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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.

    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
    • HDFC Ergo Health Insurance
      "Very Good Service"
      0.5 4.0/5 "Great!"
      Overall it had been a good experience with them so far and i had directly went to take this insurance policy. The process was done online and it has been simple and easy where it was hassle free. I have not yet made any claim with this insurance policy so there has not been any experience in that. There has not been any hassle made by them so far.
      Was this review helpful? 0
      , mumbai
      Reviewed on Jul 20, 2018
    • Star Health Health Insurance
      "Excellent Service"
      0.5 5.0/5 "Blown Away!"
      I had taken this insurance almost three years and it had been a good experience with them so far. I had been making all the payments online and it has been easy in making the payments. One of my friend referred me in taking this insurance and i had directly went to them in taking the insurance policy and it has been a hassle free process.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jul 20, 2018
    • Royal Sundaram Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      I have my health insured with Royal Sundaram general insurance from last 3 months, it is a family health policy with the coverage value of Rs 1 lakh per member. I have no claim experience so far with this insurance and i get good tax benefits on this policy.
      Was this review helpful? 0
      , mumbai
      Reviewed on Jul 20, 2018
    • Star Health Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      I have my health insured with Star health from last 6 months, i pay a premium of Rs 5500 for this insurance policy and it is a family coverage. I have not claimed anything so far from this insurance policy and the coverage value is Rs 10 lakhs.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jul 20, 2018
    • Star Health Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      I have a health insurance policy with Star health from last 15 years and it is a good policy. It is a family policy with the coverage value of Rs 7 lakhs for this insurance. I have no claim experience so far from this insurance and i pay a premium of Rs 4000 for this insurance.
      Was this review helpful? 1
      , chennai
      Reviewed on Jul 18, 2018
    • ICICI Lombard Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I've an employer provided health insurance policy with the ICICI Lombard. The company is paying the premium. It offers of a coverage of 2 lacs for me annually. I do not have any claim experience with the policy. So far there hasn't been any issues with the policy. I'll have to wait and see how they respond to my claims in future if I'll have any.
      Was this review helpful? 0
      , bangalore
      Reviewed on Jul 17, 2018
    • HDFC Ergo Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have choose this Hdfc insurance mainly because of convincing premium benefits . This policy covers Cashless hospitalization, pre diseases coverage . Overall am satisfied with customer care and service. Am getting income tax benefits and the premium amount which am paying is quiet high , I make the payment through on line.
      Was this review helpful? 1
      , ahmedabad
      Reviewed on Jul 17, 2018
    • ICICI Lombard Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I took health insurance from Icici health insurance . I have choose this insurance mainly because of convincing premium with too many benefits . This policy covers Cashless hospitalization. , pre diseases coverage . Overall am satisfied with customer care and service. Am getting income tax benefits
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jul 17, 2018
    • Star Health Health Insurance
      "Best service"
      0.5 5.0/5 "Blown Away!"
      I took health insurance from Star health insurance . I have choose this insurance mainly because of convincing premium with too many benefits . This policy covers Cashless hospitalization , pre diseases coverage . Overall am satisfied with customer care and service. Am getting income tax benefits
      Was this review helpful? 1
      , vadodara
      Reviewed on Jul 17, 2018
    • review Health Insurance
      "Not satisfied"
      0.5 1.0/5 "Really Bad"
      I took health insurance from Iffco tokio health insurance . I have choose this insurance mainly because of convincing premium amount . I have closed this insurance as they told it cover pre disease coverage . During claim process , there is no proper response from the customer service and response .
      Was this review helpful? 0
      , vadodara
      Reviewed on Jul 17, 2018
    • New India Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I've a health insurance policy which is provided by the employer in partnership with the New India Insurance . The company is paying the premium, so far there hasn't been any claim experience with the policy. It offers 10 lacs hospitalization coverage and a whopping 1 Crore accidental benefits. Considering the features and benefits it is recommendable health insurance policy to have.
