Day Care Treatment: Treat of Insurance

Day Care Treatment: Treat of Insurance

Not too long ago, doctors would recommend people to get hospitalized even for minor health-related problems. Minor injury stitches would take at least 2 days of hospitalization. This resulted in time loss of time and extra expenses. With the advancements in medicine and technology, most of the surgeries and treatments nowadays are done within 24 hours.

According to reports, more than 200 common surgeries require less than 24 hours to be performed. This type of treatment is known as daycare treatment.

What is day care treatment in health insurance?

Most modern group health insurance and individual plans now include coverage for daycare procedures, ensuring you're protected even if your treatment doesn't require more than 24 hours.The Insurance Regulatory and Development Authority of India (IRDAI) has instructed health insurance companies to include a list of daycare treatments under their insurance policies. The treatment expenses will be borne by the insurer either through reimbursement or a cashless facility. 

Read: Mediclaim Policy: Saving your Life and Life Savings

What are the treatments covered in the daycare treatment insurance policy?

Different health insurance companies have a different extensive list that includes all the treatments covered in the policy. Therefore, the policyholder must thoroughly go through the policy document carefully to avoid any future hassles. Here are some commonly covered procedures:

1. ENT treatments: Septoplasty, Tonsillectomy, Nasal sinus surgeries, Tympanoplasty
   
   
2. Cardiac procedures: Coronary angiography
   
   
3. Cancer care: Chemotherapy, Radiotherapy
   
   
4. Eye surgeries: Cataract, Foreign body removal, Tear duct operations
   
   
5. Dialysis & gastrointestinal procedures: Hemodialysis, Colonoscopy, Appendectomy, Hemorrhoidectomy
   
   
6. Minor dental and skin surgeries
   
   
7. Tongue-related surgeries: Glossectomy, Tongue excision
   

Advantages of Day Care Treatment in Health Insurance

• Due to the high inflation rate in the health care industry, the cost of surgeries and treatments is at an all-time high. Therefore, having this policy has the biggest advantage of saving a lot of money.
• Policyholders can avail of cashless facilities by getting their treatment done in any one of the network hospitals of insurers. Alternatively, they can avail of reimbursement from insurers if they take the treatment from a hospital not under their network or PPN.
• It is easy to claim this treatment for policyholders as it usually follows the same procedure that of in-patient hospitalization. The insurers pay the total sum of the treatment.
• This provides convenience and peace of mind to policyholders, as they don’t have to worry about managing medical bills and can easily access quality healthcare. It allows them to focus on recovery without added financial stress
• Daycare treatment also provides tax benefits to the policyholders according to Section D of the Income Tax Act, 1961.

 Read: Domiciliary Hospitalization in Health Insurance

What akes a Medical Treatment Eligible as a Day Care Procedure?

A medical treatment qualifies as a day care procedure when:

1. It requires advanced medical technology or equipment.
   
   
2. It is performed under general or local anesthesia.
   
   
3. The treatment is completed within 24 hours, meaning no prolonged hospitalization is needed.
   
   
4. It is listed under the approved day care procedures of the health insurance provider.
   
   

Simply staying in a hospital for less than 24 hours doesn't automatically make a treatment a daycare procedure. The treatment must be included in the insurer’s official daycare list, which varies slightly across different providers.

Need Help With Day Care Treatment Claims?

At Pazcare, we make navigating day care procedures and claims effortless.

Read: How to calculate Insurance Premium?

What are the Things to Consider Before Buying a Daycare Treatment Policy?

Before purchasing a health insurance policy with daycare coverage, it’s crucial to evaluate a few key factors to ensure it meets your medical and financial needs. Here’s what to keep in mind:

 1. Check the Sum Insured

With medical costs rising year after year, make sure the policy offers an adequate sum insured that covers common and advanced daycare procedures without exhausting your coverage too quickly.

 2. Choose the Right Type of Policy

Are you buying for yourself or your family? Understand the difference between individual and family floater plans. Choose one that aligns with your healthcare needs and life stage.

 3. Know the Exclusions

Every policy has its own set of exclusions. Carefully read what treatments or procedures are not covered under daycare benefits to avoid surprises during claim time.

 4. Check for Co-payment Clauses

Some policies may require you to pay a portion of the bill. Understand if your plan has a co-pay clause and what percentage you may need to bear out-of-pocket.

 5. Review the Network Hospital List

Always review the list of network hospitals where you can avail of cashless daycare treatment. Make sure there’s one conveniently located near your home or workplace.

 6. Read the Fine Print

Don’t skip the terms and conditions. Go through the policy document carefully to understand claim processes, waiting periods, sub-limits, and pre-authorization requirements.

Employee Healthcare Benefits by Pazcare

Now purchase group mediclaim policy, group term insurance plan and group personal accident policy for your team at competitive prices from Pazcare. What is more interesting is that you can purchase the group health insurance plan for a team with as low as 2 employees. You can also include corporate wellness programs as part of your employee benefits plan. Get unlimited doctor consultations, health check-ups, therapist consultations at discounted prices. To know more about group insurance and employee wellness programs, take a look at our group health insurance guide and corporate wellness program guide.

Talk to our team to get more insights and competitive quotes for your team.

Interested in Daycare Coverage for Your Team?

With medical advancements, daycare procedures now cover over 200+ treatments that don’t require 24-hour hospitalization. Protect your employees and their families with health plans that include modern, high-quality daycare coverage.

Talk to our team to get a customized quote and understand how daycare treatment coverage can be part of your employee healthcare benefits.