OPD Insurance- Why it is important in your medical Insurance Policy?

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OPD insurance, or “outpatient department insurance,” is a type of health insurance that covers the costs of medical treatments and procedures that do not require an overnight stay in a hospital. This can include doctor’s appointments, diagnostic tests, laboratory work, and certain types of therapy or rehabilitation.

OPD Insurance
OPD Insurance

General health insurance, also known as comprehensive health insurance, typically covers a wide range of medical expenses such as hospitalization, surgeries, doctor’s appointments, diagnostic tests, prescription drugs, rehabilitation, preventive care, maternity coverage, coverage for pre-existing conditions and coverage for mental health services. However, OPD insurance is not always included in general health insurance plans.

“What will be the case if you have to do follow up visit to doctors and it is frequent visit. What if these follow up visits are not covered under your medical insurance policy. It will put a extra burden on your budget and here is where OPD insurance become important.”

Some general health insurance plans may include OPD coverage as part of the plan, but it is not always the case. Some insurance companies may offer OPD insurance as an add-on to a general health insurance plan, while others may offer it as a stand-alone policy. It is important to check the coverage details of any insurance plan to determine if OPD coverage is included.

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What is General Health Insurance

General health insurance, also known as comprehensive health insurance, typically covers a wide range of medical expenses. Here are some examples of what is typically covered under a general health insurance plan:

  1. Hospitalization: This includes the cost of staying in a hospital for medical treatment, including room, board, and nursing care.
  2. Surgeries: This includes the cost of surgical procedures, such as elective surgeries, emergency surgeries, and major surgeries.
  3. Doctor’s appointments: This includes the cost of visiting a doctor for a regular check-up, or for treatment of an illness or injury.
  4. Diagnostic tests: This includes the cost of laboratory tests, X-rays, MRIs, CT scans, and other types of diagnostic tests.
  5. Prescription drugs: This includes the cost of medication prescribed by a doctor.
  6. Rehabilitation: This includes the cost of physical therapy, occupational therapy, and speech therapy.
  7. Preventive care: This includes the cost of preventive screenings, such as mammograms and colonoscopies.
  8. Maternity coverage: This includes the cost of prenatal care, delivery, and postnatal care.
  9. Coverage for pre-existing conditions: This includes coverage for medical conditions that existed prior to enrolling in the insurance plan.
  10. Coverage for mental health services: This includes the cost of seeing a therapist, counselor, or psychiatrist, and the cost of medication used to treat mental health conditions.

It is important to note that coverage can vary depending on the insurance plan and the insurance company. It is always a good idea to check the coverage details before buying a plan.

What is OPD Insurance

OPD insurance, also known as “outpatient department insurance,” is a type of health insurance that covers the costs of medical treatments and procedures that do not require an overnight stay in a hospital. This can include doctor’s appointments, diagnostic tests, laboratory work, and certain types of therapy or rehabilitation.

OPD insurance is typically offered as an add-on to a basic health insurance plan, although some insurance companies do offer stand-alone OPD insurance policies. It is important to check the coverage details of any OPD insurance plan, as the level of coverage can vary between plans.

In summary, OPD insurance is a type of health insurance that covers the costs of medical treatments and procedures that do not require an overnight stay in a hospital. It can help individuals save money on healthcare expenses and provide peace of mind, as well as access to a wider range of healthcare providers. However, it is important to check the coverage details before buying any plan.

Benefits of OPD Insurance

OPD insurance is important for several reasons. Here are a few key benefits of having OPD coverage:

