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We can never predict the rise of life-threatening conditions, which makes it important to have health insurance. One of the best ways to ensure that medical expenses incurred as a result of illness, surgery, or an accident are covered is through health insurance. But what if your claims are denied?
It is essential to be aware of the situations in which your claims could be denied. You can avoid issues with your medical claim settlement by keeping track of a few simple things. Inpatient and outpatient care are the two categories used to categorise medical procedures and surgeries.
Although both types provide healthcare services, there are significant differences in the duration, and expenses involved for medical facilities where patients are treated. Knowing whether you are an inpatient or an outpatient is essential if you need medical care and have health insurance that pays for your expenses.
Inpatient care
When a patient needs to be admitted to the hospital for testing, treatments, or medical procedures, this is referred to as an inpatient hospitalisation. Patients who have pre-planned surgery or a medical emergency are typically categorised as inpatient hospital patients. Most of the time, the inpatient department’s admitted patients might need careful monitoring and surveillance from healthcare professionals.
Outpatient care
When a patient merely needs a consultation with a doctor or a few minor treatments, they receive outpatient care and do not need to be admitted to the hospital but requires diagnostic procedures and rehabilitation.
Typically, these operations are carried out in clinics, diagnostic facilities, etc. If you purchase a health insurance policy, you cannot be covered for outpatient hospitalisation unless you select a specific add-on cover to do so.
Outpatient Treatment
OPD treatment means the one in which the Insured visits a clinic / hospital or associated facility like a consultation room for diagnosis and treatment based on the advice of a Medical Practitioner. The Insured is not admitted as a day care or in-patient.
Difference between Inpatient care and Outpatient care
| Factors | In patient care | out patient care |
| Meaning | When a patient must remain in the hospital for longer than 24 hours to receive treatments or undergo procedures. | When a patient can receive the necessary consultations in an OPD clinic or department without the need for a formal hospitalisation. |
| Treatments | Complex surgeries, accidental injuries, traumatic injuries, severe ailments, etc. | Treatments that does not necessitate hospitalisation but requires consultation of a medical practitioner. |
Why do you need outpatient coverage in your health insurance?
Whether you require inpatient or outpatient care depends on the type of medical treatment you require. In today’s world, getting health insurance with OPD coverage is essential for the following two reasons.
The prevalence of long-term medical conditions is rising due to a sedentary lifestyle, raising overall medical expenses. In order to meet everyday medical bills without fear, it’s essential to have a health insurance plan that offers coverage for inpatient care.
Summary
Understanding the difference between inpatient and outpatient treatment can help you in choosing the right health insurance plan that works best for you and your family. Before choosing the right insurance plan, read the policy’s terms and conditions carefully.
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The Information including but not limited to text, graphics, images and other material contained on this blog are intended for education and awareness only. No material on this blog is intended to be a substitute for professional medical help including diagnosis or treatment. It is always advisable to consult medical professional before relying on the content. Neither the Author nor Star Health and Allied Insurance Co. Ltd accepts any responsibility for any potential risk to any visitor/reader.