What is Daycare Treatment and OPD Treatment in Health Insurance?

Health insurance is something that the majority of the urban population buys. As we grow older, we start developing some health conditions. Some of us get certain health conditions because of genetics, while others develop because of their lifestyle. Whatever the situation is, to fix the problem, we need a doctor and the right treatment. And all these need a good amount of money these days. The more critical the problem is, the higher the medical charges are. In one such situation, a health insurance policy comes to the rescue. 

When we start looking for a health insurance policy, we mostly think of the time when we are hospitalized. We do not pay attention to the fact that some treatments do not need us to be hospitalized. The OPD treatment is enough for some people. If you want to get coverage for the OPD treatment, you still will have the option. 

Now that you are looking for OPD treatment, do not confuse it with daycare treatment. You need to know that these are two different things and so is the coverage. So let us first understand the meaning of OPD treatment vs daycare treatment.

What is OPD treatment?

The outpatient department (OPD) does not need patients to take admission to the hospital. You would be required to visit a doctor at his/her clinic to get the particular treatment. As you get a health insurance policy that provides coverage for OPD expenses, you will get coverage for consultations with doctors, pathological tests, and investigations. It may also provide coverage for daycare treatment, dental procedures, and even costs related to maternity treatment. In an OPD treatment, you do not need to get hospitalized at all.

What is a Daycare treatment?

Also called daycare procedure is the treatment that does not need you to be hospitalized for many days. It can be completed even in just a few hours and you will be released the same day. A daycare treatment will not require you to be hospitalized even for 24 hours. Some of the daycare procedures are cataract surgery, chemotherapy, dialysis, dental surgery (the result of an accident), tonsillectomy, and several others.

Differences between OPD Treatment and Day Care Treatment  

A few of the differences between these two are mentioned herein below:

Hospital admission: In an OPD treatment, there is no need for hospitalization at all. In daycare treatment, hospitalization is mandatory but for less than 24 hours.

Coverage scope: The majority of the health insurance policies provide coverage for daycare procedures; however, OPD costs are not included in all the health insurance policies.

Coverage scope: Daycare procedures are covered up to a certain sum assured. The OPD treatment is not included in the sum insured, it rather is available in a sub-limit.

The claim process for OPD Treatment and Daycare Treatment 

The claim processes for these two types of treatments are different. Let us take a look at them.

OPD treatment: For an OPD treatment, the costs incurred can be claimed after you submit the documents needed. OPD reimbursements come with sub-limits.

Day care procedures: For a daycare treatment, the claim process is just like the regular hospitalization. You will be able to avail yourself of the benefits that come with a cashless system. However, you have to undergo the procedure in a network hospital. The health insurance company needs to be intimidated prior to hospitalization and you also have to submit all the required documents. If you get the procedure done at a non-network hospital, you can claim the reimbursement by submitting all the required documents within 7 days of the procedure.

To find health insurance policies that provide coverage for OPD treatment and daycare treatment, you must visit the IIFL website.

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