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By clicking Start Now, you authorize Niva Bupa to Call/SMS/Whatsapp on your registered mobile overriding DNCR.Health Insurance with OPD Cover in India
Health insurance with OPD cover in India offers comprehensive protection beyond hospitalisation. It helps manage routine healthcare expenses such as doctor consultations, diagnostic tests, and pharmacy bills, ensuring better financial planning and peace of mind.
Network of 10,000+ cashless Hospitalisation
30 Mins Cashless Claim Policy
1.5 Crore+ Happy customers
Why Choose Niva Bupa?
Trusted by over 1.5 crore+ happy customers, Niva Bupa (formerly known as Max Bupa Health Insurance) provides a wide range of health insurance plans to suit every need
30 min
Cashless Claim Processing 1
15 Lakh+
Claims paid since inception 2
1.5 Crore+
Happy customers served till date
Custom Health Insurance Plans designed for You
A plan that rewards you for starting young
Starts from
₹8,6321
Annual Premium
₹5,00,000
Sum Insured
- Lock the age, pay premiums as per entry age till you claim
- Don’t lose what you don’t use. Carry forward the balance sum insured
- Maternity coverage including IVF, Adoption and more
- Use and get back your base coverage. Unlimited times and forever
Nothing Seems Impossible. The Most Comprehensive health insurance plan.
Starts from
₹7,8212
Annual Premium
₹5,00,000
Sum Insured
- Save as you age. Pay as per entry age, until you claim.
- Use and get back your base coverage. Unlimited times and forever.
- Don’t lose what you don’t use. Carry forward the balance sum insured
- Up to 30% discount on renewal premium basis step count
A Health Insurance Plan that works your way
Starts from
₹4,8043
Annual Premium
₹5,00,000
Sum Insured
- Pay Apne Hisaab se! Flexible or One Time. Sooner the payment, higher the discount
- Get 50% of your premium back, accumulate it, and even get 10% bonus for life. No waiting periods or exclusions on this amount.
- Get ₹5,000, if treatment taken in any Govt. hospital and claim not paid under this policy
- Access unlimited digital consultations with general physicians through our mobile app.
A comprehensive health insurance plan,with coverage for you and your family according to your needs and lifestyle.
Starts from
₹11,5714
Annual Premium
₹5,00,000
Sum Insured
- Comprehensive coverage up to ₹3 Cr
- In-built travel insurance coverage for multiple trips in a year
- Modern Treatments coverage
- Maternity (worldwide) and new born baby cover
The Smart Health Insurance Plan with Smart Feature to keep your family protected
Starts from
₹11,7755
Annual Premium
₹5,00,000
Sum Insured
- No Room Rent Capping
- Modern Treatments Covered up to Sum Insured
- Hospitalisations of 2 hours or more covered
- One time refill of Base Sum Insured, even for same illness.
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How does Our Claim Process work?
Get to know the steps involved in the claim Process, Whether it is a planned or emergency hospitalisation. Filling a claim is made easy by choosing any of the following ways:
Hospital Admission:
Get admitted to a Niva Bupa network hospital.
Identification:
Present your Niva Bupa Health Card or policy number along with valid ID (Passport/PAN card/Voter’s ID) to the hospital staff.
Pre-authorisation:
The hospital will verify your details and submit a pre-authorisation request to Niva Bupa.
Niva Bupa Confirmation:
After verification, Niva Bupa will confirm coverage to the hospital via fax and email, and notify you by text and email, typically within 30 minutes of the request.
Final Settlement:
Upon completion of treatment and necessary formalities, the hospital will settle the claim with Niva Bupa according to your policy terms.
Benefits of Health Insurance Plans for 10 Lakhs
There are several benefits of health insurance 10 lakhs. Some of them are mentioned below.
Cashless Hospitalisation:
10 lakh health insurance plans provide cashless hospitalisation facilities, eliminating the need for policyholders to pay upfront for medical expenses. This means policyholders can access medical treatment at any network hospital, both locally and nationally, without having to make immediate payments
Understanding OPD Cover in Health Insurance
OPD coverage meaning is a feature in certain health insurance policies that reimburses you for medical expenses that do not require hospitalisation. These include routine doctor visits, health checkups, dental consultations, physiotherapy, eye tests, and even medicines and diagnostic tests. Unlike regular health insurance, which activates only during inpatient care, OLD coverage ensures you are also financially supported for day-to-day medical needs.
Health insurers either offer this as an add-on rider or include it in comprehensive plans. The reimbursement method may vary; some require submission of bills, while others may have a cashless OPD network.
Comparing OPD Healthcare Insurance Plans
Availing diagnosis and treatment services at the OPD requires you to spend a maximum of 24 hours at the hospital. The expenses incurred due to these services are included in several medical plans. If not, you can also opt for an add-on cover to include these expenses.
To make an informed decision about the best health insurance with OPD cover plan for you, compare your options based on the following factors.
Coverage: Check what is covered under the policy. Different insurers may offer varying coverage, so it's essential to compare the policy's features. Look for coverage for diagnostic tests, consultation fees, medical bills, and prescription medication.
Network Hospitals: Check if the insurer has a broad network of hospitals and clinics where you can access cashless treatment. If you require frequent OPD visits, ensure the network hospitals are in proximity to your residence or place of work.
