Today, medical advancements have significantly shortened the duration of many treatments, eliminating the need for prolonged hospital stays. However, the costs of these short-term yet advanced medical procedures can be considerable. This is where health insurance plans with daycare treatment coverage come into play.
But what is daycare treatment in health insurance, and why is it essential for your health insurance policy? Let’s break it down.
What is Day Care Treatment?
The meaning of the care procedure is quite simple.
It refers to medical procedures that require hospitalisation but are completed within 24 hours. Unlike traditional inpatient treatments, these procedures do not need an overnight stay in the hospital.
Why is Day Care Treatment Important?
Now that you have answers to the question, ‘What is daycare treatment?’ let’s understand its benefits.
- Comprehensive Coverage for Short-Term Procedures
Daycare coverage in health insurance plans includes medical procedures that do not require an overnight hospital stay but require specialised care. It allows policyholders to receive treatment without extended hospitalisations.
- Reduced Financial Burden
The insurer covers the costs of short-duration treatments with daycare coverage, which can be significant even without extended hospital stays. It reduces out-of-pocket expenses and makes health insurance plans for your family more affordable.
- Access to Advanced Medical Treatments
Due to technological advancements, many advanced medical procedures are now available as daycare procedures. You can access these treatments without worrying about costs.
- Faster Recovery Time
The meaning of the care procedure is shorter hospital stays. You can recover in the comfort of your home, which often leads to quicker recovery. This benefit allows patients to return to their daily routines faster.
- Increased Flexibility in Treatment Options
Daycare coverage under your health insurance policy offers flexibility in choosing treatment options. You can easily schedule treatments without major disruptions to your daily life.
Therefore, when considering health insurance plans for your family, check whether the policy includes comprehensive coverage for daycare procedures.
What Are Eligible Medical Treatments for Day Care Procedures?
What is a daycare in a hospital, as per the Insurance Regulatory and Development Authority of India (IRDAI)?
For medical treatment to classify as a daycare procedure, it must meet the following criteria:
- Performed as an inpatient in a hospital
- Requires specialised observation or care after its completion
- Performed for a continuous period of less than 24 hours
The IRDA daycare procedures list only indicates treatments recognised for daycare coverage. The daycare treatment list can vary across health insurance plans. Some common examples include:
- Cataract surgery
- Tonsillectomy
- Hernia repair
- Endoscopy
- Colonoscopy
- Chemotherapy
- Dialysis
- Radiotherapy
- Angiography
- Heart surgeries
- Dental procedures
- Orthopaedic surgeries
Note: Refer to the daycare treatment list mentioned in your policy documents to know ‘what is a daycare in a hospital’ as per your insurer.
How is Day Care Treatment Different from OPD?
While daycare treatment requires a short hospitalisation period, whereas Outpatient Department (OPD) services involve medical consultations or minor procedures that do not require hospital admission. The difference is in the level of care needed. Daycare treatment means more complex medical procedures that necessitate hospital-based care for a few hours, whereas you can handle OPD treatments without any hospital stay.
When selecting health insurance plans for your family, differentiate between these two types of care and ensure both are adequately covered.
For example, the IRDA daycare procedures list includes procedures like chemotherapy, minor surgeries, dialysis, and cataract surgery. OPD covers doctor consultations, diagnostic tests, and medications.
Claim Process for Day Care Treatments in Health Insurance
The claim process for daycare treatment is generally similar to inpatient hospitalisation. You can choose between cashless settlement at network hospitals or reimbursement for treatments at non-network hospitals.
However, the specific steps may vary depending on the insurance provider. You will need to submit the following documents:
- Pre-authorisation form (if required)
- Medical bills
- Doctor’s prescriptions
- Discharge summary
- Health insurance card
Daycare treatment is an essential component of health insurance plans. It provides timely access to quality medical care, reduces costs, and ensures peace of mind. By carefully selecting a health insurance plan with comprehensive daycare coverage, you can safeguard yourself and your family from unexpected medical expenses.
With Generali Central, you can enjoy the peace of mind of knowing your healthcare needs are well covered. Their plans, like DIY Health Insurance for customised coverage, Health Absolute for family protection, and Health Elite for premium benefits, provide comprehensive protection against medical expenses.
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