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Day care treatment & procedures covered under ACKO health insurance

Health insurance plans have become necessary nowadays to manage high-cost healthcare procedures, so now ACKO also covers Day care treatment & procedures*

✓ ZERO out of pocket costs ✓ ZERO waiting period ✓ ZERO deductions at claim

Zero Waiting period
Zero
Waiting period
14,300+ Cashless hospitals
14,300+
Cashless hospitals
100% Bills covered
100%
Bills covered

UID: 5703 | *T&Cs apply

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Home / Health Insurance / Articles / Daycare treatment & procedures

Health insurance plans have become necessary to manage high-cost healthcare procedures. Most health insurance providers offer coverage for extended hospital stays and major treatments or surgeries. However, many treatments don’t require an extended hospital stay but still drain patients’ finances. Thankfully, daycare treatment procedures requiring less than 24 hours are now covered under many health insurance policies. 

However, not every insurance company covers all daycare procedures. Therefore, you should check what types of daycare treatments a policy covers before buying.

What is a day care treatment procedure?
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A day care treatment procedure involves medical operations, treatments and surgeries that require less than 24-hour hospitalisation. Few examples of day care procedures are cancer chemotherapy, appendectomy, angiography, radiotherapy and more.

A daycare procedure refers only to medical surgeries, operations, or treatments that require no more than 24 hours of hospitalisation due to modern medical technology. Therefore, OPD consultations on sprains, fractures, and other smaller procedures should not be confused with daycare treatments. 

What are all day care treatment procedures covered under health insurance?
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Generally, all health insurance policies include day care coverage. However, the list of day care procedures may change from one insurer to another. Here are some of the commonly covered procedures.

List of day care treatment procedures under health insurance:
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Treatment

Operations/Procedures

Eyes

Cataract

Throat

Adenoidectomy

Gastro

Appendectomy

Rectal

Piles/fistula

Nose

Septoplasty

Others

Angiography, Chemotherapy, Radiotherapy

Please note that this is only an illustrative list. You may go through the policy document for detailed information on day care coverage. 

Different Types of Daycare Procedures Included in Health Insurance
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ACKO health insurance is a popular health insurance policy chosen by many families. It is suitable for patients who need daycare treatment. This healthy insurance policy includes many daycare treatments and procedures, such as:

To know more, the policyholders can go through the policy documents. These documents list the different types of daycare procedures and treatments. The individuals must know the definition of every medical procedure.

Importance of Buying Day Care Coverage in Health Insurance
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Daycare treatments requiring less than 24-hour hospitalisation can be costly, but having them covered by health insurance offers vital financial support.

Convenient Healthcare
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Daycare coverage ensures access to high-quality medical care without the burden of treatment expenses, providing peace of mind.

Simplified Claim Process
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Policyholders can easily claim reimbursements or use a cashless facility depending on the chosen hospital and policy terms, making the process seamless.

Wide Healthcare Network
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Health insurance provides access to a broad network of healthcare providers, ensuring timely and quality care when needed.

Tax Benefits
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Health insurance premiums qualify for tax deductions, offering policyholders the added advantage of savings

Is Day Care Treatment Different From The OPD Option?
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Daycare treatment and OPD might sound similar, but they are different from one another. Daycare treatment needs a short hospitalisation time, while OPD or Outpatient Department (OPD) includes medical consultations and small procedures. OPD services do not need hospital admission.

The difference between these two options is the level of care given to the patients. Daycare treatment includes complex procedures and surgeries. They include the option of medical admission and include hospital-based care and treatment.

Some daycare treatments include major treatments such as chemotherapy and dialysis. On the other hand, the OPD includes diagnostic tests and doctor consultations.

What is covered?

What is not covered?

Daycare treatment coverage in health insurance offers medical expenses associated with any surgery, treatment, or operation that requires the policyholder to spend less than 24 hours in a hospital. Some examples of daycare treatments include eye surgery, dialysis, chemotherapy, and any illness or injury requiring you to spend only a few hours at a daycare centre.

A day care treatment under health insurance doesn’t cover you for all short-term medical procedures. Treatments managed by the Outpatient Department (OPD) are not considered as day care procedures.

For example, medical consultation for minor injuries, seasonal illness, and regular consultations are considered under OPD. Such procedures don’t require any major surgery, hence are not covered as day care treatments.  

