• 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

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    • ICICI Lombard Health Insurance
      "Average Policy"
      0.5 3.0/5 "Satisfactory"
      I have my health insured with ICICI lombard from last 2 years, the coverage value of this insurance policy is very less which is Rs 1 lakh. I am not aware of the premium amount as my company pays it. I do not have claim experience so far with this insurance policy.
      Was this review helpful? 0
      , pune
      Reviewed on Apr 24, 2018
    • Star Health Health Insurance
      "Health insurance with STAR"
      0.5 3.0/5 "Satisfactory"
      I have taken health insurance from STAR HEALTH & ALLIED INSURANCE. and the premium amount is 2500 for 2.5 lakhs of policy coverage.They dont provide any cashless faculty but provide reimbursement. There is no claim experience till now. Its an individual policy.
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      , chennai
      Reviewed on Apr 24, 2018
    • Religare Health Insurance
      "EXCELLENT"
      0.5 5.0/5 "Blown Away!"
      Religare Health Insurance service is good. The payments are through Ecs. The offers of Religare covers the top hospitals,it was very much helpful for me. The benefits is for the whole family. It was an good experience with Religare Health Insurance service.
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      , chennai
      Reviewed on Apr 23, 2018
    • Bajaj Allianz Health Insurance
      "Good policy for health"
      0.5 5.0/5 "Blown Away!"
      I have taken a health insurance with BAJAJ ALLIANZ GENERAL INSURANCE and the premium i am paying was 13600 annually. The provide cashless facility and the claim experience was good. The have cashless facility almost 99% of coverage done through the insurance.
      Was this review helpful? 0
      , kolkata
      Reviewed on Apr 21, 2018
    • Star Health Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I hold a health insurance with Star health from last 2 years, i pay an insurance premium of Rs 11000 every year. I get a good coverage value of Rs 5 lakhs for this health insurance policy. I have not claimed anything so far with this insurance policy.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 20, 2018
    • Apollo Munich Health Insurance
      "best experience"
      0.5 3.0/5 "Satisfactory"
      I had taken a Health insurance policy from the top most private sector insurance company APOLLO MUNICH. Most of all benefits are covered under one policy, so no need to top up my insurance plan. I had received my health card and my policy document by mail. They have a good network with a best corporate hospitals.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 20, 2018
    • Religare Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      I have my health insured with Religare health 4 months back, i am happy with the coverage value of this insurance policy. A premium of Rs 8000 has to be paid every year for this health insurance. I do not have claim experience so far with this insurance and they cover Rs 5 lakhs for this insurance.
      Was this review helpful? 0
      , ahmedabad
      Reviewed on Apr 20, 2018
    • Max Bupa Health Insurance
      "very good policy"
      0.5 5.0/5 "Blown Away!"
      I had taken a Health insurance policy from the top most private sector insurance company MAX BUPA. Most of all benefits are covered under one policy, so no need to top up my insurance plan. I had received my health card and my policy document by mail. They have a good network with a best corporate hospitals.
      Was this review helpful? 0
      , mumbai
      Reviewed on Apr 20, 2018
    • Religare Health Insurance
      "Good policy"
      0.5 4.0/5 "Great!"
      From RELIGARE Health i have taken the health insurance. They provide cashless facility. There is no claim experience with them. There is health check up available on the insurance policy. Its an individual policy.The customer service and response is good.
      Was this review helpful? 0
      , mumbai
      Reviewed on Apr 20, 2018
    • Bajaj Allianz Health Insurance
      "Good policy to use"
      0.5 4.0/5 "Great!"
      I am having the BAJAJ ALLIANZ health insurance policy around a year ago. The customer support service is good with the BAJAJ ALLIANZ GENERAL INSURANCE company. I need to pay the premium amount of Rs,13,000 every year once. This policy covers 3 members in my family. This policy has the medical coverage of Rs,3,00,000 which can be used be all three members.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Apr 19, 2018
    • United India Health Insurance
      "Average Policy"
      0.5 3.0/5 "Satisfactory"
      I have a health insurance policy with United India Insurance from last 5-6 years, my claim experience was not up to the mark as they covered only 40% of the billed amount. I have a coverage value of Rs 3 lakhs and i pay a premium of Rs 3200 for this insurance.
      Was this review helpful? 0
      , surat
      Reviewed on Apr 19, 2018
    • HDFC Ergo Health Insurance
      "best policy"
      0.5 4.0/5 "Great!"
      I had taken a health insurance policy from the public sector insurance company HDFC ERGO GENERAL INSURANCE. My annual premium amount is reasonable by comparing with other premiums. I did not received my policy document by mail and hard copy too. I contacted the customer care to courier my health card to my registered communication address.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 18, 2018
    • Apollo Munich Health Insurance
      "extra ordinary experience"
      0.5 5.0/5 "Blown Away!"
      I had taken a health insurance policy from the top most private sector insurance company APOLLO MUNICH. They couriered my health card to my registered communication address. They have a good network with corporate hospitals. I had a good positive claim experience and i claimed nearly 95% of billed amount.extra ordinary experience
      Was this review helpful? 0
      , coimbatore
      Reviewed on Apr 18, 2018
    • New India Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have no claim experience so far with the health insurance, i am using this insurance from last 1-2 years and i am not aware of the premium amount as my company pays it. The coverage value of this insurance policy is 3-4 lakhs and i am satisfied with it.
      Was this review helpful? 0
      , chennai
      Reviewed on Apr 18, 2018
    • Star Health Health Insurance
      "Excellent service"
      0.5 5.0/5 "Blown Away!"
      Holding the health insurance policy from the STAR HEALTH & ALLIED INSURANCE company and I have got this policy on 2013. I pay Rs,16,000 every year to renew the policy. This policy covers 4members in my family . Star health insurance policy has the medical coverage up to Rs,10,00,000,.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Apr 18, 2018
    • Bajaj Allianz Health Insurance
      "Good health insurance policy"
      0.5 3.0/5 "Satisfactory"
      I have got the health insurance policy from the bajaj and this policy covers only one member which is myself actually it is a self policy . I pay the premium amount in every month on month . I pay Rs,15000 to this policy. This policy has the medical coverage up to 5lakhs and I am satisfied with it.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 18, 2018
    • HDFC Ergo Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with HDFC ERGO from last 1month, i have not claimed anything so far with this insurance. The coverage value of this insurance policy is 3 lakhs and i am satisfied with it. I pay a insurance premium of Rs 11000 every year.
      Was this review helpful? 0
      , mumbai
      Reviewed on Apr 17, 2018
    • Star Health Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with Star health from last 3 years, i am not aware of the premium amount as my company pays for the health insurance. I am happy with the coverage value of Rs 2 lakhs for this health insurance. I do not have claim experience so far with this insurance.
      Was this review helpful? 0
      , mumbai
      Reviewed on Apr 17, 2018
    • HDFC Ergo Health Insurance
      "best policy"
      0.5 5.0/5 "Blown Away!"
      I had taken a health insurance policy from the HDFC ERGO GENERAL INSURANCE. My annual premium is very reasonable by comparing with other premiums. I had a positive claim experience. The claim procedure is very easy and simple. The costumer support is good and well responsive.
      Was this review helpful? 0
      , mumbai
      Reviewed on Apr 17, 2018
    • New India Health Insurance
      "good experience"
      0.5 5.0/5 "Blown Away!"
      I had taken a health insurance policy from the NEW INDIA ASSURANCE. I had received health card. My annual premium is Rs. 12,000/- which is very reasonable by comparing with other insurance polices. They had a good network with top most corporate hospitals.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 17, 2018
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