List of Day Care Treatments Covered under Health Insurance in India

Daycare treatments are medical procedures or surgeries that require 24 hours or less of hospitalization. While a health insurance policy typically covers the cost of extended hospital stays, these daycare treatments can still be financially draining if not covered under a cashless program. Several health insurance plans offer coverage for daycare treatments. This article provides a list of common daycare treatments and the health insurance plans that cover them.

What Medical Treatments Fall Under Day Care Procedures?

Medical treatments are classified as daycare procedures when they are:

• Performed in a hospital as an inpatient procedure.
• Require specialized observation or care afterward.
• Completed in less than 24 hours.

Some common daycare treatment options include:

• Diagnostic tests
• Chemotherapy
• Dialysis
• Infusion therapies
• Dental treatment
• Eye treatment

List of Daycare Treatments Covered as per IRDAI

1. Treatment of Nose and Nasal Sinuses

   • Excision and destruction of infected tissue of the nose
   • Procedures on the turbinates (nasal concha)
   • Nasal sinus aspiration

2. Ear Operations

   • Tympanoplasty (closure of an eardrum perforation)
   • Reconstruction of the auditory ossicles
   • Removal of a tympanic drain
   • Reconstruction of the middle ear
   • Fenestration of the inner ear

3. Skin and Subcutaneous Tissue Treatments

   • Local excision or destruction of diseased tissue of the skin
   • Free skin transplantation
   • Revision of skin plasty
   • Chemosurgery on the skin

4. Ophthalmology (Eye Treatment)

   • Incision of tear glands
   • Excision and destruction of infected tissue of the eyelid
   • Procedures on the canthus and epicanthus
   • Removal of a foreign body from the conjunctiva, cornea, lens of the eye, etc.
   • Incision of the cornea
   • Cataract operation
   • Retinal detachment surgery

5. Orthopedics (Bone Treatments)

   • Incision on bone (septic and aseptic)
   • Osteosynthesis for closed reduction of fracture, luxation, or epiphysiodesis
   • Suture and other procedures on tendons and tendon sheath
   • Arthroscopic knee aspiration

6. Cancer Treatment

   • Radiotherapy
   • Chemotherapy

Note: Daycare procedures also include treatments for the urinary system, heart, and sexual organs.

What are the Benefits of Daycare Health Insurance?

• Offers coverage for short-duration treatments of 24 hours or less.
• Even minor daycare treatments can be costly, and health insurance for daycare treatment reduces out-of-pocket expenses.
• Provides extensive protection, from diagnosis to aftercare.

How Does Daycare Health Insurance Work?

If you're wondering why bother about daycare procedures, thinking you can bear a day's hospital expense, you might be making a grave mistake. Nowadays, even diagnostic tests that don't require hospitalization can be expensive. Some tests can cost thousands. Ignoring this can lead to significant out-of-pocket expenses. The biggest benefit of daycare coverage is significant cost savings.

For Instance: Mr. Kapoor had an accident and, hence, had to undergo Septoplasty, a surgical process to correct displacement of the nasal septum. The doctor quoted ₹60,000 for the surgery. Since the technique was advanced, the surgery was successful, and Mr. Kapoor was discharged within a day, saving room rent. But what about the cost of the surgery itself? Previously, insurers did not cover treatments that did not require hospitalization for more than one day. However, with a health plan that includes daycare procedures, this problem can be easily solved. Thus, with daycare procedure coverage, Mr. Kapoor was able to cover the surgery cost.

How to Choose Health Insurance Based on Daycare Procedure Coverage?

1. Comprehensive Coverage

   Check the list of daycare treatments covered under the health insurance policy before buying. Beyond just the length of the list, assess which procedures are most relevant and beneficial for your potential future needs.

2. Adequate Sum Insured

   Look for a health insurance policy with a sum insured that adequately covers the potential costs of daycare procedures. Considering medical inflation, opt for a higher sum insured.

3. Review Inclusions and Exclusions

   When buying a health insurance plan with daycare coverage, carefully review both the inclusion and exclusion lists. Prioritize plans that include common procedures like cataract surgery.

4. Understand the Co-payment Clause

   Before buying the policy, check the co-payment clause. This will help you prepare for potential out-of-pocket expenses during treatment.

5. Consult an Insurance Advisor

   An insurance advisor can help you understand the different policy options and choose the one that best suits your needs and budget. You can schedule a call with PolicyX.com experts at your convenience.

Insurance Companies that Offer Daycare Procedures

1. Star Health Insurance - Treatments Covered

   • Ophthalmology
   • Neurology
   • Urology
   • Plastic Surgery
   • Oncology
   • ENT
   • Gastroenterology
   • Thoracic surgery

   Know More About: Star Health Insurance

2. SBI Smart Health Insurance

   • Tonsillectomy
   • Cancer Chemotherapy
   • Cataract Operation

   Know More About: SBI Health Insurance

3. United India Health Insurance

   • Lithotripsy
   • Radiotherapy
   • Auroplasty
   • Hydrocele

   Know More About: United India Health Insurance

4. Care Health Insurance

   • Tympanoplasty
   • Myringotomy
   • Stapedotomy (Treatment of various lesions in the middle ear)

   Know More About: Care Health Insurance

Health Insurance Plans for Daycare Coverage

Check out more health insurance plans.

Choose the Best Health Insurance Plans!

Daycare procedure health coverage is essential in today's era of rising medical inflation. It offers financial relief and savings. Ensure you choose a health insurance company that covers a broad range of treatments.

Remember to prioritize policies that cover common procedures, offer a sufficient sum insured, and have a transparent claim settlement process. Investing in a robust health insurance plan with daycare coverage can offer you peace of mind and ensure that you can access timely and quality medical care without facing significant financial strain.

Compare plans covering cataract surgery, chemotherapy, and more.