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Day Care Treatment Vs OPD In Health Insurance

by Byrne Anderson
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A single hospitalization that stretches more than a week is usually enough to wipe your savings clean. The only way by which you can receive the best in medical care while also protecting your hard-earned money is by opting in for health insurance. Indeed, health insurance holistically protects your physical, mental, and financial well-being.

Now, buying health insurance for the first time can be a bit confusing. While reading the fine print, you may come across several terms that might seem alien to you. You might feel tempted to just skip the jargon; however, doing that would leave you with incomplete information. And, that is not ideal when buying something as important as health insurance. Two of the most common terms in healthcare and health insurance that are often the subject of confusion are day care procedures and OPD. In this article, we aim to help you understand the differences between these two terms in healthcare and how your insurance covers them.

Day Care Procedures and OPD – The Definitions

Day care procedures and OPD are often assumed to be two terms used for the exact same thing. However, they are different from each other. The line of difference is quite a fine one so, let’s separate them by looking at their individual meanings.

  • Day care procedures

A day care procedure is a type of medical procedure that is carried out in a hospital but, does not require overnight hospitalization. The treatment is usually completed within a few hours. The patient may then go home the same day.

Some examples of day care procedures are chemotherapy and cataract surgery.

  • OPD

OPD stands for outpatient department. In OPD care, the patient receives medical treatment at the doctor’s clinic without having to go to the hospital. OPD care too is usually completed within an hour or so post which, the patient may go home.

When you head over to your doctor for general consultation, this procedure comes under the purview of OPD care. A dental treatment, such as root canal, is also considered as an OPD procedure.

Day Care Procedures and OPD – Claiming Coverage

Your health insurance policy will have its own clauses which list out how day care procedures and OPD will be covered. Here is a brief look at how most health insurance providers accommodate these medical expenses within their policies.

  • Day care procedures

Day care procedures usually come under cashless claims if the treatment is done at one of the insurance provider’s network hospitals. You need to keep the insurance company notified before you get the procedure done. If you choose to get admitted at a non-network hospital, you may send your proof of treatment and get reimbursed for your expenses as per your health insurance provider’s terms and conditions.

  • OPD

Many health insurance policies do not pay for OPD procedures. Therefore, you must check whether OPD coverage is offered in your policy, if you deem this to be an important feature. Do note that even if OPD expenses are covered, this coverage will be subject to certain sub-limits that have been laid down by your insurance provider.

It is extremely important that you understand every detail of your health insurance policy. Knowing what to expect will help you choose the right policy and prevent any surprises later on when you have to make a claim. We hope this article helped you understand the fine line of difference between day care procedures and OPD. Finally, do remember to renew your health insurance on time to enjoy all the benefits the policy holds. Take care and stay fit!

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