Health insurance agnostics often mention about the lack of cover for small or over-the-counter medical expenses to justify their skepticism. Their main grudge is that visits to a doctor and the associated medicine bills which involve sizeable costs are not reimbursed by health policies.
The Insurance Regulatory and Development Authority (IRDA) chairman urged insurers to launch more 'day-care' based covers. He highlighted the fact that non-hospitalization expenses amount to almost twice the hospitalization costs. He pointed out that many treatment procedures do not have the 24-hour hospitalization because of the advancements in medical technology.
AdvertisementMany mistakenly believe that expensive procedures which pertain to critical illnesses are not covered by their standard policy, as these do not require 24-hour hospitalization. 'Day-care' means treatment procedures that require less than 24-hours hospitalization. Examples of Day-care treatment are dialysis, radiation, cataract, chemotherapy, lithotripsy and tonsillectomy and so on.
Many insurance companies offer policies whose unique selling proposition is coverage of outpatient department (OPD), dental and maternity expenses. These products cover treatments that neither requires 24-hour hospitalization nor do they form a part of the 'day-care' procedures list. Day-Care relates primarily to small-time expenses while OPD pertains to expensive procedures which would have entailed at least 24-hour hospitalization, but for advancements in medical technology.
Barring the scope of coverage, OPD covers' are similar to regular indemnity-based health plans, where the hospitalization expenses are reimbursed by the company either through the cashless route or after submission of the required documents.