Health insurance advice: why you should cover OPD treatments


In the event of serious illness or hospitalization, the costs are covered by your health insurance. However, a number of follow-up visits to doctors and diagnostic centers before and after hospitalization often account for an equally large part. When not covered by health insurance, the burden of these expenses can burn a hole in one’s pocket.

Although health insurance plans are easily accessible at the click of a mouse, the detailed information of these that benefit policyholders is often not at their fingertips. Many insurance companies prefer to keep OPD treatments out of plans, from which most policyholders cannot take advantage of them. The OPD guarantee is intended for anyone who believes they can incur health expenses without suffering from a serious and prolonged illness requiring hospitalization.

Here we will briefly explain why insurance companies try to avoid adding OPD plans and why policyholders should add the same in their health plans.

What is OPD treatment?

Outpatient department, or simply, OPD treatment is where certain treatment or diagnosis of a certain type of disease on the advice of a doctor. This involves the patient visiting the clinic or one of the doctors consulting rooms.

Why do insurance companies avoid covering DPOs?

OPD treatments are frequent in nature and include treatment for baseline viral fever, infections, regular checkups, or ongoing medication monitoring. Therefore, many insurance companies keep OPD treatments out of the scope of the policy as it comes at a huge cost to them.

“If an insurance plan includes an elderly person, children, or someone with a prolonged illness that requires frequent visits to the doctor for regular checkups and consultations, OPD coverage is definitely part of it. Otherwise, it is not suggested that OPD be part of the basic plan, because a healthy young person does not need frequent visits to a doctor.In addition, OPD comes with sub- limits and OPD requires a limited cost involvement that an insured can easily afford,” said Naval Goel, CEO and Founder of Living mint.

Why do you have to include OPD in the insurance cover?

Experts say that due to rising medical costs and the growing use of online consultations, the inclusion of OPD coverage is very important “It is important that policyholders purchase OPD coverage, especially when consultations regular routines are a must due to a pre-existing condition,” Naval Goel, CEO of PolicyX, said.

“With the effect of Covid-19, hospital visits have become more risky due to the high risk of infection. Thus e-consultations have become a must for the masses to consult doctors to reduce exposure to COVID19. It depends on the insured whether they need regular consultations and follow-up due to pre-existing conditions. In such a case, the OPD and online consultations offer good options to the insureds”, said Goel added.

Abhishek Misra, CEO and Senior Director of Bonanza Insurance, said policyholders should go for it (OPD coverage) even if they won’t use it. “That’s how things work with medical insurance. It is intended for healthy people,” Misra said. Living mint.


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