Health Insurance 8872 views December 26, 2019

Best Health Insurance Plan with OPD Cover In India

Health Insurance Plan with OPD Cover is an additional benefit which relieves you from the stress of additional expenses. OPD stands for Out-Patient Department. It is not always necessary that in case of an illness, you need hospitalisation. Mostly, consultation to the doctor, diagnosis and treatment are done which lead to high expenditure without a hospital stay. Out-patient department or OPD cover this expenditure which is incurred without an actual stay in the hospital but in illness which includes various procedures for its cure. It saves the policyholder from the increasing outpatient care expenses. In OPD, the out-patient care expenses are taken care of by a separate department which pays all the additional expenses that account for about 62% of overall health care cost.

OPD includes consultation fees of doctors, the medical pharmacy bills, expenses of pre-emptive check-ups, diagnostic test expenses, dental treatment of the insured, health check-up cost, etc. OPD or outpatient department cover is a new and attractive feature which is offered as a part of the health insurance policies from various insurance providers which include Apollo Munich, ICICI Lombard, ManipalCigna, Bajaj Allianz, etc.

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Advantages of Health Insurance Plans with OPD Cover

  1. Health Insurance Plans with OPD Cover is a value for money plan.
  2. It provides improved financial health at the time of medical uncertainties.
  3. It also provides you with Tax Benefits under section 80D of Income Tax Act,1961.
  4. In health insurance plans with OPD cover, you can claim all the expenses except expenses incurred during hospitalisation of the patient.
  5. It covers your pharmacy expenses as well, i.e all the medical expenses
  6. A major benefit it provides is that you can get attractive discounts upon renewal of insurance if you have not filed any OPD claim in the previous year of the policy.
  7. It serves a shorter waiting period as compared to other regular health insurance plans.
  8. It serves as an Ideal package for persons who have OPD expense requirements.
  9. Out-Patient Department expenses can be claimed within a period of 90 days of availing the Health Insurance Policy.
  10. Under the OPD cover, the sum is assured on the basis of the age of the insured not on the basis of 2r hours hospitalization, unlike the other regular health insurance policies.
  11. You can make multiple claims under the OPD cover within the same year until the limit of your claim is exhausted.

How to Choose the Best Health Insurance Plan with OPD Cover in India

When you are looking for best health insurance with out-patient cover, you should go for those health insurance providers who are offering more than cover hospitalisation expenses. Health insurance plan with an outpatient department is an ideal package for people who have OPD expense requirements. The best health insurance plan must have costs regarding the following which should not go disregarded during your selection of a health insurance policy in order to make the most benefit of the policy.

  1. Doctor’s Consultation fees
  2. Health check-ups
  3. Dental treatment of the insured
  4. Diagnostic Tests expenses
  5. Pharmacy bills
  6. Any other relevant cost

Best Health Insurance Plans with Out-Patient Department (OPD) Cover

Manipal Cigna ProHealth Accumulate Plan

The ProHealth Accumulate plan offered by ManipalCigna provides outpatient cover which includes dental treatment, consultation fees, optical care expenses, the pharmacy bills, and many more.

This plan has a feature that provides the plan holder with the benefit of a “Personal Health Wallet” that helps you to pay for all your OPD expenses and keep your accumulated amount/fund in the wallet.

It also provides additional benefit to policyholders of 5% hike on the amount which is available in the digital personal health wallet.

Features and Benefits of ManipalCigna PreHealth Accumulated Plan

  1. Facilitates carry forward of renewal time of the policy.
  2. Policy tenure ranges from one to two years.
  3. The money which is accumulated in personal health wallet does not expire, thus you can use it anytime later as
  4. it is carried forward when the policy is renewed.
  5. Various Sum Insured Options are: Rs ( 5.5/7.5/10/ 15/20/25 ) lakhs.
  6. OPD expenses or wallets option are available for various amounts such as Rs 5000/ Rs 10,000/ Rs 15,000/ Rs 20,000.
  7. It also offers reward points on participating in wellness programs conducted by it. The reward points can be used to add funds to the personal health wallet or can be adjusted against the premium of the policy.

Niva Bupa Heartbeat Health Insurance

The platinum variant of Niva Bupa Heartbeat Health Insurance covers Outpatient department expenses. It is a comprehensive plan for an individual as well as his family which allows carrying forward 80% of the unutilised outpatient treatment cover in a policy year. OPD expense is covered only under the platinum variant of insurance policy by Niva Bupa which range from Rs 10,000 up to Rs 40,000 depending upon the sum assured.

