What is OPD cover, why it should be in health insurance, know everything


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OPD Cover in Insurance : Healthcare is becoming increasingly more expensive. On the other hand, out-of-pocket expenses are also increasing. In such a situation, you should try your best to improve your health insurance and ensure the best coverage. Insurance companies are also now offering multiple options to customize and meet the unique medical needs of the customers. That is why you should review your existing coverage and try to upgrade to a policy that offers cashless outpatient department treatment (OPD), daily cash rider, guaranteed cumulative bonuses and lower sub-limits.

OPD Cover: Why it should be in health insurance, know

Add required riders to the scheme
Also, add some necessary riders to the scheme and take top-ups to improve the insurance cover. If your current plan does not offer these cost-effective features, consider switching plans. You can take a policy from your own insurance company or any other such company. OPD is very important in this. Know further why it is important and what are its benefits.

what is opd
A basic health insurance covers only hospitalization, but a major portion of the healthcare expenses are related to doctor’s consultations, medicines and diagnostics. A policy with cashless OPD will take care of such expenses and will be beneficial for those with high out-of-pocket expenses or parents with young children who are prone to ailments.

OPD Cover: Why it should be in health insurance, know

All these expenses will be included
The cashless OPD will cover professional fees, diagnostic fees, medicine bills, treatment of fractures, dental treatment, authorized diagnostic centres, dental care centers and pharmacies to minor surgeries. However, most insurers do not cover OPD expenses incurred for spectacles, contact lenses, ambulatory devices like walkers etc.

what do experts say
Senior citizens should opt for OPD cover as it covers consultation charges as well as diagnostic charges and pharmacy bills. This makes the benefits of cashless OPD flexible and comfortable. Especially for those suffering from chronic diseases who require regular OPD visits.

OPD Cover: Why it should be in health insurance, know

Guaranteed Cumulative Bonus
Also look for policies with Guaranteed Cumulative Bonus which protects the loss of cumulative bonus in return for the same premium after a claim. There are some health plans that offer a guaranteed cumulative bonus of 25-30% per annum, which goes up to 200% of the sum assured, irrespective of the claim amount. However, if you opt for fresh coverage for such amount, you will have to pay additional premium. Also, look for a policy that offers loyalty discount on applicable premiums after a few years of renewal. Some insurers offer additional discounts if the renewal of the policy is done through the National Automated Clearing House or Standing Instruction either by direct debit from a bank account or by credit card. Experts say that opting for Guaranteed Cumulative Bonus is beneficial as it results in higher coverage amount without any additional premium.

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english summary

What is OPD cover why it should be in health insurance know everything

Add some necessary riders to the scheme and take top-ups to enhance the insurance cover. If your current plan doesn’t offer these cost-effective features, consider switching plans.

Story first published: Wednesday, November 16, 2022, 17:29 [IST]





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