Day Care Treatment

Day-care treatment is a medical treatment or procedure where a patient is discharged from the hospital within 24 hours of admission. Such procedures are usually either non-invasive or minimally invasive, and require very little hospitalisation.

  

Health insurance plans that cover day-care treatments generally tend to offer coverage for almost all the expenses in connection with the procedure. This includes nursing expenses, room charges, surgeon fees, consultation fees, anaesthetics, medicines, surgical devices, and post-hospitalisation expenses. 

People often confuse day-care treatment with OPD consultations. However, it is essential to understand that not all short-term medical treatments are regarded as day-care procedures. When we talk about day-care treatment, it means treatments, surgeries, and operations where you need to be hospitalised for less than 24 hours.

 

When hospitalisation and treatment procedures exceed the 24 hours timeline, the expenses for the same are covered under hospitalisation costs in your health insurance plan. On the other hand, smaller medical consultations such as fractures, sprains, etc. are covered under OPD benefits.

Check out these health insurance plans that offer a wide range of features along with the day-care treatments. The table below gives a quick insight into the features and premium of some of these plans.

You must read your health insurance policy document carefully to know about the scope of coverage in day care procedures. Following are a few standard things that are covered in the day care treatment. 

All costs, including room, boarding, and nursing expenses, along with the fees of surgeons, consultants, specialists, and anaesthetists will be covered for the medical procedures. Further, medical expenses, like the cost of prosthetic devices, medicines/drugs, orthopaedic implants, vascular stents, X-rays, medical reports, surgical appliances, operation/theatre charges, etc. are also covered under the day care treatment in health insurance.

If you are planning to purchase the best health insurance policy, always remember to have a policy that includes day-care procedures. It can provide you with the following benefits.

• Top-Notch Medical Care

With the day-care treatment facility in a health insurance policy, you no longer have to worry about the quality of medical treatment. You can avail cashless, cutting-edge medical treatment at a wide network of empaneled network hospitals. These hospitals have well-trained medical practitioners and staff to provide the right services.

• Cashless Claims

The day-care procedure, in a health insurance policy, provides financial assistance at a critical time through cashless health services. For availing this key benefit, you have to inform the health insurance company about the details of your day-care procedure in advance. With the pre-approved request, you can receive medical treatment, without having to pay cash. The medical bills will be directly settled by the insurer.

• Tax Benefits

Did you know? A health insurance policy, equipped with the day-care procedure facility, can also provide you with additional tax benefits. You can avail tax benefits on making premium payments towards your health policy, as a deduction under Section 80D of the Income Tax Act, 1961.

• Health CDC Benefit

Claim by Direct Click (CDC) is a key highlight of health insurance that is available on Bajaj Markets. This unique app-based feature allows you to raise and settle claims of up to ₹20,000 in a hassle-free manner. Here, you have to use the insurance wallet app to make claims. Once you provide the requisite details, including discharge date, an estimate of expenses, and details about the diagnosis and treatment, your claim amount will be shortly transferred to your account.

• Complete Peace of Mind

The last thing you need at the critical time of undergoing medical treatment is stress and worry. The assured quality of treatment at an empaneled network hospital, along with the financial assistance, ensures that you undergo treatments with zero worries and complete peace of mind.

Most health insurance plans offer day-care treatment as part of their coverage. However, the nature of the diseases or ailments covered differs from insurer to insurer. On the other hand, treatments such as cosmetic/beautification surgeries and certain dental surgeries are not typically covered.

The eligibility criteria for treatments under the day-care procedure cover come down to 3 factors:

• The procedure must be medically necessary

• The patient must be admitted to the hospital for this treatment

• The medical procedure/treatment should take less than 24 hours

The process to raise claims on day care procedures is the same as raising claim requests on hospitalisation expenses. Your insurer will process the day care treatment claim as a part of your health insurance cover. Let’s understand the steps to raise cashless and reimbursement claims:

Cashless Claim via Network Hospitals

• Step 1: Go to the nearest network hospital for your day care treatment in health insurance and inform the insurance provider about the procedure before being hospitalised.

• Step 2: The hospital shall share the same information with your insurer to confirm that the treatment comes within the terms and conditions of their day care procedure cover.

• Step 3: Once the procedure is done, the hospital shall receive all medical payments from the insurer based on the terms of your insurance cover.

Reimbursement Claims via Non-Network Hospitals

• Step 1: Choose a non-network hospital for the procedure and inform your insurer about the hospitalisation.

• Step 2: Pay all the required treatment-related costs from your own pocket.

• Step 3: Submit a soft copy of important documents to raise a reimbursement claim for day care treatment.

Here are a few things you must keep in mind before availing the day-care treatment.

• The treatments covered under OPD benefits are different from day-care treatments in health insurance. So, while a dental clean-up is covered under OPD, dental insurance are covered under the day-care procedures. Knowing the difference between the two will help you raise the right claim request with your insurer.

• Avoid buying a health insurance plan solely based on the day-care procedures covered under the policy. Go through the fine print of your health insurance document and get your queries resolved before signing the deal.

• You must always remember to submit the original documents of your prescription, medical reports, etc. to the insurance company. If you fail to submit the required documents while filing a claim, it can result in rejection.

Best Health Insurance Plans Available at Bajaj Markets