Benefits and features of Niva Bupa Heartbeat Health Insurance

  1. It has no restriction for entry age
  2. The policy tenures are one year and two years.
  3. If you opt for a two-year policy term, then you get discounts on the premium of the policy.
  4. The premium on the policy will depend on the age of the eldest insured member, thereby providing benefit to the insurer.
  5. The maternity benefits under this plan include cover for all the expenses which are incurred both before and after the childbirth.
  6. It facilities to carry forward 80% of the outpatient cover of the policy to the next policy year if it is not utilised during a policy year.
  7. It considers the age of the eldest member of the family to determine the premium on the policy.
  8. It also offers additional benefits like Tax benefit to the insured/policyholder under section 80D of Income-tax.
  9. It also covers diagnostic tests up to sub-limits.
  10. Under the platinum plan, for heartbeat individual floater the base sum that can be insured can be Rs 15 Lakhs, Rs 20Lakhs, Rs 50 Lakhs, and Rs 1 Crore, in which out-patient department expenses are covered up to Rs15,000; Rs20,000; Rs 35,000; Rs 50;000.
  11. For Heartbeat Family First plan, the base sum which is insured Rs 5 Lakh, Rs 10 lakh, and Rs 15 lakh for every insured person or a floater sum insured( it is available on a floating basis over a base sum insured to the policyholder). The OPD expenses covered is up to Rs 35,000.

Apollo Munich Maxima Health Insurance Plan

Maxima is India’s first 360 degrees plan which is offered by Apollo Munich Health Insurance (Now HDFC ERGO) Company. It is offered to an individual and a family. This is the most comprehensive health insurance plan with OPD cover in India. The family cover under this plan comes under floater basis, available only for 2 adults/2 adults+ 2 children. The most important benefit provided by the plan is the outpatient department, being the first Indian plan covering both the inpatient and outpatient medical expenses. Maxima plan provides coupons which can be used for a free consultation with any general practitioners or physicians or gynaecologist or paediatricians.

TypeTotal Number of Consultancy Coupons Provided OPD BenefitsHealth Check-up Facility annually within a specified network
1 Individual 4 CouponsDiagnostic Test, dental treatments, pharmacy bills, contact lenses, spectacles expenses= Rs 5,0001 Entitlement Certificate
2 Adults6 CouponsDiagnostic Test Expenses, spectacles expense, pharmacy bills, contact lens, dental treatment= Rs 5,5002 Entitlement Certificate
2 Adults + up to 2 Children8 CouponsPharmacy bills, spectacles and Contact lens expense, Diagnostic test, dental treatment= Rs 7,0002 Entitlement Certificate

Features and Benefits of Maxima Health Insurance Plan

  1. Policy Tenure is one year.
  2. The policy does not have a limit on maximum cover ceasing age.
  3. Under the floater coverage, the premium is determined on the basis of the age of the eldest insured member of the family.
  4. Entry age for the health insurance plan is a minimum 30 days and a maximum 65 years. It means is available for any child who is even 3 months up to 65 years of individuals.
  5. Its provides the benefit of carrying forward of the policy amount up to 50% to the next policy period if the out-patient treatment is not used in a policy year.
  6. The maternity benefits under this plan include cover for all the expenses which are incurred both before and after the childbirth.

Bajaj Allianz Tax Gain Plan with OPD Cover

The Tax Gain Plan is a family floater health Insurance policy offered by Bajaj Allianz Insurance Company. It provides cover for out-patient expenses as well as hospitalisation expenses both under a single policy plan. Tax Gain Plan is a good option for people who are looking outpatient department cover along with tax management. It provides the policyholder with cashless facility through a wide network of hospitals across the country.

Features and Benefits of Bajaj Allianz Tax Gain Plan with OPD cover

  1. The insured person can claim the policy for dental procedures and dental treatments under out-patient department section.
  2. It also covers ambulance charges up to Rs 1,000 in case of emergency
  3. It provides care procedures of 130 days as per the terms and conditions of the policy.
  4. Insurance policy covers claims for dentures expenses, crutches, spectacles under OPD section.
  5. There is no restriction of waiting periods in this policy under out-patient expenses.
  6. As suggested by the name, Tax Gain plan offers great tax benefits to the insured/policyholder as provided under section 80D of the Income Tax Act.
  7. It facilitates the claim of outpatient department expenses quickly and easily.

So, if you want coverage for OPD expenses, choose health insurance plan with OPD cover benefits and get covered for the minor expenses too.

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