• How Daycare Treatment is different from OPD Treatment?

    In this tech-driven world where health insurance plans are readily available at the click of a mouse, resorting to the old-fashioned ‘through-the-agent’ means is so passe. What the latter entails is a series of misinformation on the agent’s part while the policy holder puts in little to no effort in learning the basics of a policy they are buying.

    If you have made the shift from using an agent and are personally looking through insurance offers by yourself, then kudos to you. But, the insurance industry, like any other, is filled with clever play of words that a beginner would find hard to understand.

    In this page, we will outline the basic differences between day care treatment and outpatient department (OPD) treatment. Although, the difference between the two may not seem like much, there are plenty you need to be informed about when shopping for health insurance policies.

    Daycare Treatment:

    It is a very well known fact among seasoned policy buyers that an individual must be hospitalised for at least 24 hours to be able to make a health insurance claim. But, as technology has grown exponentially over the last two decades, not all key procedures require day-long hospital visit.

    Let’s take the example of an individual undergoing a corrective eye surgery. Up until a few years ago, they would have had to admit themselves to a hospital for at least a few days. However, procedures like LASIK and ICL (Implantable Contact Lens) among others, have cut short a few days long procedure into one that can be carried out in less than an hour.

    Some of the most common procedures that are likely to be listed in day care treatment-specific insurance policy include eye surgery, dental surgery, chemotherapy, haemodialysis among others. One point worth noting here is that day care treatments covered in insurance plans differ from policy to policy.

    Outpatient Department (OPD) Treatment:

    OPD is a treatment wherein certain treatment or diagnosis of a certain type of illness upon the advice of a medical practitioner. This involves the patient visiting the clinic or any of the doctors’ consultation rooms.

    While OPD still feels similar to daycare, the actual difference can be explained with the level of hospitalisation involved in either of these cases. For instance, in a day care treatment, a patient needs to be admitted to the hospital for however short a duration to trigger an insurance claim. On the other hand, an OPD is getting a procedure done without needing to be admitted. A perfect example for OPD would be root canal, which could be taken care of with a routine visit to a dentist’s office rather than getting admitted.

    How are Settlements Made for OPD and Day Care Treatments?

    Making settlements for day care treatments is quite similar to what it is with regular hospitalisation. To make a claim, you would need to submit all the relevant documents regarding the treatment you have availed within the timeline specified in the fine print. There’s also an advantage for you in case of day care treatments as they are usually planned well. For instance, when you getting any of the day care related procedures, you can step into one of the many network hospitals affiliated to your insurance provider. This will enable you to take the cashless route as your insurance company will handle all the payments in your stead. To make this happen, you should inform your insurance provider a few days in advance and also provide all the necessary documentation for the treatment you have availed.

    Getting an OPD treatment claim is slightly different from daycare ones as it works like indemnity-based plans. Here, you will need to pay for your treatments yourself and later opt for a reimbursement by presenting all the paperwork. An aspect worth noting here is that OPD treatments usually come with a sublimit and the cost of any breach in limit will have to be borne by you.

    To sum it up, health insurance jargons aren’t as hard to comprehend as they are made to be. All that is expected of a prospective policy buyer would be to do their due diligence and read through the terms and conditions of the insurance they are buying.

    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.

