Health insurance plans have become necessary nowadays to manage high-cost healthcare procedures, so now ACKO also covers Day care treatment & procedures*
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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.
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.
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.
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.
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:
Eye Treatment- The daycare treatments of eyes include operations on tear ducts, cataract surgery, removal of foreign bodies, and other corrective surgeries.
Heart Surgery- This insurance policy covers heart surgeries such as coronary angiography.
Tongue Treatment- Health insurance policy covers the various treatments and procedures related to the tongue. It covers the different types of surgeries such as excision, incision, Glossectomy, and tongue reconstruction.
Cancer Treatment- Health insurance policy includes the different kinds of cancer such as Chemotherapy and Radiotherapy.
ENT- Ears, throat, and nose surgeries are covered in this plan. The health insurance policy covers the different types of ENT, such as septoplasty, Tonsillectomy, foreign body removal, Tympanoplasty, and grommet insertion.
Other Kinds of Surgeries- ACKO health insurance policy covers many other types of surgeries on the body. It includes lesion policy, hemodialysis, skin surgeries, sclerotherapy, colonoscopy, joint surgeries, operations in the face, and piles.
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.
Daycare treatments requiring less than 24-hour hospitalisation can be costly, but having them covered by health insurance offers vital financial support.
Daycare coverage ensures access to high-quality medical care without the burden of treatment expenses, providing peace of mind.
Policyholders can easily claim reimbursements or use a cashless facility depending on the chosen hospital and policy terms, making the process seamless.
Health insurance provides access to a broad network of healthcare providers, ensuring timely and quality care when needed.
Health insurance premiums qualify for tax deductions, offering policyholders the added advantage of savings
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.
The eligibility of medical treatment under day care procedure cover comes down to three factors.
The procedure/treatment has to be medically necessary.
The procedure/treatment should require the patient to be admitted to a hospital.
The procedure/treatment should require less than 24 hours because of advanced medical technology.
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.
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.
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.
Several nuanced differences exist between a day care procedure and OPD treatment coverage.
Factors | Day Care Treatment | OPD Treatment |
Hospitalisation | Less than 24-hour hospitalisation is compulsory | Hospitalisation is not required |
Extent of coverage | To the extent of total sum insured | Coverage up to a limited sum based on the insurer. |
Examples of procedures | Cataract surgery, angiography, chemotherapy, etc. | General medical consultation for seasonal illness, health checkups, minor injury etc. |
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:
Includes Hospitalisation Charges: This plan covers the expenses of hospitalisation and admission with the cost of medical treatment. It also covers the expenses of various surgeries and treatments related to the different health issues. This plan covers the expenses of prescribed medicines, fees of practitioners, ICU charges, medicines, and so on.
Covers Daycare Treatment: Another benefit of the Acko Health Insurance Plan is that it includes the cost of daycare treatment. Daycare treatments often include a long time stay in the hospital for more than a day or 24 hours. This plan does not have any restrictions on daycare treatments. Patients can get the coverage of expenses as much as possible.
Expenses for Organ Donor: This plan includes the cost of transplanting the organ from donor to receiver. Apart from that, the plan also includes inpatient expenses while receiving an organ from the donor for transplanting.
Covers Non-medical Expenses: This health Insurance plan covers some non-medical expenses and other costs. These non-medical expenses include the cost of oxygen masks, gloves, nebulisation kits, and other consumables.
Includes a No-claim Bonus: ACKO Platinum Health Insurance Plan covers a no-claim bonus of 10% on the sum insured. This bonus can be received when the person renews the policy with the insurer. The bonus includes 100% of the base sum insured on the treatment.
Zero Waiting Time: This health insurance plan includes a zero waiting time. Patients can get complete coverage on enrollment without waiting. It also removes the Initial waiting period and the Specific Disease waiting period.
All Health Check-ups: A regular health check-up is necessary to gain a better quality of health. It helps to know the early symptoms of any health disease and identify the risk factors. This plan includes the cost of preventive check-ups for patients aged above 18 years.
This health insurance plan does not cover the following options:
Investigation Cost: This plan excludes hospital admission costs and investigation charges.
Surgery for Weight Control: This health insurance plan does not include the cost of treatment or surgery for weight control or obesity.
Narcotics: ACKO Platinum Health Insurance plan does not include the cost of treatment related to alcohol and drugs.
Maternity Expenses: Expenses related to maternity, such as childbirth-related hospitalisation and pre-natal healthcare, are excluded from this plan.
Rehabilitation Charges: This plan does not include the cost of rehabilitation or bed rest without active treatment.
Breach of Law: This health insurance plan does not include the cost of treatment of a criminal.
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:
Verify that the sum insured is sufficient to cover potential daycare treatment expenses, ensuring comprehensive financial protection.
Review the policy document thoroughly to understand which treatments are covered and excluded under daycare procedures.
Check the list of network hospitals to identify nearby facilities, making it easier to access cashless claim services conveniently when needed.
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.
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.
Day care treatments in a health insurance plan are usually covered up to the total sum insured.
Yes, senior citizens also get coverage for day care procedures in health insurance.
An OPD or outpatient department treatment involves general health consultations and minor treatments related to fractures, stitches etc.
Currently, treatments for COVID-19 do not include any day care procedures.
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.