      Was this review helpful? 1
      , mumbai
      Reviewed on Jul 16, 2018
    • Bajaj Allianz Health Insurance
      "Useful Service"
      0.5 4.0/5 "Great!"
      I've an employer provided insurance policy with the Bajaj Allainz. The company is paying the premium, I do have a claim experience with the policy where I claimed 100% amount needed for the treatment. It was a cashless treatment and the whole process was smooth and hassle free.
      Was this review helpful? 0
      , new delhi
      Reviewed on Jul 16, 2018
    • National Insurance Health Insurance
      "Good Service so far"
      0.5 4.0/5 "Great!"
      I've a health insurance policy with the National Insurance. It offers an annual Coverage of 3 lacs, the policy covers me and my parents and I do not have any claim experience with the policy so far. I never had any issues with their services.
      Was this review helpful? 1
      , gurgaon
      Reviewed on Jul 14, 2018
    • ICICI Lombard Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I've a health insurance policy with the ICICI Lombard. It took almost one month to receive the policy document soft copy. I am paying a premium of 650 per month. They're yet to send me the hard copy. Overall it hasn't been a good experience with the policy so far.
      Was this review helpful? 0
      , delhi
      Reviewed on Jul 14, 2018
    • Reliance General Health Insurance
      "Good Service"
      0.5 5.0/5 "Blown Away!"
      I've been using the Health Insurance policy from the Reliance General Insurance. The company is paying the premium. The policy covers me and my parents. The policy offers an annual coverage of 5 lacs for me and 2 lacs for my parents. So fat I do not have any claim experience with the policy.
      Was this review helpful? 1
      , bangalore
      Reviewed on Jul 14, 2018
    • HDFC Ergo Health Insurance
      "Good Service"
      0.5 5.0/5 "Blown Away!"
      I've an employer provided health insurance policy with the HDFC Ergo. It offers an annual coverage 5 lacs, the company is paying the premium. I do have any claim experience with the policy. I have claimed this policy two times for me and wife both they approved. The claim processing was really easy and they settled almost 30000.
      Was this review helpful? 0
      , pune
      Reviewed on Jul 14, 2018
    • Apollo Munich Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with Apollo Munich from more than 10 years and it is an individual policy. I am happy with the coverage value of this insurance policy. I have not claimed anything so far from this insurance policy and the policy is covered up to Rs 3-4 lakhs.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jul 13, 2018
    • Max Bupa Health Insurance
      "Don't buy health insurance from Max Bupa"
      0.5 0.5/5 "Unacceptable"
      I have taken policy for brother. while playing he suffered from knee injury. During hospitalization doctor suggested for ligament operation. After that we applied for cashless but max bupa rejected cashless and suggested for reimbursement. After hospitalization we submitted all claim document. max bupa send message that within 21 days claim will approved. Now after 40 days also claim is not approved and showing Suspense status . after that i checked review from many website, i come to know that max bupa claim ration is zero. This is fake company who not settle any claim. Below are my claim details: Claim Number: 339012 Final Status: Suspense Claim Decision Date: Saturday, June 9, 2018 12:00 AM
      Was this review helpful? 1
      , pune
      Reviewed on Jul 12, 2018
    • Star Health Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      I have a health insurance policy with Star health from last 7 years and it is one of the good insurance policy. I pay a premium of Rs 10000 for this insurance and it is a family heath policy. My claim experience was good and i have claimed 2 times. The coverage value was 90% and it was a cashless treatment.
      Was this review helpful? 1
      , ahmedabad
      Reviewed on Jul 12, 2018
    • United India Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with United India Insurance from last 15 years, i am happy with the coverage value of this insurance policy. I have no claim experience so far with this insurance policy. This is a family policy so the coverage value is Rs 3 lakhs.
      Was this review helpful? 0
      , coimbatore
      Reviewed on Jul 12, 2018
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