    Daycare Vs OPD treatment Reviews

  • Page 1 of 50 1 2 3 4 5
    • Apollo Munich Health Insurance
      "The Best"
      0.5 5.0/5 "Blown Away!"
      Since I'm working with health insurance. It is easy to claim in Apollo Munich. The best hospital list covered in this policy. The best health insurance company in PAN India. In my company, they are paying the insurance premium for me and my family.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jun 14, 2018
    • HDFC Ergo Health Insurance
      "Good Service"
      0.5 3.5/5 "Pretty good"
      I've a health insurance policy with the HDFC Ergo. I pay a premium of 6100 Per year, I do not have any claim experience with the policy and it offers full coverage for my entire family. They offer a coverage 2 lacs annually which is pretty good for me. Overall it has been a good experience with the features of the policy. .
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      , ghaziabad
      Reviewed on Jun 14, 2018
    • Bajaj Allianz Health Insurance
      "Good Health Insurance policy"
      0.5 5.0/5 "Blown Away!"
      So far i have never claim the health insurance. I can claim upto 7 lakhs. I have taken this insurance policy for me and dependent. The employer take care of the premium amount. I have never contact the customer care. Almost most of the hospital has been covered in this health insurance
      Was this review helpful? 0
      , coimbatore
      Reviewed on Jun 14, 2018
    • Universal Sompo Health Insurance
      "Average"
      0.5 3.0/5 "Satisfactory"
      I have a health insurance policy taken from Universal Sompo, it was the best deal I came across when I was looking for the policy, the premium amount that I paid was quite reasonable and not too high, the sum assured amount was also good. I never got chance to take the services of this policy I have no claim experience from them so far.
      Was this review helpful? 0
      , kolkata
      Reviewed on Jun 14, 2018
    • Universal Sompo Health Insurance
      "Best Health insurance policy"
      0.5 5.0/5 "Blown Away!"
      I have taken this policy for the first time. I have not claimed the policy so far. I have paid around for Rs.8500 as premium. It family based health insurance policy. I can claim upto 5 lakhs. Cashless treatment is available. There is no pre-existing offer is available. I have taken this policy last month. Most of the hospitals are covered in this policy.
      Was this review helpful? 0
      , gurgaon
      Reviewed on Jun 14, 2018
    • review Health Insurance
      "Good policy"
      0.5 4.0/5 "Great!"
      It is a health insurance policy from HDFC. Accidental benefits are there. If i admit in a hospital, i can claim for that also. I took this policy for my whole family. I'm paying Rs. 4500 for every year. I can claim upto 3 lakhs in a year. If i renew the policy without any claim, they will offer some bonus points. I never claimed this policy so far. Cashless treatment is available.
      Was this review helpful? 0
      , chennai
      Reviewed on Jun 13, 2018
    • Royal Sundaram Health Insurance
      "Good policy to use"
      0.5 5.0/5 "Blown Away!"
      I got the health insurance policy from the ROYAL SUNDARAM GENERAL INSURANCE company and i have got it around 5 years. This policy covers 4members in my family and it has the medical coverage amount of Rs,3,00,000 . I pay the premium amount of Rs,8,000 to renew the policy every year.
      Was this review helpful? 0
      , bangalore
      Reviewed on Jun 13, 2018
    • United India Health Insurance
      "Good policy to use"
      0.5 5.0/5 "Blown Away!"
      Got the health insurance policy from the UNITED INDIA INSURANCE company and I having this policy from past 5 years. The customer support and the response is good with the United India and this policy covers 4 members in the family. This policy has the medical coverage up to Rs,3,00,000 and I pay the premium amount of Rs,10,900 to renew this policy.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jun 13, 2018
    • Apollo Munich Health Insurance
      "Good Service"
      0.5 3.0/5 "Satisfactory"
      I've a health insurance policy with the Apollo Munich Insurance company. I pay a premium of 19000, I do not have any claim experience with the policy. Sometimes I make payments via cheque and sometimes online. Overall their services are good even though I never had any claim experience with them.
      Was this review helpful? 0
      , new delhi
      Reviewed on Jun 12, 2018
    • ICICI Lombard Health Insurance
      "Good Service"
      0.5 5.0/5 "Blown Away!"
      I've a health insurance policy with the ICICI Lombard general Insurance company. I am paying a premium 39000 per year. I do not have any claim experience with this policy. So far in terms of the features and benefits it is a recommendable policy to have. I pay the premium online.
      Was this review helpful? 0
      , mumbai
      Reviewed on Jun 12, 2018
    • Star Health Health Insurance
      "Best Health Insurance policy"
      0.5 5.0/5 "Blown Away!"
      Cashless treatment is available only in cities. In other rural areas, i cannot claim the policy for cashless transaction. In rural side, i have to collect all the bill and claim the policy after i paid my bill. I have claimed the policy once for my father. I used to make the payment of Rs. 7500 for me and any wife. I have already recommended this policy to my friends. I can claim easily and i got the payment as soon as possible if i issue the documents properly.
      Was this review helpful? 0
      , chennai
      Reviewed on Jun 12, 2018
    • Bajaj Allianz Health Insurance
      "Best"
      0.5 5.0/5 "Blown Away!"
      I am having the health insurance policy with the Bajaj allianz general insurance company. I would like to say that the coverage value is around three lakh Rupees. Cashless treatment is applicable there, so I have not faced any such claims with them as such.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jun 12, 2018
    • Star Health Health Insurance
      "Good service"
      0.5 4.0/5 "Great!"
      Got the health insurance policy with the STAR HEALTH & ALLIED INSURANCE company around 3 years ago. This policy covers 4members in my family. This policy has the coverage amount up to Rs,2,00,000 and I am satisfied with it. The medical coverage and the cashless treatment options are good with the Star health insurance policy.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jun 12, 2018
    • ICICI Lombard Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I've a health insurance policy with the ICICI Lombard which is provided by the company. The company is paying the premium. It is a policy worth the money and I never had any claim experience with them. I'll have to wait and see how they respond to my claim request in future.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jun 11, 2018
    • Universal Sompo Health Insurance
      "Good Service"
      0.5 5.0/5 "Blown Away!"
      I've a health insurance policy with the Universal Sompo . I pay a premium of 10000 Per year, the coverage is good and I never had any claim experience with the policy overall it is a useful health insurance policy to have.
      Was this review helpful? 0
      , kolkata
      Reviewed on Jun 09, 2018
    • Star Health Health Insurance
      "Good Service"
      0.5 5.0/5 "Blown Away!"
      I've a health insurance policy with the Star Health. We do not have any experience with the policy. Overall service good. My brother handles the payments for this policy. I am not aware of any other details regarding this policy. It offers coverage for the entire family. I never had any issues with the policy and their services.
      Was this review helpful? 0
      , mumbai
      Reviewed on Jun 08, 2018
    • United India Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with United India Insurance from last 8 years, i am not aware of the premium amount as the company pays it. I have a coverage value of Rs 1 lakh and that covers spouse and children. I have no claim experience so far from this insurance policy.
      Was this review helpful? 0
      , chennai
      Reviewed on Jun 08, 2018
    • Apollo Munich Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with Apollo Munich from last 6 months, i am happy with the coverage value of this insurance policy and it is family policy. A premium of Rs 8000 has to be paid for this insurance. I have no claim experience and the coverage value of this insurance is 3 lakhs.
      Was this review helpful? 0
      , mumbai
      Reviewed on Jun 08, 2018
    • ICICI Lombard Health Insurance
      "Good Service"
      0.5 3.5/5 "Pretty good"
      I've had taken a health insurance policy from the ICICI Lombard. I never had any claim experience with the policy. I'll have to wait and see how they respond to my claim requests in future. So far, I never had any issues with their services till date.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jun 07, 2018
    • Reliance General Health Insurance
      "Good Service"
      0.5 3.5/5 "Pretty good"
      I've a health insurance policy with the Reliance. I never used this policy for any medical purposes. I've been paying a premium of 11000 per year for the policy. I never had any claim experience with the policy. I see this as a back up fund in case of any medical emergency.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jun 07, 2018
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