Health Insurance with OPD Treatment Cover and other Key Benefits


4 Benefits in Comprehensive Health Insurance

Looking at the rising costs of healthcare in India, buying a health cover should be a top priority. Sometimes, medical expenses are not just limited to hospitalisation costs. OPD visits, for instance, can lead to a lot of expenditure. This is why one should opt for health insurance which covers OPD expenses. 

Besides, there are many other benefits which must be considered when opting for a policy. This is required so that you are adequately covered and saved from any out-of-pocket expenditure. 

We list some key benefits that you must look for in a comprehensive health insurance plan. 

OPD Treatment Cover

OPD or Outpatient Department is a section of a hospital, or a clinic where a patient can avail medical services without getting admitted in the hospital. The medical services include doctor’s consultations, diagnosis of ailments, minor medical procedures, follow-up visits after discharge from hospital, pharmacy, etc. All these expenses get covered under a health policy with OPD treatment cover. 

The expenses are covered on reimbursement basis. Policyholders must read the policy documents to understand the terms and conditions. They must also be clear about the number of times they can make claims for OPD expenses.

Day Care Treatment Cover

Day care treatment cover differs from OPD cover. The two terms should not be confused. A wrong understanding of such technical jargons can lead to rejection of the claim. Let us explain.  

The basic difference is in the fact that hospitalisation of duration less than 24 hours is required, in order to avail the coverage for day care treatment. On the other hand, for OPD treatment, a patient need not be hospitalised to avail medical care. 

Moreover, the process of getting claims is different. The OPD coverage is similar to indemnity based plans wherein the claims are reimbursed for the expenses incurred by an individual. This means, you can visit any hospital for OPD care, pay the bills from your pocket and then get your claims reimbursed. However, for day care treatment, a policyholder can avail the cashless hospitalisation facility at any network hospital. 

Cover for Pre and Post Hospitalization

As said earlier, medical expenses are not only limited to hospitalisation costs. A person is likely to incur hefty medical bills in case an illness requires prolonged medical care that goes beyond hospitalisation. The expenses may also increase due to regular health check-ups and diagnostic tests. Opting for a health plan with comprehensive coverage will take care of all such expenses. A good health policy covers pre-hospitalization costs for 30 days before admission and post hospitalization costs up to 60 days. 

Recharge of Sum Insured

This is a beneficial feature that enables a policyholder to stay worry-free even after the sum insured is exhausted within a policy year. Health insurance with comprehensive coverage would offer the option of automatic recharge of sum insured. In this feature, the entire sum insured amount would be restored which can be utilised for hospitalisation expenses in future. However, there may be some conditions. So, one must read and understand the policy brochure while opting for a policy.  

Buying a good health insurance which covers OPD expenses, day care treatment expenses, etc. also makes you eligible for tax benefits under Section 80D of Income Tax Act, 1961. 

It is highly advisable that you choose a health policy which offers you maximum coverage and high sum insured, given the fact that medical treatment costs are skyrocketing. Also, look for other benefits like daily allowance, cover for alternative treatment, ambulance cover, etc. Remember to take into account various factors such as age, medical condition, etc. which can impact the premium rates. 

You can receive coverage for your OPD expenses by opting for ‘Care’ - a comprehensive family health insurance policy offered by Care Health Insurance (Formerly Religare Health Insurance).