What Is the Difference Between OPD Treatment and Day Care Treatment?

  • Author :
  • TATA AIG Team
  • Published on :
  • 16/01/2022

How many times have you been confused by the technical jargon in your health insurance policy? Unfortunately, for many people, such a situation can lead to them not being able to purchase the health plan that they need. People also often get confused between health insurance and mediclaim insurance, not knowing that the coverage offered by both the plans is different.

For the uninitiated, the mediclaim insurance only covers hospitalisation, pre-existing illnesses and accident-related treatments for a specified time limit while health insurance is more comprehensive in nature and covers pre-and-post hospitalisation, hospitalisation, ambulance expenses and can also offer compensation to the policyholder’s family in case of loss of income.

Much like the difference between these two types of policies, the daycare treatment cover and the OPD (Outpatient Department) treatment cover are two terms in your health insurance plan that may sound the same but are actually different. So, if you have been blissfully ignorant of the difference between OPD and daycare treatment, now is the best time to take some notes.

What is Daycare Treatment?

Daycare treatment is when you have to be hospitalised for a day or 24 hours and you receive the required treatment under local or general anaesthesia. This can be a small accident that leads to minor injuries or can even be a dental procedure as a result of an illness, injury or accident.

However, the important point here is that you are to be hospitalised for a day for it to qualify as a daycare treatment. For example, radiation, dialysis, etc., come under the daycare treatment list of your insurance policy.

When you want to purchase a health insurance policy, be sure to under the daycare treatment meaning in detail so that you do not have to face any unwanted hassles in times of an emergency.

What is OPD treatment?

On the other hand, OPD or OutPatient Department treatment is when you visit the doctor at their clinic for consultation. This may be in the stages prior to the actual treatment and during the consultation, you need not be hospitalised.

Suppose you simply visit your doctor in the hospital with a minor stomach ache and undergo a regular check-up, this will come under OPD treatment. You can visit a diagnostic centre, a consultation room, pharmacy, etc., even inside a hospital but that will not be called daycare treatment.

Your health insurance policy will also have an OPD treatment list that will entail all the instances that are eligible for OPD treatment. That way, you need not be confused about what is covered under this section in your health plan.

What is the Difference Between OPD and Daycare?

Unlike inpatient treatments, both OPD and daycare require lesser time for treatment. However, the main difference lies in the level of hospitalisation; there is no need for hospitalisation for OPD treatments.

But even if you avail of day care treatment at a clinic or do not need to be hospitalised, you cannot be eligible for filing a daycare procedure claim. If you want to file a claim for OPD treatments, our Tata AIG Medicare Premier offers a coverage of up to ₹5000 per year after you have availed of the cover for two consecutive policy years. It also covers 540+ day care procedures at a daycare centre or hospital due to injury, disease or illness.

Let’s take a look at these two examples to clearly understand how OPD treatment and daycare treatment is different.

Miss Rashmi got her medical insurance online a couple of years ago and recently, had to visit her doctor with a high fever. He suggested she take enough rest, eat healthy and prescribed a few medicines that would bring down her fever. After paying the doctor's consultation fee, Rashmi went back home in less than an hour.

A few months later, Rashmi met with an unfortunate bike accident one early morning that fractured her left hand. Needless to say, she had to be rushed to the hospital where the doctor said that though the fracture was not too serious, she would have to stay under observation for the rest of the day after the hand had been put in a cast.

In the first case, Rashmi didn’t have to spend any time in the hospital. The consultation at the clinic hardly took any time and she was able to go back home with the prescription and the medical advice. In the second scenario, she had to be hospitalised for the day due to her accident which means she availed of daycare treatment. Had she been hospitalised for a few more days, it would have qualified as inpatient treatment.

In both cases, Rashmi was covered under a health insurance policy. Therefore, the cost of her consultation and medication was covered under the plan while she also received coverage for her daycare procedure at the hospital.

Choose a Health Insurance Policy Today!

With changing times, a lot of treatments, such as a cataract operation, have come under day care procedures, in contrast to being termed as inpatient treatment earlier. That way, you can save your time as well as money by availing of such procedures under daycare treatment.

As you can see through the above examples, a suitable health insurance policy helps you cover both, OPD and daycare treatment, without you having to worry about the expenses. To ensure that you get a health policy that is suitable for your needs, always use a health insurance premium calculator to find adequate coverage in your health insurance plan while paying affordable premiums.

With health insurance being easily available online, it has become simple to avail of medical insurance online. Not only is the process quicker and more convenient but also the need for excessive documentation required in offline health insurance policies is eliminated when you apply for health insurance online.


Knowing the difference between OPD treatment and daycare treatment in health insurance can help you choose the right plan so that in times of medical emergencies, you are able to access quality healthcare and avail of the treatment without having to worry about the costs.

Disclaimer / TnC

Your policy is subjected to terms and conditions & inclusions and exclusions mentioned in your policy wording. Please go through the documents carefully.

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