What makes a medical treatment eligible as a day care procedure?
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The eligibility of medical treatment under day care procedure cover comes down to three factors.

How to file a claim for day care procedure?
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The process of filing a claim for a day care procedure is similar to an inpatient treatment claim. You can choose a cashless or reimbursement claim settlement method based on the type of hospital selected for a day care treatment. 

Cashless claim via network hospitalisation:
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Step 1 - Choose a network hospital for your day care procedure and inform the insurer before your hospitalisation.

Step 2 - The insurer will receive the same information from the hospital confirming that the treatment comes within the terms and conditions of a day care procedure cover.

Step 3 - The hospital will receive all medical payments from the insurance company based on your daycare procedure cover terms.

Reimbursement claim via non-network hospitalisation:
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Step 1 - Choose any non-network hospital and inform the insurer before your hospitalisation.

Step 2 - Pay all the treatment-related costs from your pocket.

Step 3 - Submit all soft copies of relevant documents to raise a reimbursement claim.

Difference between a Day Care treatment and OPD treatment cover
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Several nuanced differences exist between a day care procedure and OPD treatment coverage.

FactorsDay Care TreatmentOPD Treatment
HospitalisationLess than 24-hour hospitalisation is compulsoryHospitalisation is not required
Extent of coverageTo the extent of total sum insuredCoverage up to a limited sum based on the insurer.
Examples of proceduresCataract surgery, angiography, chemotherapy, etc.General medical consultation for seasonal illness, health checkups, minor injury etc.

 

Benefits of ACKO Platinum Health Insurance
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The platinum health insurance policy of ACKO includes many options for different families. This health policy has some similar features to a normal health insurance policy. However, this policy offers many benefits over other health insurance policies. Some of the major benefits of the ACKO Platinum Health Insurance policy are:

Exclusions Of ACKO Platinum Health Insurance
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This health insurance plan does not cover the following options:

  1. Investigation Cost: This plan excludes hospital admission costs and investigation charges.

  2. Surgery for Weight Control: This health insurance plan does not include the cost of treatment or surgery for weight control or obesity.

  3. Narcotics: ACKO Platinum Health Insurance plan does not include the cost of treatment related to alcohol and drugs.

  4. Maternity Expenses: Expenses related to maternity, such as childbirth-related hospitalisation and pre-natal healthcare, are excluded from this plan.

  5. Rehabilitation Charges: This plan does not include the cost of rehabilitation or bed rest without active treatment.

  6. Breach of Law: This health insurance plan does not include the cost of treatment of a criminal.

Things to Consider While Buying Day Care Health Insurance Coverage
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Including daycare procedures in your health insurance can protect you from the financial strain of treatments or surgeries that don’t require extended hospitalisation. However, to make the most of your policy, consider these essential factors:

Total Sum Insured
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Verify that the sum insured is sufficient to cover potential daycare treatment expenses, ensuring comprehensive financial protection.

Inclusions and Exclusions
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Review the policy document thoroughly to understand which treatments are covered and excluded under daycare procedures.

Network Hospital List
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Check the list of network hospitals to identify nearby facilities, making it easier to access cashless claim services conveniently when needed.

Frequently asked questions
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Do I need to purchase day care coverage as an add-on with my health insurance?

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Not at all. You don’t have to opt for day care treatment coverage separately. It comes included in the health insurance as a feature, depending on the terms of the policy.

Which day care treatments are covered under a health insurance plan?

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The list of day care treatments changes from insurer to insurer. Hence, you should read the policy document carefully to understand what all procedures are accepted as day care treatments.

Is there a limit to the claim amount for a day care procedure?

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Day care treatments in a health insurance plan are usually covered up to the total sum insured.

Can senior citizens get coverage for day care treatments?

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Yes, senior citizens also get coverage for day care procedures in health insurance.

What comes under OPD treatment?

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An OPD or outpatient department treatment involves general health consultations and minor treatments related to fractures, stitches etc.

Is there any day care treatment for the COVID-19?

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Currently, treatments for COVID-19 do not include any day care procedures.

Are day care treatment procedures covered under Group Health Insurance?

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Yes, day care treatment procedures are also covered under Group Health Insurance. However, you should check with the insurance provider to understand what procedures are included in the respective policy.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on industry experience and several secondary sources on the internet; and is subject to changes. Please go through the applicable policy wordings for updated ACKO-centric content and before making any insurance-related decisions.