Day Care procedures covered under Health Insurance

Day care procedures refers to those surgeries and treatments which do not require the patient to be admitted in the hospital for 24 hours. Details about such procedures is provided by each insurance company in a document known as “Policy wordings”. However, the list of day care procedures is not standard, and it may vary from one insurance company to another. So, it is important for the policyholder to refer to this document to check which treatments and procedures are covered under this head. To make you understand better, here we have discussed what treatments are included under day care procedures and how you can easily file its claim.

What treatments day care procedures include?

Below is the list of some of the common treatments covered under day care procedures-

Operations Procedures/inclusions
  • Incision of tear glands
  • Excision and destruction of infected tissue of the eyelid
  • Procedures on the canthus and epicanthus
  • Removal of a foreign body from the conjunctiva, cornea, lens of the eye etc.
  • Incision of the cornea
  • Operation of cataract
  • Surgery for Retinal detachment
  • Excision and destruction of infected tissue of the nose
  • Procedures on the turbinates (nasal concha)
  • Nasal sinus aspiration
  • Stapedotomy
  • Operations on the auditory ossicles
  • Tympanoplasty (closure of an eardrum perforation)
  • Removal of a tympanic drain
  • Reconstruction of the middle ear
  • Fenestration of the middle ear
  • Reconstruction of the tongue
  • Glossectomy
  • Other tongue operations
  • Ligament tear and meniscus tear surgery
  • Orthopedics and trauma surgery
  • Fractures and sutures on tendons
  • Dislocation surgery
  • Arthroscopic knee aspiration
Skin and subcutaneous tissue
  • Local excision or destruction of diseased tissue of the skin
  • Skin transplantation and restoration
  • Chemosurgery to the skin
  • Incision to skin and subcutaneous tissue
  • Plastic surgery of the mouth
  • Incisions to the mouth, jaw and face

Other operations
  • Lithotripsy
  • Coronary angiography
  • Haemodialysis
  • Radiotherapy (for cancer)
  • Chemotherapy

Besides the above-mentioned procedures, surgeries performed on the digestive tract, male and female reproductive organs are also covered.

How to choose a health plan based on a day care procedure? 

While selecting a health insurance policy that covers day care procedures, insured is advisable to look for such policies that cover a broad range of categories instead of ones that list specific procedures. Broad categories generally cover more surgeries and procedures than specific ones. Additionally, you should also look for some other factors as well before investing your money in any health policy. Other factors which you need to consider includes cashless facility, age limit, sub limit, co-pay etc. It is important to check them as they all play a very important role in a health insurance policy. 

On the other hand, if you are novice to buying a health plan or are confused regarding choosing a best policy. Then, in that case, you can also seek help from your health insurer’s or can research online by visiting their website. This will aid you in buying a health plan that best suits your health requirements.

How to file a claim for a day care procedure?

The process for filing day care claims is the same as that of a regular health insurance policy. This is because day care procedure coverage is an in-built policy feature offered under a health plan.

In the case of planned procedures, you can avail a cashless facility. For this, you need to give prior intimation to your insurance provider.

However, in the case of unplanned procedures, your insurer will reimburse you only after you have submitted them the documents. 

Bottom Line

Opting for a day care procedure along with your health plan is imperative. It helps you to avoid unnecessary financial burden which in result add to your savings. So, do your research well before choosing your health insurance that covers a broad range of day care treatments.