What is daycare treatment in health insurance

Day-care treatment refers to admission for a treatment where, due to advances in the field of medicine, admission for more than 24 hours is not required. It takes much less time for some treatments to be performed now than before. Treatment is done using general or local anesthesia under day-care. Examples of day-care treatments include cataract surgery, nasal sinus aspiration, cancer chemotherapy, cancer radiotherapy, etc.

Following are some of the benefits of getting daycare treatment cover: 

• Cashless Treatment: Generally, most day-care treatments or operations are done in a planned manner. If you want to get any daycare treatment then you can avail of the cashless facility in a network hospital by informing your insurance company in advance, as per its terms and conditions.
• Easier claim process: You can either avail of cashless treatment at a network hospital or claim reimbursement later by paying the bill of the treatment yourself. The method of claiming is almost the same as in cases of inpatient hospitalization.
• Convenience: A daycare treatment facility in any health policy ensures timely and quality medical care without any hassle. The insurance company settles your bill in collaboration with the day-care center or hospital so that you can get your treatment done peacefully without worrying about the medical bills.
• Savings: One of the major benefits of taking health insurance is tax exemption. You can get a tax exemption on the premium paid annually under Section 80D of the Income Tax Act 1961.

With a good policy like myUpchar Bima Plus, you can get cover for a variety of daycare treatments. The many types of surgeries that can be claimed are:

• Heart: Coronary Angiography
• Eyes: Cataract surgery, removal of foreign objects in the eye, tear duct operation and corrective surgery.
• ENT: Removal of a foreign object in the ear, Septoplasty, Nasal sinus aspiration, Tonsillectomy, Myringotomy with grommet insertion, Tympanoplasty and other operations of the middle and inner ear
• Tongue: Cutting, excision, glossectomy, reconstruction of the tongue and other surgeries of diseased tissue of the tongue
• Cancer treatment: Radiotherapy and chemotherapy
• Other surgeries: Hemodialysis, Colonoscopy, Lesion removal, Hemorrhoids, Appendicectomy, Hydrocele treatment, Lithotripsy, Sclerotherapy, Thoracoscopy, skin surgery, bone fracture and joint surgery, mouth and face operations, surgery for certain dental injuries, etc.

It is worth noting here that the names mentioned above are only a few of the many procedures covered by health insurance companies. After taking the policy, you should go through your policy document thoroughly within the free look period of 15 days, so that you can acquaint yourself with the correct information about day-care treatment. In myUpchar Bima Plus, the insurance partner Care Health Insurance itself lists more than 540 such procedures that are covered in day-care.

(Read more: Which is the cheapest health insurance)

Day-care treatment is a very important part of any health insurance plan as it saves the insured from the cost of expensive medical treatments that do not require hospitalization for more than 24 hours. Day-care treatments can usually be claimed up to the sum insured amount.

If you have a mediclaim policy, you should be covered for the expenses incurred on daycare treatment as it is an essential feature of any medical policy. Keeping the following things in mind will help:

• Sum insured amount: Like other sectors, inflation has increased significantly in the health services sector. Since this has made treatment costly, you should choose a good policy for your health needs, which also has a high enough sum insured.

• Policy type: Whether you are leaning towards an individual insurance policy or a family floater, you should always choose a good health cover. You should ensure that the plan you choose gives you the benefit of day-care treatment along with comprehensive coverage of medical expenses.

• What is not covered: You should go through your health insurance document thoroughly, so that you understand the diseases or conditions for which you will not get a claim.

• Co-payment: We suggest that you do not choose a policy with the option of co-payment if possible. Despite this, if you have taken such a policy already, then read the document carefully and prepare yourself to pay some part of the bill during any treatment.

• Network hospital: Whichever health insurance you have chosen for yourself, you must definitely check how many hospitals are there in that company's network. Also, check whether hospitals near where you live are on this list. This is necessary because you will get the cashless facility only in the network hospitals. By taking myUpchar Bima Plus policy, you will get the benefit of the cashless facility in more than 8,350 hospitals.

(Read more: What is not covered in health insurance)

While not simple, the process of buying health insurance is relatively easy. The bigger questions arise in the minds of many people when they have to tell the insurance company about the treatment and file the claim. It is worth noting here that it is necessary to inform the insurance company about the hospitalization within a stipulated time. Below are some important things you need to know to be able to file a daycare claim correctly.

Under regular health insurance, you can claim for daycare treatment in the same way as you would in case of hospitalisation. For any kind of planned or emergency treatment, one should ideally go to a network hospital, so that you can get the cashless facility. The cashless facility is a great facility under which you do not need to make any cash payment for hospitalization. You should keep information about the company's network hospitals handy and visit the same in times of need. On arrival at the hospital, you should contact the TPA desk and submit a copy of your health card and other ID proof along with filling the pre-authorization form. If you reach a hospital that is not included in the company's cashless network, you will have to pay the entire bill yourself. Later, you can submit the necessary documents, including the doctor's prescription and all the bills, to the insurance company for reimbursement.

(Read more: Why a medical policy is better than a medical loan)

Centers established for day-care treatment (treatment of injuries or diseases) are called day-care centers. It can also be a medical setup built inside a hospital, which is registered with the local body. This center should be run under the supervision of a registered and qualified medical practitioner. Following are the main things required for any day-care center:

(Read more: COVID-19 Health Insurance)

• The center should have qualified nursing staff.
• The center should have a qualified medical practitioner.
• The center should have its own fully-equipped operation theatre so that daycare treatment can be conducted.
• The center has to maintain a daily record of its patients and make it accessible to the authorized employee of the insurance company.