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Significance of buying a Separate OPD Cover in India
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Significance of buying a Separate OPD Cover

Hospital visits are seldom easy on your pockets. Anyone who has visited a hospital in recent times would know the expenses have sky-rocketed over the years. And the predictions for the future aren’t too optimistic as well. Medical inflation has always been one of the highest. Thus, opting for a health insurance plan is one of the smartest decisions that you can make.

However, health insurance plans do not always offer OPD cover as a part of the policy. And if you feel it is alright not to have an OPD cover, that might not be entirely true. Given the higher expenses of inpatient hospitalisation, it is only natural to believe that inpatient expenses are the highest. However, data suggests otherwise.

Over 62% of all the medical expenses went towards OPD expenses and not inpatient expenses as one might expect. Though the treatment costs are higher for admitted patients, OPD charges accumulate over time and can set you back by a good margin.

What is OPD Cover?

OPD or outpatient department is where one patient visits to receive treatment or medical attention without having to be admitted to the hospital. You can visit the outpatient department for consultations or diagnosis as well. 

Some common examples of treatment covered as a part of the outpatient department are dental treatment, eye care treatment, minor surgeries, diagnosis, etc. And the amount of money that you spend on any of these is known as OPD expenses.

Significance of buying a Separate OPD Cover in India

OPD Cover in Health Plans

In simple terms, a health insurance plan that offers coverage for expenses related to the OPD department is said to have OPD cover. There are two different ways by which you can avail the benefits of OPD cover. Firstly, if the OPD cover is already bundled along with your health insurance plan. 

Alternatively, your health insurance plan does not have OPD cover and you need to buy the same separately. In either case, here are some prominent reasons why you should opt for an OPD cover.

  • Even though the OPD expenses might seem less as compared to inpatient expenses, OPD visits are more frequent. And they add up over the year. As much as 62% of all medical expenses are OPD related.
  • As more people explore workouts and gyms, injures related to both become even more common. 
  • Senior citizens might be frequent visitors to the outpatient department. Having an OPD cover can help them save a considerable amount of money.
  • The number of visits to doctors has constantly been on the rise. Given the trend, having adequate coverage isn’t a luxury anymore. It is more of a need.


Importance of Buying a Separate OPD Cover

Buying a health insurance plan brings a lot of perks to the table. However, a separate OPD Health Insurance cover can accentuate those benefits by some margin. Here are some of the major benefits of buying a separate OPD cover.

  • You can claim for expenses related to non-emergency visits to the hospitals or other visits that do not require any sort of hospitalisation.
  • People who visit the OPD frequently will save a considerable amount of money with the help of this cover.
  • People who buy a regular set of medicines on a monthly basis, the cover can help them save on hefty medical bills.
  • The cover helps you to cut down regular out of the pocket payments towards medical expenses.
  • Depending on your insurance provider, you can either opt for a cashless claim in a network hospital or proceed with reimbursements of the expenses already made.
  • Working individuals with a group health insurance plan can improve the coverage of their plans, which are otherwise a bit limited. A health insurance plan along with OPD cover will complement your group health insurance.
  • The OPD cover can be particularly beneficial for senior citizens. OPD treatments include dental treatment, minor surgeries, consultation, etc. There is a high possibility of them being frequent visitors to the OPD.
  • Some insurance providers offer coverage for accidental emergencies as well. 
  • You can opt for a family floater plan as well, ensuring cover for your loved ones.


OPD cover along with a health insurance plan offers a lot of useful features and benefits. However, the plan has some exclusions like any other insurance plan. In simple terms, your policy does not hold good for the following conditions.

  • The policy does not cover treatment for substance abuse
  • The policy does not cover treatment for any illegal activities
  • The policy does not cover cosmetic surgeries
  • The policy does not cover expenses related to injuries that are self-inflicted


An OPD cover along with your health insurance plan offers a lot more benefits than you would have imagined. The cover is easy to add to an existing plan and enhance its capabilities.

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