OPD treatment means the type of treatment wherein the insured visits a clinic/hospital or associated facility like a consultation room for diagnosis and treatment based on the advice of a medical practitioner. Hence, OPD cover provides coverages for expenses such as doctor's consultation fees, pharmacy bills, health check-ups, and diagnostics tests.
In comparison to other health insurance policies, the sum insured under OPD coverage is determined by the insured person's age. Health insurance with outpatient care coverage, of course, gives additional financial security.
There are is no specific eligibility criteria to avail of OPD benefits. Any individual who is feeling unwell can go to a doctor's clinic for consultation and treatment.
**However, the possibility is that your health insurance company may have some sort of eligibility criteria or waiting period for OPD coverage. Therefore get in touch with your health insurance provider to understand the criteria.
Health ailments come unannounced, and you can never predict when you might need hospitalization or can get yourself treated without it. Therefore, it is better to be prepared in advance for both the situations. Having a health plan with OPD cover not only provides coverage but also offers several perks. Read the following points to know the benefits:
People often get confused in OPD & Daycare treatments. Before buying any policy, do understand how one is different from the another. Take a look at the below given comparison to get a clear picture about the two:
Parameters | Day-care Treatments | OPD Treatments |
Hospitalization Type | Under day-care treatments, the patient is required to stay in the hospital for a few hours. | OPD treatments do not require any hospitalization. Patients can come, consult the doctor and can go. |
Waiting Periods | Generally comes with a waiting of three years, which means treatment can be availed only after serving the waiting period except for any accidental injury. | It comes with a waiting period of 90 days. |
Sub-limits | There are no sub-limits. Treatment costs are covered up to the chosen sum insured. | Comes with a sub-limit of your overall sum insured limit. |
Treatments Covered |
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A health insurance which covers OPD offers coverages against the below-mentioned expenses:Â
There are several illnesses that can be treated only by the medicines prescribed by doctors. Sometimes, these doctor's consultations may continue for a longer period, often burdening your pockets. Thus, before buying a health plan, make sure that the OPD is covered under the same, and get your consultations, diagnoses, and treatments covered under a health plan.
With a continuous increase in the healthcare facilities, a normal doctor consultation from a private hospital can cost somewhere between Rs.700- 1000. This means for a normal viral fever, you will have to spend almost 4-5k which will include all the tests & consultations.
To protect you from such expenses, it is better to have health insurance with an OPD cover.
Yes, the OPD treatments come with a sub-limit. Go through the policy wordings carefully to know the OPD limit of your policy.
Get in touch with the experts at PolicyX.com. They will help and assist you with all your queries.
Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.