Health Insurance with OPD Cover

What is OPD Cover?

The OPD cover refers to a health insurance cover that pays for the cost of outpatient treatment. It ensures that the health insurance provider covers the medical expenses of the insured incurred without hospitalization. Most health insurance plans do not offer an OPD cover and hence, it is usually available as an add-on cover.

Some health insurance companies in India provide OPD insurance cover along with the basic plan. Check out the details of the OPD health insurance plans with their coverage benefits, and features. 

Health Insurance Plans with OPD Cover in 2024

Check out the table below with different health insurance plans with OPD cover from different health insurers in India:

Benefits of OPD Expenses Coverage in Health Insurance

Health insurance plans with outpatient department cover prove to be beneficial for the policyholders in the following ways:

• It is useful for patients who require frequent hospital visits for OPD consultations including something as basic as viral fever
• The insured can get recompensed for hefty pharmacy bills
• OPD cover is beneficial for patients with pre-existing medical conditions that often require frequent medical consultations
• Those who are immunocompromised may also find OPD health cover beneficial
• People suffering from chronic medical conditions such as asthma, diabetes, arthritis, thyroid, etc., who may require regular doctor consultations can benefit from OPD cover

Note: OPD consultations are covered only in-network hospitals and clinics. 

Which OPD Health Insurance Plan Should you Buy?

Check out the health insurance plans with OPD cover in detail below:

1. Aditya Birla Activ Health Enhanced Platinum Plan

   Aditya Birla Activ health enhanced platinum plan- cover for dental consultation and investigation the sum insured is Rs 2lakh to Rs 2 Crore. The policy is available on both individual and family floater basis.

   The policy covers General physician/ specialist visits for 10% of the OPD limit per visit, medicine and diagnostic cover 50% of the OPD limit.

2. Bajaj Allianz Tax Gain Health Insurance Plan with OPD Cover

   Anyone between the age group of 18 years and 75 years can buy the Bajaj Allianz Tax Gain health insurance policy. It is a family floater health plan that covers out-patient expenses (OPD) and hospitalization expenses under a single policy.

   The policyholder can file a claim for dental procedures, spectacles, dentures, and crutches under the Tax Gain Plan. For cashless facility, it gives you access to more than 6500 hospitals across India.

3. Care Family Health Insurance Plan

   Care Family health insurance plan offers comprehensive coverage benefits for a wider range of medical procedures and diseases. OPD insurance is provided as an optional cover, in which the insured can claim an amount equal to their medical bills at the time of reimbursement.

   The OPD coverage amount ranges from Rs 5,000 to Rs 50,000 that you can opt for as per your requirements. There is no co-payment for members up to the age of 60 years.

4. Cholamandalam Family Healthline Plan

   Chola Healthline is a comprehensive family insurance policy that provides health cover to families on both individual and floater basis. OPD cover can also be availed under this Family health plan as an add-on cover by paying an additional premium. It includes coverage for dental expenses, hearing aids, contact lenses, spectacles, etc.

5. Digit Care plus OPD Insurance Plan

   Digit Care Plus is an OPD insurance plan that is specifically designed to cover Outpatient Department treatment expenses incurred by the insured during the policy term. The expenses that can be claimed under this plan include medical consultations and examinations, diagnostic fees, medicine bills, surgical treatments, dental treatment, hearing aids, etc. The policy also covers COVID-19 hospitalization expenses.

6. Future Generali DIY Health Insurance Plan

   Future Generali DIY Health Insurance plan covers outpatient expenses of the insured. The OPD coverage limit range from Rs 2000 to Rs 10,000.

7. HDFC ERGO Day2Day Care Plan

   The HDFC ERGO Day2day Care plan provides OPD coverage from day 1 of the policy. It offers unlimited consultations of general physicians and specialists to the insured.

8. ICICI Lombard Wyn Shield Plan

   The ICICI Lombard Wyn Shield plan covers the cost of outpatient expenses incurred by the insured during the policy year. It also includes OPD consultations for psychiatric conditions, mental health issues and AYUSH treatment.

9. Liberty Health Prime Connect Plan

   The Liberty Health Prime Connect plan offers OPD treatment as an optional cover. It includes the nursing expenses, medicine costs, physical therapy charges, diagnostic test costs, etc.

10. Magma HDI OneHealth Insurance Plan

    The Magma HDI OneHealth Insurance plan covers the cost of outpatient consultations, diagnostic tests and medicines of the insured. It also covers OPD expenses on dental treatment, contact lenses, spectacles and hearing aids.

