Why Should You Opt For OPD Cover in Health Insurance ?

Not all diseases require hospitalisation. There are certain ailments for which the treatment can only require consultations, diagnosis and treatments without a stay in the hospital. Outpatient Department or OPD includes all such treatment variables. 

In India, various insurance companies offer OPD cover health insurance to policyholders as financial coverage against such types of treatments that do not require hospitalisation. In short, medical insurance with OPD covers includes expenses incurred outside of in-hospital treatment. 

Why is OPD Cover Health Insurance Necessary?

Purchasing health insurance that covers OPD expenses is necessary for the following reasons:

Increasing need

Our lifestyle and way of living is constantly evolving. This change has led to the prevalence of various illnesses and chronic ailments requiring long-term care. Thus, it is essential to purchase health insurance with OPD benefits. This cover will help to take care of regular medical expenses.

OPD costs contribute to most of the total healthcare costs

Outpatient department costs account for 62% of total healthcare costs. So, a cover against these medical expenses is beneficial. 

What are the Benefits of OPD Coverage?

The specific benefits of this plan are as follows:

Additional coverage

When you purchase an insurance plan including an outpatient expense cover, you get extra protection that provides financial coverage against daily medical expenses. 

Cashless claim

Some insurers offer a cashless scheme to cover treatments undertaken at the outpatient department. This makes your claim process smooth and eases off cash crunches arising during medical treatments.

Sum insured

A sum insured amount gets determined based on the policyholder’s age for plans with OPD cover health insurance. In a floater policy, the eldest member’s age gets considered.

Greater tax reliefs

Health insurance plans covering OPD expenses provide greater tax exemption on the premium amount. In addition to this, there will be no tax deduction at the source for claims.

Multiple claims possible

With this cover, you can claim your expenses multiple times. 

Pharmacy bills covered

Your pharmacy bills will get covered under such a health insurance plan. This means if you purchase medicines, you can get the same reimbursed.

Covers a wide variety of expenses

Expenses such as crutches, spectacles, contact lenses, hearing aid, and many others get covered under such a health scheme.

Carry forward benefit

Certain insurance service providers allow you to carry forward a fixed portion of an unutilised sum insured amount in a specific policy period. 

Medical Insurance with OPD Benefits – Eligibility

There is no specific eligibility norm when it comes to availing of outpatient department benefits. Anyone unwell can visit their nearest clinic and avail of medical treatment. A policyholder can then claim expenses under this healthcare scheme.

If you are eligible to purchase a particular health insurance policy with an outpatient cover, you can utilise the benefits. 

OPD Cover Health Insurance: Inclusions

Following are the expenses covered under an outpatient department cover:

1. Doctor’s fees or any other consultation fees
2. Diagnosis costs like X-ray fees
3. Crutches and wheelchair
4. Routine check-up
5. Vaccination
6. Minor surgeries and dressing
7. Dental treatment expenses
8. Hearing aid
9. Spectacles and contact lenses (covered by specific plans)

What is Not Included under OPD?

Find all the exclusions as listed below:

1. Expenses of cosmetic treatment
2. Physiotherapy
3. Thermometers and BP monitors 
4. Supplements
5. Vitamins 
6. Dietician fees and consultation

How to Buy OPD Coverage Health Insurance?

Follow these simple steps to purchase a health insurance policy with OPD cover:

1. Select a health insurance plan with OPD cover online from a reliable insurer. 
2. Enter details such as name and contact information. While choosing an insurer, you will find a ‘Get Quote’ option on the screen. Click on it to find details of your plan premium and more. 
3. In case you have any pre-existing diseases or are on medications, confirm it in this step. 
4. Choose the policy sum insured, tenure, add-ons and other details as required. 
5. You must compare the premiums before settling for one that is under your budget. 
6. After paying the premium online from the payment gateway, the policy will be issued, and the details will be mailed to you.

Final Words

Medical insurance with OPD cover helps boost the scope of coverage under insurance policies further. Through this scheme, policyholders can take care of their daily medical expenses, as mentioned above. With a growing rise in basic medical expenses such as consultation fees, diagnosis fees, and more, this healthcare policy can be extremely beneficial for any family. 

To avail of an OPD cover under your health insurance policy, turn to Navi health insurance. Download the Navi App today to enjoy an instant paperless application process!

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