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Why You Need an OPD Cover in Your Health Insurance Plan in 2022

OPD cover is a new feature that has been introduced as part of health insurance policies from several insurance providers. Health has always been a top priority among human beings. Considering the condition of this world amid a pandemic, the need for an all-inclusive insurance plan is at an all-time rise. In this digital age, the Bajaj Finserv Health app provides you with a health insurance plan that covers OPD expenses and many other benefits for a wide array of health issues.

OPD or Outpatient Department is a term used to refer to the treatment of an illness that does not require hospitalization. It includes the doctor consultation fee, follow-ups, diagnostic tests, and pharmacy Bills. It is one of the most crucial functions of any hospital. It is the first point of contact between the patient and the hospital staff. Therefore, it reflects the overall functioning of the hospital at a single glance.

Why Should You Buy a Health Insurance Plan With an OPD Cover?

A survey conducted in 2018 has observed that OPD expenses in India account for nearly 62% of the total medical care expenses compared to in-patient department (IPD) expenses. Many health issues do not require hospitalization and require treatment in an OPD. In these instances, you would be visiting the clinic of your doctor or the OPD of the hospital.

The doctor will then assess your condition that might include various diagnostic lab tests, following which the doctor will prescribe you medicines to treat the problem. In most regular insurance policies, these expenses are not covered, leaving you in a state of financial helplessness. There is a rising need in today’s time for insurance with an OPD cover due to the increasing number of chronic illnesses that add to the overall expenditure on medical treatment.

There is also a lack of healthcare records at the national level, causing hesitancy among insurers in underwriting the risks. Having a plan with OPD treatment can help us avail the best outpatient treatment without dealing with the consequences of operational flaws. This concept of including OPD expenses in insurance policies is new. In some of these policies, OPD cover is inclusive. Whereas in some others, it is to be purchased separately.

It is most beneficial for people prone to illnesses, those who have chronic or pre-existing conditions, which require regular checkups. Policy Holders can also claim tax exemption from the premium they have paid in insurance policies such as these. They will save on income tax deductions as there is no tax-deductible at the source.

You can also avail additional coverage on your insurance along with OPD expenses. Several insurance companies provide a cashless facility with an additional premium. The sum insured is determined based on the age of the one insured. Since it is a floater policy, the age of the older members is taken into consideration. Regular reimbursements on pharmacy bills and doctor consultation fees are given, along with several other medical bills, including contact lenses, spectacles, crutches, hearing aids, and dentures.

The insurance claiming process is simple and easy to avail. It makes it easy for people of any age to access these policies considering senior citizens would most benefit from them. OPD expenses are usually claimed within 90 days of availing of the policy. You have to file a claim for the expense incurred without hospitalization. The insured can also claim reimbursement on their expenditure more than once during the policy period. Since OPD services include several services and more transactions, the monetary value of these policies tends to be higher than a regular insurance policy.


Due to the pandemic, global financial and health crises have come to the fore. Both of these are directly linked. Although many require in-patient treatment, most of the population has resorted to outpatient treatment. This has increased the need for a digital platform where multiple medical services are available, including an insurance policy covering OPD services.

It is necessary to get OPD benefits in your insurance policy to cover daily medical expenses without any financial concerns. The Bajaj Finserv Health app is a one-stop repository for anyone looking to claim reimbursements on their OPD expenses.

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