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  • Day Care Procedures Covered under Health Insurance

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    Health insurance policies are slowly becoming the norm, with a number of Indians buying these policies to offset the high costs of healthcare. While most health insurance policies cover major surgeries and hospital stays, there are also shorter, day care procedures that can be claimed under your health insurance policy.

    Day-Care-procedure-is-Covered-in-Health-Insurance

    What is a Day Care Procedure?

    A day care procedure is a surgery or medical procedure that formerly required a prolonged stay in hospital but can now be completed in less than 24 hours. Thus, while the patient is in hospital for a short period of time, he/she does not spend a full 24 hours in the hospital, which is the minimum period for which claims can be filed.

    Day care procedures are surgeries or procedures that no longer require extended periods of hospitalisation thanks to advances in medicine and technology. However this does not prevent them from being a drain on the patient’s finances. In fact, the cost of these procedures after factoring in medical tests and medications could add up to a large sum of money.

    In light of this, health insurance companies have made it possible for policyholders to file a claim in the event they have to undergo such a procedure, thus bypassing the 24 hour hospitalisation rule.

    List of Day Care Procedures:

    Operations Procedures/Inclusion
    Eyes
    • Cataract operation.
    • Removal of foreign body.
    • Corneal incision.
    • Tear duct operations.
    • Eyelid incision.
    • Corrective surgery for entropion, ectropion.
    Nose and Sinus
    • Nasal sinus aspiration.
    • Operation on nasal concha.
    • Other operations on the nose.
    • Foreign body removal.
    Ear
    • Stapedotomy.
    • Stapedectomy.
    • Operations on the auditory ossicles.
    • Tympanoplasty.
    • Operations on the middle ear.
    • Reconstruction of the middle ear.
    • Incision of the inner ear.
    • Other operations on the inner ear.
    Tongue
    • Reconstruction of the tongue.
    • Glossectomy.
    • Other operations on the tongue.
    Bones
    • Ligament tear and meniscus tear surgery.
    • Orthopaedics and trauma surgery.
    • Fractures and sutures on tendons.
    • Dislocation surgery.
    • Other joint and bone surgery.
    Skin and subcutaneous tissue
    • Skin transplantation and restoration.
    • Chemosurgery to skin.
    • Incisions to skin and subcutaneous tissue.
    • Excision of diseased skin and subcutaneous tissues.
    Face
    • Plastic surgery to the mouth.
    • Incisions to the mouth, jaw and face.
    • Other operations to the mouth and face.
    Other operations
    • Lithotripsy.
    • Coronary angiography.
    • Haemodialysis.
    • Radiotherapy (for cancer).
    • Chemotherapy.

    Additionally, surgeries performed on the digestive tract, male and female reproductive organs are also covered.

    Things to Keep in Mind:

    Day care procedures are covered subject to them being in the list of procedures covered by the particular insurance company. When looking for policies that cover day care procedures, it is advisable to look for ones that cover a broad range of categories instead of ones that list specific procedures as the broad categories generally cover a lot more surgeries and procedures.

    Filing a Claim for Day Care Procedure:

    When filing a claim for a day care procedure, the policyholder can follow the same process as a regular health insurance claim as day care procedures are a part of the protection provided under the health insurance policy.

    GST rate of 18% applicable for all financial services effective July 1, 2017.

    Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

    Day Care Procedures Reviews

  • Page 1 of 50 1 2 3 4 5
    • Star Health Health Insurance
      "Average Service"
      0.5 3.0/5 "Satisfactory"
      I was using the health insurance policy with the Star Health. I am paying a premium of 35K per year. On one occasion I claimed the policy and they were able to reimburse only 75% of the amount claimed which wasn't satisfactory.
      Was this review helpful? 3
      , hyderabad
      Reviewed on Sep 15, 2018
    • Reliance General Health Insurance
      "Average Service"
      0.5 3.0/5 "Satisfactory"
      I've a health insurance policy with the Reliance General Insurance. I am paying a premium of 27000 per year. It is for the entire family. There hasn't been any claim experience so far. I will have to wait and see how they respond to my requests in future if I will have any.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Sep 15, 2018
    • New India Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      My health insurance is with New India Assurance from last 1 year, i am not aware of the premium amount as my company pays it. I have no claim experience so far with this insurance policy and the coverage value is Rs 2 lacs for individual.
      Was this review helpful? 1
      , bangalore
      Reviewed on Sep 14, 2018
    • Apollo Munich Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with Apollo Munich from last 7-8 years, i have no claim experience so far with this insurance policy. I pay a premium of Rs 12000 for this insurance policy and the coverage value is Rs 5 lacs for this policy.
      Was this review helpful? 0
      , pune
      Reviewed on Sep 12, 2018
    • Cigna TTK Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with CIGNA TTK from last 2 years, i am happy with the coverage value of this insurance policy. I pay a premium of Rs 12000 for this insurance policy. I have no claim experience so far with this insurance and the coverage value of Rs 4.5 lacs.
      Was this review helpful? 0
      , bangalore
      Reviewed on Sep 12, 2018
    • Max Bupa Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with MAX BUPA from last 6 years, i am happy with the coverage value of this insurance policy. I have no claim experience so far with this insurance and i get no claim bonus every year. The coverage value for this insurance is Rs 15-20 lacs.
      Was this review helpful? 0
      , faridabad
      Reviewed on Sep 12, 2018
    • ICICI Lombard Health Insurance
      "Good Policy"
      0.5 3.0/5 "Satisfactory"
      I have recently taken a health insurance policy with ICICI LOMBARD. I have to pay a premium of Rs 15000 on yearly basis. This policy i got it along with the personal loan taken from Fullerton. They gave a coverage of Rs 3 lacs for this insurance policy.
      Was this review helpful? 1
      , rajahmundry
      Reviewed on Sep 12, 2018
    • Star Health Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      My health is insured with STAR health from last 1year and it is a good policy to use. It is a family policy where the coverage value is Rs 3 lacs per individual. I do not have claim experience with this insurance and i pay a premium of Rs 15000 for this insurance.
      Was this review helpful? 1
      , coimbatore
      Reviewed on Sep 12, 2018
    • Religare Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      I have a health insurance policy with Religare from last 1.5 years, a premium of Rs 14000 has to be paid for this insurance policy and it is a family coverage. My claim experience was very good and they covered 100%. Coverage value is Rs 5 lacs +5 lacs (auto refill) for this insurance.
      Was this review helpful? 0
      , ahmedabad
      Reviewed on Sep 12, 2018
    • Reliance General Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with Reliance general insurance from last 3 months, i pay a premium of Rs 10000 for 2 individuals and each one has the coverage value of Rs 5 lacs. It is a good policy to use and i have not claimed anything so far from this insurance.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Sep 12, 2018
    • National Insurance Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I hold an Individual health insurance policy with National insurance from last 4 years, i have not claimed anything so far from this insurance policy. I pay a premium of Rs 3000 for this insurance policy and the coverage value is Rs 1.5 lacs for this insurance.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Sep 12, 2018
    • HDFC Ergo Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with HDFC ERGO from last 1.5 months, i am happy with the coverage value of this insurance policy. A premium of Rs 6000 has to be paid for this insurance policy. I have no claim experience with this insurance the coverage value is Rs 5 lacs.
      Was this review helpful? 0
      , palanpur
      Reviewed on Sep 12, 2018
    • ICICI Lombard Health Insurance
      "Normal Service"
      0.5 4.0/5 "Great!"
      I've a health insurance policy with the ICICI Lombard. I am paying low premium, there hasn't been any claim experience with the policy so far. Considering the premium I pay it has been a normal experience with the policy so far.
      Was this review helpful? 1
      , udaipur
      Reviewed on Sep 11, 2018
    • ICICI Lombard Health Insurance
      "Good Service"
      0.5 5.0/5 "Blown Away!"
      I've a health insurance policy with the ICICI Lombard, I am paying the premium and I do not have any claim experience with the policy so far. I'll have to wait and see how they respond to my claim requests in future. It has been a hassle free experience so far.
      Was this review helpful? 0
      , bangalore
      Reviewed on Sep 11, 2018
    • Star Health Health Insurance
      "Start Health Insurance Fraud"
      0.5 0.5/5 "Unacceptable"
      My father purchased Star health insurance for family safety and was paying premium from last 2 years but when time came insurer refused to give claim stating that throughout the hospitalization and all investigation reports are within normal limits. My brother was admitted in family hospital delhi for 24 hours, doctors diagnosed him and billed approx 13500.
      Was this review helpful? 2
      , new delhi
      Reviewed on Sep 08, 2018
    • Chola Ms Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with Cholamandalam health insurance from last 2 years, i am happy with the coverage value of this insurance policy. I am not aware of the premium amount as my company pays it. It is a family coverage and they cover up to Rs 5 lacs for this insurance.
      Was this review helpful? 0
      , bangalore
      Reviewed on Sep 08, 2018
    • Apollo Munich Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with Apollo Munich from last 3 months, i am happy with the coverage value of this insurance. I am not aware of the premium amount as my company pays it. The coverage value is Rs 10 lacs for accidental policy and Rs 10 lacs for death policy.
      Was this review helpful? 0
      , pune
      Reviewed on Sep 08, 2018
    • National Insurance Health Insurance
      "Very Good Service"
      0.5 4.0/5 "Great!"
      I had taken this insurance policy almost ten years back and the premium had been paying online. The premium amount has not been higher and it was nominal. Their customer support and their staff responses also had been good as well. They also covers most of the hospitals in our locality.
      Was this review helpful? 0
      , coimbatore
      Reviewed on Sep 07, 2018
    • ICICI Lombard Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have an Individual health insurance policy with ICICI Lombard from last 4 years, i pay a premium of Rs 6500 for this insurance policy. I have not claimed anything so far from this insurance policy. The coverage value for this policy is 7 lacs.
      Was this review helpful? 1
      , faridabad
      Reviewed on Sep 06, 2018
    • Star Health Health Insurance
      "Satisfactory"
      0.5 5.0/5 "Blown Away!"
      Star health is good in the health insurance policy. The medical coverage is good. It is for my family and I and fortunately I had not had a claim experience til date. The premium is normal and there are good benefits too. There is a no claim bonus too.
      Was this review helpful? 1
      , secunderabad
      Reviewed on Sep 06, 2018
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