Is Fracture covered in Health insurance?
Hi All,
I'm unsure if fracture is covered in health insurance?/ To the extent I read the policy, I think it is getting covered under day care treatment head, can someone clarify?
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As pointed by Rohit in this thread, Health Insurance usually doesn't cover a OPD event unless it is specifically included in your policy.
Asad
Hello Jaspreet,
OPD ≠ Day Care
Daycare covers hospitalization costs that require less than 24 hours of "in-patient" treatment due to technological advancement in medical science. OPD is treatment carried out in the OPD section of a hospital or around the doctor's consultation room. OPD is covered only in certain special policies.
The question to ask here is:
- Whether the person who has suffered a fracture require admission as an inpatient in the Day Care or under OPD?
- Does the treating of the fracture - plaster etc. necessitate hospitalization - require surgery in an operation theatre, or will it be done in the OPD section of the hospital?
If the person is treated under OPD - then health insurance usually won't cover it.
If admission to a hospital is necessary to treat the injury then it usually would get paid for.
Regards,
Team Beshak.
Dear Jaspreet,
A fracture most times is administered as part of OPD, in general it not covered in a health insurance policy as it does not require over 24 hrs hospitalisation. However, there are someplans that do cover small amount of OPD expenses. If you hold such a plan you will be given coverage.
Day care treatments are procedure that due to advancement of technology can be done with a few hours without requiring hospitalisation. So getting a only hand or leg plastered which requires few hours in an emergeny... will not be covered.
Regards
Rohit Dhingra