Claim Process: Understand the claim process, including the documentation required for reimbursement. Check if the insurer offers a cashless claim process where you don't need to pay out of pocket. Cashless health insurance plans are usually more convenient than those based on the reimbursement model.
Waiting Period: Check if there are waiting periods for specific illnesses or medical conditions before you can claim benefits. Some insurers may have a waiting period of up to two years. Due to a long waiting period, patients sometimes delay their visit to a doctor's clinic, which can prove harmful in the long run.
Co-payment and Deductibles: Check if the policy has a co-payment or deductible, which is the amount you need to pay before the insurer covers the remaining cost. A high deductible will lead to higher out-of-pocket expenses but lower premiums.
Premium: Compare premiums for different policies and understand the factors that affect them, such as age, medical history, and coverage amount. To estimate premiums for different plans, consider using an online premium calculator. It will help you select the best health insurance policy to suit your budget.
Reviews and Ratings: Check online reviews and ratings of the insurer, especially from existing policyholders, to understand their experiences with the insurer's claim process and customer service.
What Does OPD Cover Typically Include?
While the scope of OPD cover can differ from one insurer to another, a typical OPD benefit in Indian health insurance may include:
Consultation Fees: Reimbursement for general physician and specialist consultations.
Diagnostic Tests: Blood tests, X-rays, MRIs, and other diagnostic tests as prescribed.
Pharmacy Expenses: Coverage for prescribed medicines and drugs.
Minor Medical Procedures: Treatments like wound dressing, minor fractures, and stitches.
Dental Care: Basic dental procedures like cleaning, fillings and extractions.
Eye Care: Eye tests and consultations with ophthalmologists.
Vaccinations: In some cases, even preventive care, such as flu shots, is also covered.
Why is OPD Cover Becoming Important in India?
OPD cover is becoming increasingly important in India due to the rising costs of medical consultations and diagnostics that don't require hospitalisation. It offers financial support for everyday healthcare needs, making health insurance more relevant and comprehensive.
1. Rising Outpatient Costs
Even though OPD visits may seem minor compared to a hospital admission, their costs can add up quickly, especially for families with children, senior citizens or those managing chronic conditions like diabetes, asthma, or hypertension. A couple of doctor visits, tests and medicines every month can run into thousands of rupees.
Adding OPD cover to your health plans helps mitigate these recurring costs without dipping into your savings.
2. Healthcare Inflation
Indian’s healthcare inflation is among the highest in the world, driven by increased consultation fees, diagnostic rates, and medicine prices. OPD cover ensures your health insurance remains relevant and useful, even for non-emergency needs.
3. Changing Healthcare Trends
Today more people are opting for daycare and outpatient procedures due to technological advancements. Conditions that once required hospitalisation can now be treated through same-day consultations or minor procedures. OPD coverage helps support this shift by covering such treatments under insurance.
4. Preventive Health Care is Gaining Ground
With growing awareness of health and wellness, people are becoming more proactive about preventive health checkups and screenings. OPD benefits encourage this behaviour by offering reimbursements for annual tests and routine medical advice.
Who Should Opt for OPD Cover?
Not everyone may need OPD cover, but for many, it can be a game-changer. Whether you're dealing with frequent doctor visits, managing a chronic illness, or simply want more value from your health insurance, OPD cover offers added convenience and financial relief for everyday medical needs.
1. Young Working Professional
While they may not need frequent hospitalisation, young adults often visit doctors for general illnesses, dental concerns, and eye check-ups. OPD cover ensures these expenses are accounted for.
2. Families with Children
Children often require regular visits to paediatricians, ENT specialists, dentists, and undergo vaccinations. Having an OPD plan means parents don’t have to worry about regular check-up costs.
3. Senior Citizens
The elderly often need to manage multiple medical appointments, diagnostic tests, and prescription medications. OPD cover can significantly reduce their financial burden.
4. People with Chronic Illnesses
Patients with diabetes, cardiac conditions, and asthma require ongoing treatment and regular consultations. OPD cover supports the long-term management of such conditions without requiring hospitalisation.
5. Self-Employed Individuals
Freelancers and business owners often lack access to employer-sponsored health plans. A policy with OPD cover offers more holistic protection and ensures access to healthcare without straining their income.
Final Thoughts
Health insurance with OPD cover is not just an upgrade, it’s a smart, proactive step toward managing everyday healthcare expenses. As India’s healthcare model continues to move toward outpatient-based services and preventive care, OPD cover can bridge the gap between traditional health insurance and real-world medical needs.
If you're evaluating new insurance options or planning to renew an existing policy, consider one that includes OPD cover. It not only adds more value to your investment but also gives you the confidence to prioritise your health without financial hesitation.
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Watch what our customers are saying. REAL STORIES with REAL IMPACT!
Vippan Kapur
It is unbelievable how Niva Bupa claim team came to my aid, Monday to Sunday no day off.
Meenakshi Khanna
Within few hours we got the claim number and in the next three days the amount was reflected in our bank account.
Vijay Kapoor
With the help of Niva Bupa Health Insurance, I was able to get my son treated without worrying about the high medical cost.
Diviay Chadha
Whenever we have filed for a claim with Niva Bupa, the process was very smooth and people were very helpful.
Parveen Singh
The Niva Bupa team was extremely helpful, be it day or night, someone was always available.
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