Importance of OPD in Health Insurance Post COVID-19

Not all medical conditions necessitate hospitalisation. However, even while hospital stays and procedures are covered by insurance, OPD visits can be expensive, particularly in the wake of COVID-19, when we are all more careful and seek medical attention for even the smallest issues. OPD (out-patient department coverage) in health insurance is the solution.

Why? Because People Are at a Risk

During the COVID-19 pandemic, there has been a sudden increase in the need for ICUs. A patient who is corona positive needs attention immediately and even needs to be admitted to the ICU in some cases. In such situations, people in the middle-class sector face the highest amount of problems. A health insurance policy ensures that the Covid-19 positive patient gets timely treatment. 

Covid-19 spreads from one person to another and is a contagious disease. It can be very stressful and hectic to incur hospitalisation and pharmacy costs. A health insurance policy ensures that the infected patient or patients are covered financially. 

Expenses Are Covered When You Don't Need Hospitalisation

An important reason you should get OPD covered in health insurance is that your health insurance will cover you even when you are not hospitalised. The trivial costs are covered, and as medical costs rise, even considerably more extensive coverage may not be enough.

Especially during the COVID-19 time when people are scared to visit hospitals, treatment through OPD can be a life saviour.

Importance of OPD in Health Insurance Post COVID-19

Covid after-effects might be here to stay. People often complain of inflammation, breathing issues, and heart complications. Due to this primary reason, OPD centres now have longer queues and meanwhile, OPD expenses can be costly. Hence, you need an OPD cover in health insurance to save yourself from high expenses. 

Another benefit of an OPD cover in health insurance is that it helps you pay for pharmacy and consultation while securing your wallet. So, make sure that your health insurance covers your OPD expenses. 

OPD Health Insurance Benefits

1. You Save Out on Consultation Fees

It might be possible that you try to stay away from consulting a doctor due to their high fees. OPD or out-patient coverage in your health insurance ensures that you get advice at the right time from the right experts. It saves money, which is especially important for families with children or dependents owing to frequent health visits.

2. Diagnostic Tests are Covered

You need to undergo some examinations and tests to reach the root cause of the problem when you fall ill or if there is an emergency. But you may be concerned about the hefty expenses. The best health insurance makes sure you don't have to break the bank to get the testing done.

Some tests such as thyroid, liver function, and lipid profile may cost up to Rs 7k in metro cities. Your health insurance's OPD coverage offers financial assistance and pays for hospital diagnostic expenses.

3. You can Pay the Pharmacy Bills

The cost of medicines is rising at an astounding rate of 8% annually. Many people stop their medication due to the high costs of medicines, and some even leave the treatment in between. 

Health insurance with OPD benefits includes paying for the pharmacy bills. You can get your treatment done and relieve yourself of the financial burden.  

4. COVID Vaccination is Included

Indians are pro-covid vaccinations and are happy being a part of the drive. Over half of India's population has been properly vaccinated, while the other half is yet to receive it! However, the Covid-19 vaccination costs have increased by more than 6 times in private hospitals and metro cities. An OPD health insurance that covers Covid-19 helps you have your vaccination and save yourself from the burden of the sky-high costs. 

What Should You Consider Before Buying Health Insurance?

• One should be aware of all the terms and conditions of health insurance and always have OPD-covered individual health insurance. 
• You should always keep your insurer informed about any pre-existing diseases. 
• You should never forget the covers provided, maximum limits, and the waiting period. 
• Ensure you know what you're buying, such as the deductibles, waiting period, and cumulative bonuses. 
• Choose a policy with a high insurance sum, as medical costs are touching the roof every year. 
• It is best to get your health insurance as soon as possible as you will have to pay a lower health insurance premium.
• Ensure that you renew your health insurance regularly, as you can lose out on some benefits if there is a gap between the expiry and renewal.

Which Insurance Company Should You Go For?

The options for health insurance these days are limited, especially when it comes to providing full coverage. So make sure to research your options carefully and select the top one. One such insurance provider that offers complete coverage for all of your medical requirements is Niva Bupa.

Why Choose Niva Bupa?

Niva Bupa provides policies that ensure the amount is always sufficient, and you get adequate coverage to financially protect you and your family. Visit Niva Bupa today and get your OPD-covered health insurance in this COVID-19 time.

Frequently Asked Questions

1. Can OPD charges be covered in health insurance?

   Yes, OPD charges can be covered in health insurance through specific OPD coverage plans that include doctor consultations, diagnostic tests, and prescribed medications without requiring hospitalisation. Most insurance companies offer OPD cover as an add-on benefit for an additional premium. 

2. What is the OPD limit for health insurance?

   OPD limits vary by insurance provider and plan type, usually ranging from ₹5,000 to ₹50,000 annually. Some plans offer specific consultation limits, such as up to four visits to general physicians and specialists per year with reimbursement caps per consultation.

3. How to claim OPD bills in health insurance?

   OPD claims work through reimbursement by submitting necessary bills, prescriptions, and medical reports to the insurance provider. You need to fill out claim forms, attach original receipts, doctor prescriptions, and diagnostic reports. Some insurers process reimbursements quarterly, whilst others may offer faster processing depending on the plan. 

4. Can OPD be cashless?

   Yes, many insurance providers now offer cashless OPD services at their network hospitals and clinics. Cashless OPD coverage allows you to receive treatment without upfront payment, as expenses are settled directly between the hospital and the insurance company. 

5. Can I claim OPD in Niva Bupa Health Insurance?

   Yes, Niva Bupa offers OPD coverage for outpatient consultations, diagnostics, and medications through their various health insurance plans. Our GoActive plan provides up to 10 OPD consultations annually (based on plan eligibility) with both cashless and reimbursement options. Coverage includes specialist consultations, general physicians, and diagnostic services within their network.