Health Insurance with OPD Cover – Know the benefits and importance of OPD

Not every visit to the hospital requires admission for treatment or hospitalization. Some hospital visits are limited only to the OPD meaning the Outpatient Department. This department in the hospital takes care of patient cases that are less critical and do not require urgent medical attention as in the case of an emergency.

However, truth be told, the expenses incurred in OPD hospital visits can be quite an amount and sometimes even burn a hole in the pocket of the bearer. This can be due to the higher frequency of visits required to the OPD, meaning the patient is called multiple times for doctor consultations, diagnosis, running diagnostic tests, taking X-rays, or for undertaking other procedures carried out at the OPD.

To help patients reduce the financial burden of bearing OPD costs, some benefits of health insurance with OPD Cover. Let us look at at least 5 of such plans that can provide financial relief to the patient and their family during difficult times.

What is OPD in a Hospital?

Before we talk about health insurance with OPD cover, let us begin by understanding in brief what OPD means in a hospital setting.

OPD is the abbreviated form of Outpatient Department. As is evident by the name, Outpatient is the exact opposite of Inpatient Department where those patients who are admitted into the hospital for treatment (brief or longer) can be found. As against this, the Outpatient Department or the OPD is where those patients come who simply need doctor consultations upon visit for a diagnosis of their respective health conditions.

The OPD patients consult the resident or consulting doctor available and pay consultation fees for the same. The OPD medical department is therefore responsible for overseeing appropriate medical assistance to all patients who visit the hospital for the first diagnosis of the condition. Upon diagnosis and prescription of treatment, some patients are then guided towards the IP department for admission for critical care.

What is health insurance with OPD cover?

We learned above the exact OPD meaning and what the OPD department of the hospital takes care of. Now, what does OPD stand for in the context of health insurance? Let us understand below.

We already discussed earlier that OPD stands for Outpatient Department and that it is responsible for providing the basic care and assistance to a patient when they first come to the hospital. Now all the patients who visit the OP department of a hospital are required to pay a certain consultation fee or charge for seeking consultation with a specific doctor or specialist. All these charges are collected by the OP department of the hospital.

The cost of bearing these OPD expenses can sometimes be quite a bit, depending on the number of times the visits are required. This is where the OPD cover benefit of health insurance comes as a huge relief.

What is Health Insurance with OPD Cover?

We learned the meaning of OPD in the specific context of health insurance above. Now let us briefly understand health insurance with OPD cover.

Some health insurance plans provide an additional OPD cover benefit to their policyholders, meaning the latter can now claim coverage for certain non-emergency, less-critical health conditions as well. This is particularly helpful considering that most health conditions that require medical attention can be non-urgent and non-risky as well. In this case, a simple visit to the doctor’s clinic for consultation or diagnosis can invite a certain amount of expense.

This would include the doctor’s consultation fee in addition to the cost of running diagnostic tests, scans, or X-rays (if so required), not to forget, the cost of buying medicines from the pharmacy for the condition diagnosed. These costs sure add up and can sometimes mean a huge burden to the patient and his/her family.

Now, imagine a mediclaim policy that comes with the inclusive benefit of OPD cost cover! This would mean a significant portion of your healthcare expenses being completely covered by the insurer! Of course, OPD insurance comes with a wide array of benefits which we’ll discuss in the next section.

Health Insurance with OPD benefits: Benefits of health insurance with OPD cover

Some of the major benefits of availing this cover include:

• Coverage of regular medical bills, particularly of the pharmacy (in case you tend to buy a monthly supply of medicines)
• Coverage for non-emergency medical visits to the hospital (those that do not require hospitalization), which can be quite a few in a year
• Coverage for regular doctor consultations and health check-ups at the hospital
• Extra coverage over and above hospitalization expenses
• Tax benefits on premiums
• Flexibility to claim reimbursement of medical bills more than once to cover healthcare costs as and when they arise

 

5 Best Health Insurance Plans with OPD Expenses Coverage Benefits

We discussed above the key benefits of buying OPD insurance cover. If you’re considering investing in one of these, here are the top 5 plans that are worth putting your money in:

Name of the Insurer	Health Insurance Plan with OPD Expenses Coverage	Minimum Sum Insured	Plan Benefits	Claim Settlement Ratio of Insurer
Max Bupa	Heartbeat	Rs. 15 lakh	Global coverage, no capping on room rent, maternity cover, OPD treatment costs reimbursed, alternate treatments like Unani, Ayurveda, etc. also covered	89.46%
Manipal Cigna	Lifetime Health	Up to Rs. 3 crore	Domestic and international coverage both, no room rent capping in global coverage, also covers hospitalization cost in India, unlimited restoration of sum insured for unrelated health conditions	91%
Aditya Birla	Activ Health Enhanced Plan	Between Rs. 2 lakh and Rs. 2 crore	Benefits of health insurance, chronic care, and wellness benefits all included in one single plan, cost for modern treatments covered, like oral chemotherapy, robotic surgery, etc.	94%
SBI	Arogya Plus Plan	Up to Rs. 1 lakh, 2 lakh, and 3 lakh	OPD cover for the whole family, also included multiple other covers such as Mental Illness Cover, HIV/AIDS Cover, and Genetic Disorder Cover	96%
Bharti AXA	Health AdvantEdge	Rs. 2 lakh; up to Rs. 3 crore	OPD cover for newborn vaccinations in the first year after birth, dental treatments, air ambulance within country, domiciliary hospitalization, and wellness benefits	90%