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Inpatient & Outpatient Cover On My Health Insurance

  • Jun 13, 2022
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If you have ever been to a hospital for any treatment or diagnostic tests, you have most likely come across two common medical terms: inpatient and outpatient. What do these mean and what is the difference between them?

Inpatient and outpatient are terminologies widely used in healthcare, whether you are a patient in a private hospital or getting treated through the NHS. They are used to describe a patient’s status in a medical facility, mainly referring to the length of time the patient spends in the medical facility

When you receive inpatient treatment, you are admitted in a hospital where you will stay overnight, for at least one night. On the other hand, outpatient means you are not required to stay overnight in the hospital and you are free to leave the facility after the procedure.

There is also a third terminology you might come across, day patient (or day-case). This means you need a hospital bed for the treatment but are not required to stay overnight and will be discharged the same day.

If you want to know more about inpatient, outpatient and day patient, here is a more in-depth description of each type of treatment and the differences between them.

What is inpatient treatment?

Inpatient treatment, or inpatient care, is when a patient is required to stay in a hospital overnight to receive medical care and supervision. If you are admitted as an inpatient you will occupy a bed in a hospital and spend one or more nights there.

Does private medical insurance cover inpatient treatment?

Most private health insurance plans cover inpatient treatment as standard which means the fees incurred while you are in hospital are covered by your insurer as long as the condition and procedure are eligible under the terms of your plan. Benefit limits may apply either per claim or per policy year.

Here are some examples of what can be included in the inpatient health insurance cover:

  • Hospital accommodation, meals, and nursing care.
  • Surgeries and anaesthetics including major surgery.
  • Medication given whilst in hospital.
  • Diagnostic tests and scans.
  • Specialist fees.

What is outpatient treatment?

Outpatient treatment is when you visit a hospital, clinic, or other medical facility to receive medical treatment on the day, without occupying a hospital bed and without spending the night there.

Does private medical insurance cover outpatient treatment?

Not all health insurance policies cover outpatient care as standard. Most providers will offer outpatient treatment as an optional benefit which policyholders can add to their cover for an increase in premium.

Here are some examples of what can be included in the outpatient health insurance cover:

  • Consultations with a specialist.
  • Diagnostic tests and scans.
  • Some small operations which can be carried out in an outpatient setting – removal of skin lesions, cataract removal, biopsies.
  • Physiotherapy treatment.
  • Chemotherapy.
  • Other treatments such as chiropractic, acupuncture and podiatry.

What is day patient treatment?

Day patient treatment is when you are admitted into hospital for minor surgeries but you are discharged the same day. Unlike outpatient treatment, a day patient procedure might require longer recovery time, the use of anaesthetic and the full range of hospital facilities such a bed, supervision and food, but the patient is not expected to stay overnight.

Does private medical insurance cover day patient treatment?

Day patient treatment is usually included under the inpatient coverage of your health insurance policy which means your private day patient treatment bills may be picked up by your insurer. It also means any inpatient limits and exclusions will apply to day patient treatment too. You should always check your policy documents to understand what is covered by your health insurance plan.

Here are some examples of what can be included in the day patient health insurance cover:

  • Some eye surgeries
  • Dental surgeries
  • Inguinal hernia
  • Varicose veins
  • Cystoscopy
  • Arthroscopy

Here is a table summarising the main differences between inpatient, outpatient and day-patient treatment to help you compare them:

  Inpatient Outpatient Day patient
Length of treatment One night or more A few minutes to a few hours A few hours, possibly the whole day from morning to evening
Hospital bed required Yes No Yes
Hospital resources needed Might require full range of hospital facilities (tests, monitoring, meals) The patient requires limited resources and might not require extensive post-procedure medical supervision The procedure requires less recovery time than an inpatient treatment but would still require medical resources including a bed, medication and nurse.
Complexity of treatment Inpatient treatment is often more complex and time-consuming and full recovery may take some time Often the patient requires several outpatient appointments to treat a condition Usually a surgery from which the patient can recover in a relatively short time without extensive medical supervision
Covered by health insurance Yes, as standard Usually as an optional benefit Yes, as standard

 

Inpatient and outpatient cover with Freedom Health Insurance

Freedom Elite health insurance offers flexible health insurance with inpatient and day patient cover included as standard. You also have the option to add outpatient cover on your policy, either as full cover or limited to £1500 benefit. To make your policy even more comprehensive, you can choose to add alternative therapies cover and the private GP, dental and optical benefit. Get a free quote now.

Conclusion

Knowing the difference between inpatient and outpatient care could be important for anyone receiving private medical care, helping you get more control over your healthcare and understanding your costs. It is also important when buying health insurance because inpatient and outpatient cover could be separate on your policy and you might need to choose the benefits which are suitable for you.

If you are looking for a flexible health insurance policy that covers inpatient and outpatient cover, you can get a free, online quote from Freedom Health Insurance or contact us for any questions.

 

Disclaimer: The content of this website is provided for informational purposes only and does not substitute the specialist advice of a health insurance broker.