’s sum assured. Whereas, for OPD treatment, the insurers may include a sub-limit clause, which means you will get coverage only to a certain limit, beyond which you must pay from your pocket.
Conclusion
Often, the health insurance policyholders find the policy wordings confusing. But you must understand the underlying differences to make a valid claim. It is like taking a bitter-tasting medicine, you may not like the taste, but you take it anyway for better health.
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