  1. Cost savings: Without OPD insurance, individuals may have to pay out-of-pocket for medical treatments and procedures that do not require an overnight stay in a hospital. This can add up quickly, especially for individuals who require frequent medical care. OPD insurance can help cover the costs of these treatments and procedures, reducing the financial burden on individuals.
  2. Access to healthcare: OPD insurance can provide access to a wider range of healthcare providers. Many insurance plans have networks of preferred providers, and having OPD coverage can give individuals access to these providers.
  3. Peace of mind: Knowing that you are covered for certain types of medical treatment can provide peace of mind. This can be especially important for individuals who are at risk for certain health conditions or who have a history of chronic illnesses.
  4. Flexibility: OPD insurance policies are typically offered as an add-on to a basic health insurance plan, which gives individuals the flexibility to choose the coverage that best suits their needs. Additionally, OPD insurance can be combined with other types of insurance such as critical illness insurance for better coverage.
  5. Cost containment: OPD insurance can help contain the overall healthcare costs of a family by covering the costs of minor illnesses and treatments which may not require hospitalization.
  6. OPD insurance become integral part of your insurance policy if your policy covers an old age person, kids or a person ailing prolonged disease who require frequent visits to the doctors for regular check-ups and consultations.

In summary, OPD insurance is an important type of health insurance that can help individuals save money on healthcare expenses, provide access to a wider range of healthcare providers, and provide peace of mind. It can also be combined with other types of insurance to provide comprehensive coverage and also help contain overall healthcare costs.

What is Included in OPD Insurance Cover in Health Insurance

Here are the coverage details of OPD cover in medical insurance.

  1. Doctor consultations
  2. Diagnostic tests
  3. Pharmacy expenses
  4. OPD treatment

What is Excluded in OPD Insurance Cover in Health Insurance

Here are the exclusions of OPD cover in medical insurance.

  1. Facilities or services availed for rejuvenation, pleasure, etc.
  2. Treatments for beautification, purification, detoxification, panchakarma, etc.
  3. Cost of spectacles, lenses, implants, hearing aids, prosthetic devices, braces, etc.
  4. OPD treatment outside India.
  5. Routine examinations or preventive health check-ups.
  6. Vaccination including inoculation and immunisations except in case of post-bite treatment such as a dog bite.
  7. Investigational treatments or experiments.
  8. Sterility, infertility, and other related conditions.
  9. Complications arising out of pregnancy, miscarriage, etc.
  10. Dentures, dental treatment, and surgery of any kind.

Why Should You Get a Health Insurance with an OPD Cover?

Here are the reasons why you should consider buying medical insurance with an OPD cover.

  1. A recent survey by Practo revealed that visits to the doctor or clinic have increased from 2.7 times in 2017 to 3.2 times in 2018.
  2. OPD expenses in India account for nearly 62% of the total medical care expenses compared to In-patient Department (IPD) expenses.

Health Insurance provider who provides OPD insurance

InsurerPolicy
Bajaj AllianzTax Gain Health Insurance Plan with OPD Cover
Niva BupaGoActive Health Insurance Plan
Star Health InsuranceOutpatient Care Insurance Policy
Digit Health InsuranceDigit Health Insurance with OPD Cover
Aditya Birla Health InsuranceActiv Health Enhanced Platinum Plan

Frequently Asked Questions:

Here are some of the most commonly asked questions about health insurance plans with OPD cover.

Ques- Can I avail of tax deductions on health insurance plans with OPD cover?

Ans- Yes, you can claim tax benefits on health plans with OPD cover under Section 80D of the Income Tax Act.

Ques- When are the instances when I can utilise my OPD cover?

Ans- You can use the OPD cover in the health insurance plan for minor surgeries or treatments that do not require hospitalisation.

Ques- Can I buy an insurance plan that covers only OPD treatment?

Ans- It depends on the insurance company and the plans they offer. You need to review the plans before you buy the plan that provides coverage only for OPD treatment.

Ques- How do I buy health insurance with OPD cover?

Ans- OPD cover in health insurance is offered as an add-on cover at an additional premium. However, it may differ between insurance companies. For example, some plans are bundled with OPD cover, while other plans offer OPD cover as an add-on. Therefore, it is prudent to check the coverage details so that you can make an informed decision.

6 thoughts on “OPD Insurance- Why it is important in your medical Insurance Policy?”

  1. This article opened my eyes, I can feel your mood, your thoughts, it seems very wonderful. I hope to see more articles like this. thanks for sharing.

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