Why should you buy a health insurance policy with OPD cover?


Last Updated on January 21, 2024 by Asfa Rasheed

Nobody can deny the importance of having proper health insurance coverage these days. The medical expenses have been steadily rising over the past decade and we live in the times when suffering from any of the critical ailments can easily push the treatment bills sky-high. There is however one big challenge with many of the health insurance policies, which is that they only allow you to file a claim if there has been a minimum of 24 hours of hospitalization. This means that even if you go through a costly procedure, with no need for hospitalization, you can’t claim it under your existing health insurance policy. This is what makes the OPD cover health insurance policy, the need of the hour. Many expenses are covered under the OPD expenses and are not currently covered under most insurance policies. Before we find out what is OPD covers health insuranceand how can it help our health insurance become more comprehensive and provide wider coverage, let us first understand what is OPD.

What is OPD and what expenses are included in it?

Simply put, the OPD or Out Patient Department charges usually refer to the numerous medical charges that you can incur at a hospital without getting hospitalized. This includes consultation charges, day care procedures, short-term treatment sessions, diagnostic tests, preventive check-ups, and even medicines. These are also referred to as out-of-pocket medical expenses which many times pile up as high as the hospitalization charges. If you are visiting a hospital or a clinic under the advice of a doctor or medical practitioner, you can claim the expenses of that visit under the OPD expenses; however, if you decide or are required to get admitted to the hospital for more than a certain number of hours, you can claim those expenses under the regular health insurance hospitalization cover. Some of the most important inclusions that you get while taking an OPD covered health insurance policy are these:

  • Doctor’s consultation fees
  • Vaccinations and routine check-ups
  • Minor surgeries including laparoscopic and LASER based surgeries
  • Dental treatment and fillings
  • Hearing Aids, Spectacles, and lenses (depending on the plan)
  • Wheelchair and crutches fittings
  • Pathology, Radiology, and other diagnostic tests

Let us see what are some of the types of OPD benefits that are available with health insurance plans.

What are types of health insurance with OPD cover?

There is a growing demand from Insuretech policyholders and customers to include OPD cover in more and more health insurance plans. In response to this, most health insurance providers have included OPD cover in their bestselling plans to remain competitive. The health insurance plans currently in the market extend the OPD benefits fall under the two categories, closed or open network plans. The closed network plans restrict the customers from only availing the OPD benefits at a closed network of medical services providers and practitioners. In contrast, open network plans can avail the benefits at any practitioner or institution of their choice. The open network OPD cover plans are therefore more in demand and popular among health insurance customers.

Another key differentiator is that, whether the health insurance plan has the OPD benefit in-built in the plan or does it offer the OPD cover as an add-on rider. In these cases, the policy may offer some of the OPD charges pre-hospitalization and post-hospitalization to be reimbursed.

Who should go for health insurance with OPD coverage?

As there are very high chances that the small OPD charges can pile up and hit your finances, it is advisable to always go for the OPD coverage plans. It will save a great amount of cost and will only increase the insurance premium by a small percentage. For those people, who regularly find themselves heading for check-ups, tests, and doctor consultations it makes absolute sense to go for it. You can head to the IIFL website to compare health insurance plans with OPD coverage and make an informed decision about it.

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