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What’s the difference between outpatient, day patient and inpatient treatment?
Key takeaways: What’s the difference between outpatient, day patient and inpatient treatment?
Understanding the difference between outpatient, day patient and inpatient treatment can help you choose a health insurance plan that’s right for your needs. Different health insurers might cover these differently – for example, with some plans you pay extra to add outpatient cover to your plan. There may also be limits on what insurers will cover, how much they’ll pay out, or the number of consultations you can have.
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What's the difference between outpatient, day patient or inpatient treatment?
Are outpatient, day patient and inpatient treatment covered by health insurance?
What does outpatient cover usually include?
What does day patient and inpatient cover usually include?
Are there limits on what I can claim?
What can I do if a treatment isn’t covered?
What's the difference between outpatient, day patient or inpatient treatment?
These are AXA Health’s definitions – if you have insurance with another provider, they may have different definitions. It’s a good idea to check this in your plan documents before booking treatment, as it may affect your cover.
Outpatient treatment is when:
- You go to hospital for a consultation, tests or treatment and leave again straight afterwards.
- You don’t need to recover with a medical professional looking after you, and you don’t need someone to take you home.
A specialist consultation would usually count as outpatient treatment, as would a scan or X-ray.
Day patient treatment is when:
- You need a medical professional looking after you as you recover from your test or treatment, but you don’t stay overnight.
If you need a test that involves sedation or other preparation, and you need to recover from the sedation or preparation afterwards, this will usually count as day patient treatment. For example, you may have sedation for some camera tests (endoscopies), such as a colonoscopy or gastroscopy.
You can also have surgery as a day patient, if you don’t stay overnight afterwards.
If you’re having day patient treatment, you may be ‘admitted’ to hospital and given a wristband with your name on.
Inpatient treatment is when:
- You stay in hospital overnight or for several nights.
If you have surgery or another procedure and need to stay overnight, or if you need to stay overnight while being treated or monitored, this would be inpatient treatment.
Are outpatient, day patient and inpatient treatment covered by health insurance?
What different insurers cover as standard will vary:
- Some insurers may offer outpatient and inpatient cover as standard, or you may be able to choose whether you want to add outpatient cover to your plan.
- What’s covered under each of these will also vary between insurers.
- Your insurer may have a separate limit for specialist consultations.
With AXA Health, you can choose to add our ‘Outpatient diagnosis and care’ and ‘Inpatient and day patient care’ options to your plan, so you can tailor your cover to your needs and budget. You can choose different options for each person covered by your membership.
What does outpatient cover usually include?
Outpatient cover will usually cover the cost of:
- Consultations with specialists (you may have a separate limit for these)
- X-rays, ultrasounds and blood tests
- MRI, CT and PET scans
- Physiotherapy and other therapy sessions.
Your insurance may not cover the cost of drugs you’re prescribed as an outpatient.
What does day patient and inpatient cover usually include?
Your health insurer may cover day patient treatment and inpatient treatment together, but it’s worth checking in your documents.
Inpatient and day patient cover may pay for:
- Surgery or other procedures.
- Your stay in hospital and the care you have while you’re there.
- Diagnostic tests and treatments, such as scans and physiotherapy, whilst you're in hospital.
Are there limits on what I can claim?
Depending on your plan, there may be limits on what you can claim for each type of treatment.
Outpatient and specialist consultation limits
With most health insurance, you can choose your level of cover for outpatient appointments. Depending on how your plan is set up, you may have a limit on the number of consultations you can have, or a limit on how much your insurer will pay out for outpatient treatment.
For example, you may have one of these options:
- A limit of £1,300 on outpatient care – all your consultations, tests and treatments would come out of this limit
- A limit of 3 specialist consultations – you can have up to 3 consultations, but there’s no limit on how many tests or other types of treatment you have.
You’ll find details in your plan information.
If you use up your outpatient limit and still need outpatient treatment, you’ll need to either pay for this yourself, or ask if it's possible to be transferred to NHS care.
Anything else your insurer tells you they limit or don’t cover
There may be other things your health insurer won’t cover, so it’s always a good idea to check what you’re covered for before starting treatment. For more information, see our guide, What’s not covered by health insurance.
What can I do if a treatment isn’t covered?
If your private medical insurance doesn’t cover something, you can either have the treatment on the NHS or pay for private treatment yourself. If you decide to pay for it yourself, make sure you’re aware of how much it will cost before you start treatment. Most specialists or hospitals will be able to give you an estimate.
Find out more about our AXA Health Plan or start a quote
Reviewed by Dr Corné Hurter
I was appointed Medical Director for Services and Delivery at AXA Health in January 2026. Before then, I spent 10 years working at HCA UK in roles such as Medical Director for Care Transformation and Director of Medical Services.
During my time at HCA UK, I was part of the first cohort of doctors to complete a Medical Management and Leadership Master’s degree.
I’m passionate about patient care and innovation that supports care delivery to patients in a manner which is sustainable and value-driven.
I’m excited to be using my experience to make a real difference to members and the service we provide.