All You Need to Know about OPD Health Insurance - Greyfont

All You Need to Know about OPD Health Insurance


Without health insurance, you are utterly exposed to a higher financial risk in case of an emergency hospitalization. You may have to break your bank to pay those hefty bills. So health insurance is the need of the hour these days!

Initially, health insurance actually covered your hospitalization expenses only. But with time realising the ever growing requirements of the customers, the insurers have started evaluating their products and try coming up with new features. As a result, now health insurance also offers the Out Patient Department (OPD)benefit as well.


What is an OPD health insurance cover?

OPD health insurance is an additional feature which can be availed on payment of an extra premium to enhance the basic policy cover. However, some policies come with this feature as in-built cover as well. It includes the expenses incurred other than the hospitalization expenses incurred by the insured that are covered by the regular health insurance.


Key / Salient Features of OPD Health Insurance cover include:

•    OPD insurance covers minor hospitalization or non-hospitalisation expenses for medicine, health check-up etc.


•    It is beneficial in covering the fixed medical expenses including regular chemist expenses.


•    The extra premium to be paid for OPD cover is eligible for tax benefits under Section 80D of the Income Tax Act, 1961.


•    The total amount to be covered by OPD cover is anyhow less than the premium paid for availing it


•    The insurer compensates for the expenses incurred in X-ray, blood check, doctor’s fees, medicine cost, daycare charges etc.


•    For not claiming the OPD insurance, some insurance providers offer discounts on the subsequent year’s premium as well.


Is it worth taking the OPD cover?

People with regular medication or having health issues such as diabetes, asthma etc. can take this cover, clubbing with their basic health insurance policy. You can consider this cover in case you have to spend an additional amount on regular OPD visits or if you haven’t exhausted the deduction limit under Income Tax.


Let’s illustrate-

Imagine you have a health cover of Rs. 5 lakh which is a floater cover, where the premium for it is Rs. 10,000. Now, analysing your needs, you decide to take an OPD cover of Rs. 14,000 and pay a premium of Rs. 16,000 additionally. You can claim up to this limit, where you can avail tax benefit for the premium paid for both the policies.

Thus, OPD cover is a beneficial bet for the people who incur fixed or regular medical expenses. However, taking this cover will also mean an additional burden if you don’t have a fixed medical expense. It’s better to insure yourself with a regular health insurance plan and spare a fixed amount separately on a monthly basis for covering those abrupt medical expenses.  Even if you don’t need the money, fortunately, the fund is intact and would have grown to aid you in the future.


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