What All Daycare Procedures are Covered by Insurance?
  • Medical treatments in daycare
  • Benefits
  • How to choose daycare insurance?
What All Daycare Procedures are Covered by Insurance?
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List of Day Care Treatments Covered under Health Insurance in India 2025

Daycare treatments are medical procedures or surgeries that require only 24 hours or less hospitalisation. The health insurance policy mostly covers the cost of extended hospital stays. However, these daycare treatments might drain your finances if you do not get them covered under the cashless program. There are a few health insurance plans that also give coverage for daycare treatments. This article will give you a list of daycare treatments and the health insurance plans that can subsequently cover them.

Did you know?

A SecureNow report reveals that daycare procedures account for a significant portion of all health insurance claims, representing 29% of the total in India. This finding underscores the critical importance of including comprehensive coverage for daycare treatments in health insurance policies.

What Medical Treatments Fall Under Day Care Procedure?

Medical treatments are classified as the daycare procedure when it is:

  • Performed in the hospital as an inpatient.
  • Required a specialised observation or care afterwards.
  • Performed in less than 24 hours. 

Some common daycare treatment options are:

  • Diagnostics 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. Operation of the ear

    • 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. Treatment of the subcutaneous tissues and skin

    • Local excision or destruction of diseased tissue of the skin and
    • 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
    • Operation of cataract
    • Surgery for Retinal detachment
  5. Orthopedics (Bones)

    • An incision on bone, septic and aseptic
    • Osteosynthesis to Close the reduction of fracture, luxation or epiphysiodesis with
    • Suture and other Procedures on tendons and tendon sheath
    • Arthroscopic knee aspiration
  6. Cancer Treatment

    • Radiotherapy
    • Chemotherapy

FYI- Besides these, a day-care procedure also includes treatment for the urinary system, heart, and sexual organs.

What is the Benefit of Daycare Health Insurance?

Daycare health insurance offers a lot of benefits to the policyholders.

  • Gives coverage for the short duration of treatment like 24 hours or less.
  • A minor daycare treatment can be very costly, thus health insurance for daycare treatment reduces out-of-pocket expenses.
  • You will get extensive protection, from diagnosis to aftercare.

How Does Daycare Health Insurance Work?

If you are wondering why to bother about the daycare procedure, I can bear a day’s hospital expense, then let me tell you, you are making a grave mistake. Nowadays, over-the-counter expenses like disease diagnosis tests that do not need hospitalization or treatment as such can also burn your pocket. Few tests can cost you thousands. So, how can you simply ignore it? The biggest benefit of a day-care procedure is that it will save you money.

For Instance: Mr. Kapoor had an accident and hence, had to go for Septoplasty- a surgical process to correct displacement of the nasal septum. The doctor asked for Rs.60,000 for the surgery. Since the technique is so advanced, the surgery was successful and Mr.Kapoor was discharged within a day, thus saving room rent, but what about the cost of surgery? Previously, the insurer did not pay money for the treatment that didn’t require hospitalisation for more than one day, however, if you have a health plan that includes a daycare procedure, this problem of yours can be solved easily. Thus, with the daycare procedure, Mr Kapoor was able to pay for surgery.

How to Choose Health Insurance Based on Daycare Procedure?

Nowadays, many health insurance plans cover daycare procedures. However, the benefits of some are better than others. Whenever you buy medical coverage based on day-care procedures, keep these points in mind:

  1. Quality Matters

    Check the list of daycare treatments covered under the health insurance policy before buying. Do not just look at the long list of coverage but also check which can be beneficial for you in the future.

  2. Sum Insured

    Look for a health insurance policy whose sum insured should match the potential costs for the daycare procedures. Keeping medical inflation in mind, opt for the higher sum insured options.

  3. Check for Inclusions and Exclusions

    When buying a health insurance plan with daycare coverage, check for the inclusion list and exclusion list. Choose a plan that includes common procedures like cataracts.

  4. Co-payment Clause

    Before buying the policy, check for the co-payment clause. This way, you will be prepared for the costs that might occur during the hospitalisation.

  5. Consult With 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 your call with PolicyX.com as per your suitable timings.

pert Advise

You must check your health insurance policy terms and conditions to look out for all the covered daycare procedures. Minor procedures for the eye, nose, and others are covered. If you are confused about which health policy to purchase, consult with Policyx.com insurance experts.

Insurance Companies that Offer Day-Care Procedures

  1. Star Health Insurance - Treatments they cover

    • 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 Middle ear)

    Know More About: Care Health Insurance

Health Insurance Plans for Daycare Coverage

Name of the PlanNumber of Daycare Procedures CoveredSum Insured
Star Comprehensive Insurance PlanAll daycare procedures coveredUpto 1 Crore
Aditya Birla Activ One PlanAll daycare procedures coveredUpto 2 Crore
HDFC ERGO Optima Secure PlanAll daycare procedures coveredUpto 2 Crore
Care Health Insurance Plan541Upto 3 Lakh
ICICI Lombard Smart Super Health Insurance Plan130Upto 1 Crore

Check out more health insurance plans.

Choose the best health insurance plans!

Daycare procedures health coverage is very essential for today’s era in which medical inflation is through the roof. It gives you relief and saves you money but be sure to choose only the health insurance company that covers broadly categorized 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 day-care 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 that Cover Cataract Surgery, Chemotherapy, and More.

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Day Care Treatments Covered under Health Insurance in India: FAQs

1. What are daycare treatments in health insurance?

Daycare treatments refer to medical procedures that require hospitalization for a short duration, typically less than 24 hours. These procedures allow patients to receive treatment and return home on the same day. Examples include cataract surgery, chemotherapy, dialysis, and certain minor surgeries.

2. Does health insurance cover all daycare treatments?

No, not all daycare treatments are covered by all health insurance policies. The specific list of covered procedures varies significantly between different insurers and plans. It’s essential to carefully review your policy documents or contact your insurer to understand the specific coverage for daycare treatments.

3. What comes under daycare treatment?

Daycare treatments refer to medical procedures that require hospitalisation for less than 24 hours. Some examples are dialysis, chemotherapy, cataracts, and much more.

4. How do I know if my health insurance plan covers a specific daycare procedure?

You need to review your policy documents. Look for the section on ‘daycare procedures’ or ‘outpatient procedures’. Reach out to their customer service department or refer to their website for a comprehensive list of covered procedures.

5. How do I choose a health insurance plan with good daycare treatment coverage?

Identify your potential needs (e.g., cataract surgery, chemotherapy). Compare policies based on the list of covered procedures, coverage limits, network hospitals, and premiums. Consider factors like sum insured, co-payment clauses, and claim settlement process. Consult with an insurance advisor for personalized guidance.

6. Can I claim reimbursement for daycare treatments even if they are not listed in my policy?

Generally, no. You can only claim reimbursement for treatments specifically listed as covered under your policy. However, it’s always advisable to contact your insurer to inquire about specific situations.

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Simran saxena

Written By: Simran Saxena

An explorer and a curious person, Simran has worked in the field of insurance for more than 3 years. Travelling and writing are her only passion and hobby. Her main agenda is to transform insurance information into a piece that is easy to understand and seamlessly solves the reader’s query.