OPD Treatment & Day Care Treatment: Find Similarities and Differences in Them | 7205


OPD Treatment & Day Care Treatment: Find Similarities and Differences in Them

When it comes to purchasing health insurance, there are numerous factors to consider before making a final decision. The sum insured, OPD treatment coverage, premium charged, day care treatment cover, claim settlement process, inclusions and exclusions are a few factors to consider when deciding on the type of health policy to purchase.

In a hurry, many health insurance policy buyers ignore the essential features of the policy. Keep reading this post to learn about the difference between Daycare treatment and OPD treatment.

What is OPD treatment or Outpatient Treatment?

OPD stands for the outpatient department. Generally, in this, the patient is not hospitalised. It involves regular checkup visits at a doctor’s chambers or clinic for a specific treatment. Moreover, the treatment can be carried out by the medical practitioner in their own clinic.

A health insurance policy with OPD expenses coverage covers doctor consultations, pathological tests and investigations. It can also cover day care treatment, dental as well as the expenses related to maternity treatment.

Outpatient Department (OPD) treatment is much similar to daycare treatment, however, both can be differentiated based on the type of hospitalisation required in either of the above cases. Let’s look at it this way: in an OPD treatment, an individual is required to get the entire procedure done without having to be admitted to the hospital. However, to trigger a claim, in a daycare procedure, an individual is required to get admitted to the hospital no matter even if it is for a short duration. A good example of OPD here would be root canal treatment, which could be looked at and treated by routinely going to a dentist’s clinic without needing to get admitted to a hospital.

What is a Day Care Treatment or Day Care Procedure?

Daycare treatment, also known as daycare procedure, is a technically advance treatment that takes a few hours to get completed.

The insured person does not have to spend a lot of time in the hospital. Additionally, there is no need of a 24-hour hospital stay A few daycare procedures include dialysis, chemotherapy, tonsillectomy, cataract surgery, dental surgery (following an accident), and many others.

Let’s use Mr. Anand Mathur as an example, who is getting corrective eye surgery at a reputable facility, to further comprehend this. Long time ago, he was compelled to get himself admitted at a hospital for at least a few days. However, the development of techniques like ICL (Implantable Contact Lens) and LASIK therapy has reduced a lengthy day-long operation to something that can be completed in about an hour. Hence, Mr Mathur got his surgery done and received coverage as a part of the daycare procedure expense.

Similarity between OPD Treatment & Day Care Treatment  

OPD Treatment and Day Care Treatment share some common features. Just like the OPD treatment person chooses for a health insurance policy, they undergo treatment for their medical ailment for a short duration in day care treatment too. Hence, it concludes that both types of medical treatments demands less time.

Differences between OPD Treatment & Day Care Treatment  

  • Hospital admission – While in the case of daycare treatment, hospitalisation is compulsory for less than 24 hours, outpatient treatment does not require hospitalisation.
  • Coverage Scope – While most health insurance policies cover daycare procedures (treatment covered may vary from policy to policy), OPD treatment expenses are generally excluded from health insurance policies unless specifically mentioned.
  • Coverage Level – While daycare procedures are covered up to the sum insured, without any limit on the coverage of treatment (except for a few), OPD treatment is not covered up to the sum insured and it comes with a sub-limit.

OPD Treatment & Day Care Treatment – The Claim Process

  • OPD Treatment – In the case of OPD treatment, expenses can be claimed after the submission of the required documents. OPD reimbursements are subject to sub-limits.
  • Daycare procedures – In this type of treatment, making a claim seems like the one for regular hospitalisation. One can easily avail of the benefit of the cashless system by undergoing the procedure in a network hospital. The insured needs to intimate the health insurance provider before hospitalisation and submit all the necessary documents. In the case of a non-network hospital, the insured can claim reimbursement by submitting documents within 7 days.


As now you have understood the meaning, similarities, and differences between the OPD treatment and the daycare procedure, keep all the points in mind while choosing a policy. In order to make a well-informed decision, it is expected of health insurance plan buyers to examine and read all the mentioned terms and conditions in the policy document carefully.

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