Day care treatment & procedures covered under ACKO health insurance

Health insurance plans have become necessary nowadays 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 end up draining patients’ finances. Thankfully, day care treatment procedures that need less than 24 hours are now also covered under many health insurance policies. 

However, not every insurance company covers all day care procedures. Therefore, you should definitely check what types of day care 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 day care procedure refers only to those medical surgeries, operations or treatments that require not more than 24 hours of hospitalisation due to modern medical technology. Therefore, OPD consultations related to sprains, fractures, and other smaller procedures should not be confused as day care 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.

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

The eligibility of medical treatment under day care procedure cover comes down to three factors.

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 the terms of your day care procedure cover.

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.

There are several nuanced differences between a day care procedure and OPD treatment cover.

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.