What is Outpatient Health Insurance?

The importance of accurate diagnosis can’t be denied in terms of avail the right treatment.  However, with an increase in expenses in the medical sphere, diagnostic costs have also witnessed a steady rise in the past few years making outpatient health insurance a need. In 2022, India reported a clinical diagnostic market of 1.25 billion dollars. The number is expected to rise to 2.5 billion dollars by 2030.

With new entrants in the diagnostic sector, a further rise in expenses is expected, especially in speciality and high-end medical tests. Well, coping with these high medical expenses becomes easier with outpatient health insurance. This article will discuss outpatient insurance, its importance and why you should opt for outpatient health insurance. Let’s begin with the importance of OPD and how OPD insurance comes into the picture.

Why are OPDs Important?

OPD, stands for Out-Patient Department, is the department of a clinic/hospital responsible for the medical diagnosis of a patient. It may also include minor surgeries and screenings. OPD consultations help the physician to diagnose the illness and proceed with the treatment further. Post COVID, the strikingly rising number of OPD visits has made it easier for people to keep a close eye on their health. Not to forget, OPD expenses can be hefty as well depending on the types of diagnosis. Hence, Outpatient medical insurance can be a useful coverage that helps cover the OPD expenses of the insured individual. Continue reading to know more about OPD health insurance.

What is Outpatient Insurance or OPD Cover?

Health insurance plans have been evolving in adherence to the changing dynamics of healthcare needs. Striving to offer more comprehensive health insurance plans than ever before, health insurers have started incorporating new-age features and benefits. One such benefit that has gaining popularity recently is health insurance with outpatient coverage. A sedentary lifestyle has led to a rise in lifestyle diseases like diabetes, thyroid, hypertension, and so on. Although such diseases may not always require hospitalisation, regular doctor visits and consultations can seem never-ending. It can put considerable financial strain on the insured since regular tests, screenings, and doctor visits become a regular part of life. However, when you have health insurance with outpatient coverage, you need not worry about OPD expenses.

Types of OPD Care Covered in Health Insurance

Here is a list of coverage mostly provided under outpatient health insurance:

• Doctor's consultation
• Diagnosis of diseases
• Minor medical treatments/procedures
• Post-hospitalisation follow-ups
• Pharmacy expenses
• Investigative tests.

Who Should Buy OPD Cover in Health Insurance?

Although, anyone can buy outpatient health insurance, OPD cover may not be an in-built feature. Insurers like Care Health Insurance offers this as an add-on cover with the basic health insurance.  If you too are planning to buy one you should consider knowing these:

• People with a family history of lifestyle diseases are at a higher risk. Diabetes is one such common disease. If your parents or siblings are diagnosed with diabetes or such lifestyle diseases, it is best for you to go for regular health check-ups. For such a case, health insurance outpatient coverage can be quite beneficial. 
• For those who are looking for a comprehensive health insurance plan, having medical insurance covering outpatients can be a great choice! From in-patient hospitalisation, and daycare treatments, to out-patient, all the admissible expenses will be covered under a single plan.
• As you age, the risks of diseases and the need for robust health care increases. Regular check-ups become more important than ever before. Hence, older adults must have OPD coverage so the related admissible expenses can be covered.
• Those who have pre-existing diseases must opt for a comprehensive health plan that includes OPD coverage. Since chronic illnesses involve regular hospital visits, OPD coverage can benefit in many ways.
• When you have a financial cushion that is there to take care of your medical expenses, you can act worry-free. You no longer have to delay check-ups or compromise with a quality diagnosis and treatment.
• Outpatient medical coverage is not limited to individual health plans or to one insured member. Whether it is an individual health plan or a family floater plan, the option of purchasing OPD care coverage is generally available for everyone. Hence, all the insured members can enjoy OPD coverage.
• Health problems may not always require hospitalisation. Many people need proper diagnosis and the medicines can suffice their health needs. Outpatient health insurance can be a mental peace for you since you do not have to stress over OPD expenses.

Are Daycare and OPD the Same?

Insurance industry is full of jargons that may create confusion at times. When it comes to understanding outpatient health insurance, daycare cover is a common term that is mistakenly being used interchangeably.

Although both OPD and daycare covers do not involve in-patient hospitalisation expenses, these two are quite different. Refer to this table below to understand the differences between outpatient and daycare coverage of a health insurance plan:

Depending on the medical procedure, the costs of OPD and daycare treatments may vary. With Care Health Insurance, you get coverage for both OPD and daycare treatments as a comprehensive health insurance plan.

>> Also Read: Inpatient vs. Outpatient Care: What Your Health Insurance Covers?

End Note

Be it diagnostics, medical investigations, minor treatments, or pharmacy expenses, outpatient insurance can offer you a reimbursement for all these expenses. The continuous rise in medical costs and increasing cases of lifestyle diseases have made it important for people to invest in a comprehensive health plan. Adding OPD coverage to your health insurance can be of great significance, especially to those who are suffering from chronic diseases. You can get Care OPD as an optional cover along with your family health insurance and get coverage for 4 specialist consultations in OPD. Connect with our experts to know more about the plan and manage those unplanned yet necessary expenses.

Disclaimers: The above information is for reference purposes only: Policy Assurance and Claims at the underwriter's discretion.