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Health Insurance Coverage: Day Care Treatment Vs OPD Treatment

Are you confused between OPD treatment and day care treatment? To know which one to go for according to your medical requirements, Read this article.

  • Nov 30, 2021

With health insurance plans from top insurers now available online, most people now prefer buying a policy on their own without relying on an insurance agent. While purchasing insurance online comes with a host of benefits, the use of technical terms on websites and product brochures often makes the selection confusing.

To choose the best, it is always better first to understand these terminologies before making a decision. Two commonly used terms are day care treatment and outpatient department (OPD) treatment. Here is a detailed explanation of what they mean and how are they different from each other-

What is Day care Treatment?

For making a health insurance claim, the policyholder is required to be admitted to a hospital for at least 24 hours. But with the advancements in medical technologies, several treatments that used to require the patient to remain at the hospital for multiple days can now be completed within hours. As the policy does not cover such treatments, patients must pay for them from their pockets.

To eliminate this inconvenience, most health plans now come with day care treatment coverage for procedures such as eye surgery, haemodialysis, dental surgery, etc. that are generally completed in a few hours. If you are receiving a day care treatment that your insurer covers, you can make a claim even if you are admitted to the hospital for less than 24 hours.

What is OPD Treatment?

Outpatient department or OPD treatment does not require the patient to get admitted to a hospital for receiving treatment. It generally requires a normal visit to a doctor’s clinic or consultation room for receiving a specific diagnosis or treatment. As OPD treatment does not require the patient to get admitted to the hospital, the treatment is generally not covered by basic health plans.

But you can now find health insurance policies that come with OPD coverage. While they are not as common as plans with day care treatment coverage, you can still find some that cover outpatient treatment as well.

How is Day care Treatment Different from OPD Treatment?

While day care treatment and OPD treatment might sound similar, there is a significant difference between the two. Day care treatments require hospitalisation, no matter if it is only for a few hours. For instance, a corrective eye surgery often requires a few hours of hospitalisation and is considered a day care treatment.

But OPD treatment does not require hospitalisation and is generally provided at a doctor’s clinic. A root canal treatment is an excellent example of an OPD treatment, wherein the procedure is performed at a dentist’s clinic, and no hospitalisation is required.

Choosing the Right Health Insurance Plan

Selecting an insurance plan that is right for you abundantly depends on how well you understand the policy. Rather than assuming things, it is always better to get clear answers to all your queries and understand all the terminologies in detail before making the decision.

You can also contact a top insurer to know more about the plans they offer and then choose one that best fulfils your insurance requirements. You can also consider purchasing a family floater plan to secure the health of your loved ones too.

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Ref. No. KLI/22-23/E-BB/2435


- A Consumer Education Initiative series by Kotak Life

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