11. ManipalCigna ProHealth Prime Insurance Plan

    The ManipalCigna ProHealth Prime Insurance plan pays for the OPD medical expenses incurred on doctor consultations, diagnostic tests and medicines. It also comes with unlimited teleconsultations.

12. National Mediclaim Plus Policy - Individual

    The National Mediclaim Plus Policy - Individual provides coverage for OPD treatment as an optional cover. It comes with an outpatient expenses limit of Rs 2,000 to Rs 10,000.

13. New India Assurance Premier Mediclaim Policy

    The New India Assurance Premier Mediclaim policy covers OPD expenses incurred on dental treatment, doctor consultation, medicines and medical tests. It also pays for preventive health check-ups.

14. Niva Bupa (Formerly known as Max Bupa) Go Activ Health Plan

    Niva Bupa (Formerly known as Max Bupa) GoActive medical insurance plan offers cashless OPD coverage benefits. It helps the policyholder save their hard-earned money that goes into regular hospital visits. The OPD coverage benefits are built into the base premium.

    It provides up to 10 reimbursable/cashless OPD consultations with nearly 10,000 doctors through Practo. It includes consultations with a specialist, general physicians, pediatricians, dentists, and orthopedics, or with any other doctor as per the need of the policyholder.

15. Oriental Happy Family Floater Plan

    The Oriental Happy Family Floater plans offers coverage for outpatient expenses under the Platinum plan. It covers doctor consultations, diagnostic tests, medicines, dental and ophthalmic consultations.

16. Raheja QBE Health QuBE Insurance Plan

    The Raheja QBE Health QuBE plan offers OPD rider on the payment of additional premium. It covers the cost of doctor consultations availed on an outpatient department basis.

17. Reliance Health Infinity Insurance Plan

    The Reliance Health Infinity Insurance plan provides coverage for OPD consultations, prescribed medicines and diagnostic tests. It also covers dental OPD and surgical OPD treatment expenses under Plan B.

18. Royal Sundaram Lifeline Insurance Plan

    The Royal Sundaram Lifeline Insurance plan provides OPD treatment cover under the Elite plan. It covers the cost of OPD treatments, including dental treatment expenses, contact lenses costs and spectacles costs.

19. SBI Arogya Plus Health Insurance Plan

    SBI Arogya Plus policy covers hospitalization expense up to the sum insured i.e. Rs 1 lakh, 2 lakh, and 3 Lakh. The sum insured for OPD depends on the family type, age, and also premium. Maternity expenses are also covered up to the OPD limits. One unique benefit is HIV/AIDS cover up to Rs 50,000, mental illness cover, genetic disorders cover, and internal congenital diseases.

20. Star Outpatient Care Health Insurance Plan

    This health insurance plan covers the Outpatient consultation expenses incurred at any Network Medical Facility in India. OPD claims under this health plan are permissible for diagnostics, dental treatment expenses, ophthalmic treatment expenses, and Non-allopathic treatment expenses, physiotherapy, and pharmacy expenses.

21. Tata AIG Medicare Premier Plan

    The Tata AIG Medicare Premier plan covers the cost of high-end diagnostic tests on an OPD basis along with doctor consultations and medicines costs. However, it covers OPD expenses after a waiting period of 2 years.

22. Universal Sompo Complete Healthcare Insurance Plan

    The Universal Sompo Complete Healthcare Insurance plan provides coverage for OPD expenses incurred on doctor consultations, pharmacy and diagnostic services. However, it is covered after a waiting period of 3 years.

23. Zurich Kotak LiveWell Plan

    The Zurich Kotak LiveWell plan offers OPD benefit as an optional cover. It covers the cost of teleconsultations, doctor consultations, diagnostic services and pharmacy.

Inclusions under OPD Health Insurance Plans

The policyholder is entitled to avail of the following coverage benefits under health insurance plans with OPD cover:

• Listed below are the inclusions of our OPD cover:
• Diagnostic test
• Doctor consultation
• Investigative tests
• Pharmacy expenses 

It works as a cushion for your savings and helps you start your treatment right on time without worrying about these small expenses.

How to Buy Health Insurance with OPD Coverage?

Buying a health insurance policy with OPD cover online is simple and quick. Check out the steps below to get a suitable policy for yourself:

• Visit Policybazaar.com and select a health insurance plan with OPD cover
• Provide your contact details like your name, email id,  mobile number, contact details, pin code, age, gender, and click on ‘Get Quote’
• Confirm any pre-existing diseases or medications
• Now select the policy sum insured, duration, and other add-ons as per your requirement 
• Compare the premiums and click on the Buy Now options
• Once you pay the premium online, the policy will be issued and emailed to you on your registered email-id.

For more details, you can write to us at care@policybazaar.com

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