How Can OPD Health Insurance Help You Save Money?

For years, health insurance has been synonymous with hefty medical expenses, like hospital stays and surgeries. But what about the smaller and more frequent costs like doctor consultations, medical tests, and pharmacy bills? These out-of-pocket expenses can add up over time, putting a strain on your finances. The only way to save money on these routine medical expenses is by adding an OPD cover to your health insurance policy.

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      What Does OPD Cover in Health Insurance Means?

      In health insurance, OPD cover means the insurer pays for the medical expenses incurred on an outpatient department (OPD) basis. It covers the cost of OPD doctor consultations, diagnostic tests, prescribed medications, minor treatments & procedures, dental treatments, etc., that do not need you to stay overnight at the hospital. While most health insurance companies provide OPD cover as an optional benefit, others may offer it as an in-built cover.

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      How Can You Save Money With Health Insurance for OPD?

      Here is how health insurance with OPD cover can help you save money:

      1. Reduced Out-of-Pocket Expenses on Doctor Visits

        The cost of visiting a doctor for minor illnesses, like fever or common cold, or preventive health check-ups can quickly add up even without hospitalisation. For instance, the average cost of a doctor consultation in Indian metro cities ranges from ₹1,500 to ₹2,000. An OPD cover pays for these doctor visits, reducing your out-of-pocket expenses.

      2. Pays for Diagnostic Tests

        Medical diagnostic tests, like X-rays, MRIs, blood tests and other screenings, can be expensive, especially when required frequently. For example, the average cost of diagnostic tests in metro cities in India can range from ₹8,000 to ₹10,000. OPD coverage in a mediclaim policy covers the cost of these diagnostic tests, thereby protecting your hard-earned money.

      3. Manages Pharmacy Expenses

        Most OPD health insurance plans cover the cost of medicines prescribed by the doctor, helping you save on pharmacy bills. This is highly beneficial for people with chronic conditions, like diabetes and hypertension, who need regular medication.

      4. Prevents Financial Burden

        By making doctor visits and diagnostic tests more affordable, OPD cover encourages early detection and timely treatment of health issues. This prevents minor conditions from worsening that would otherwise lead to hefty treatment expenses in the future.

      5. Tax Benefits

        Health insurance premiums paid to buy an OPD cover are eligible for tax deductions under Section 80D of the Income Tax Act, 1961, providing you financial relief.

      Who Should Buy Health Insurance with OPD Cover?

      Although everyone should buy medical insurance with OPD cover, the following people should prioritise it:

      • People with a family history of lifestyle diseases like obesity, diabetes, etc.
      • Senior citizens
      • People with pre-existing diseases
      • Families with young children
      • People who prefer proactive healthcare
      • People with weakened immune systems

      Tips to Buy an OPD Health Insurance Plan

      Check out a few tips to buy an OPD health insurance plan:

      • Select the Right OPD Coverage Amount: Before selecting a medical insurance plan with OPD coverage, analyse how much you usually spend on doctor visits, tests, and medications in a year. This will help you get an idea of how much OPD coverage amount is enough for you and your family.
      • Check the Sub-limit Clause: Some OPD plans come with a sub-limit on the maximum amount that you can claim for specific OPD services, such as diagnostic tests, medical consultations, health check-ups, etc. So, choose a plan with a preferable sub-limit on your OPD expenses.
      • Verify the Network Hospital List: Most insurance providers offer cashless OPD treatments and services at their network clinics and hospitals. Make sure to choose an insurer with your preferred hospital or doctor on their network list.
      • Look for a Shorter Waiting Period: Some health plans may have a waiting period that needs to be served before you can file an OPD claim. Choose a plan with a shorter or no waiting period for OPD treatments so that you can claim your benefits sooner.
      • Balance Cost & Benefits: Compare multiple OPD health insurance plans to determine which one offers the best coverage at the most reasonable cost. Also, make sure not to overpay for the OPD benefits you may not need.

      FAQs

      • Q1. What is OPD full form in medical insurance?

        Ans: The OPD full form in medical insurance is Outpatient Department.
      • Q2. What is the OPD benefit of health insurance?

        Ans: The OPD benefit in health insurance covers outpatient medical expenses that do not require an overnight stay in the hospital. It helps you manage routine healthcare costs without paying out of pocket.
      • Q3. What does OPD cover?

        Ans: OPD covers a wide range of outpatient expenses, including doctor consultations, medicines prescribed by the doctor, minor medical procedures, vaccinations, dental and ophthalmic treatments, etc.
      • Q4. Can we claim OPD bills in insurance?

        Ans: Yes. You can claim your OPD bills in your health insurance policy if it comes with an OPD benefit.
      • Q5. Is dental covered in OPD?

        Ans: Yes. Dental treatment expenses are covered by OPD and can be claimed under a health insurance policy with OPD cover.
      • Q6. Is physiotherapy covered in OPD insurance?

        Ans: Yes. Physiotherapy is covered in several OPD health insurance plans. You can check your policy terms and conditions to know the exact coverage.
      • Q7. Is a root canal covered by insurance?

        Ans: Yes. A root canal treatment is covered by an OPD health insurance policy, provided it offers coverage for dental treatments.
      • Q8. Is consultation fee covered by insurance?

        Ans: Yes. Health insurance plans cover doctor consultation fees if they come with an OPD cover.
      • Q9. Can I claim OPD expenses?

        Ans: Yes. You can claim OPD expenses under your health insurance policy, provided it comes with an OPD cover.
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      Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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