10 Best Outpatient Department (OPD) Health Insurance Plans in India 2022

Not always do people get admitted to the hospital unless the ailment or illness requires surgery and post-op recovery. But it is for doctor consultations, diagnosis, and minor treatments that people frequent hospitals, and these are categorized as OPD (Outpatient Department). It is estimated that OPD accounts for 60% of the healthcare costs in India, which is relatively high, which is the main reason why you need to avail yourself of health insurance with OPD cover.

Mini Kapoor works as a junior chef at a significant five-star hotel. She has suffered from a sinus infection since the age of 15. Though she is 28 years old, she still gets affected by a sinus that worsens during winters. Being a chef, she felt her running nose and constant sneezes would make her look bad in the kitchen, which is not hygienic. So, she consults a doctor regularly and buys nasal sprays and medicines, which costs at least Rs. 5,000 every month. Mini had taken a health insurance policy with OPD coverage, which is greatly helping her to cover the monthly medical expenses.

What is OPD?

The full form of OPD is the Outpatient Department. A patient who first arrives at the hospital goes straight to OPD, and then the OPD decides the unit to which a patient will go. The OPD is designed for diagnosis, diagnostic tests and minor surgical services for patients that do not have to be admitted to the hospital.

What does OPD treatment mean? 

For all those looking to know about what is OPD? Here is a simple explanation: OPD or Outpatient Department treatments are performed in a clinic or a hospital on the advice of a doctor, without the need for hospitalization. For example, minor surgeries related to fractures, cuts, dental treatments, etc., fall under the OPD category. The general ward in the hospital is where all OPD cases are handled. They are usually completed within a few hours, and the patient can leave within a matter of a few hours.

Benefits of OPD Coverage in Health Insurance

While a health insurance policy is very helpful to take care of the medical expenses during significant illnesses, the OPD cover can cover non-risky health issues. There are even more advantages in availing of a policy with OPD coverage, which is listed below:

• It helps you claim your medical expenses on non-emergency visits to the hospital apart from hospitalization.
• It covers high medical bills, especially if you have a regular quota of medicines to buy every month.
• Useful for patients who frequent hospitals for regular OPD consultation and check-ups
• Assists in not burdening yourself with regular out-of-pocket expenses towards medical costs.

OPD Insurance Plans: Very recently, health insurance companies have started launching policies that provide health insurance with OPD. To help you choose better, we are listing the best 10 OPD insurance plans in India, based on features, sum insured, and facilities offered to policyholders.

List of 10 Best Health Insurance Plans with OPD Cover in India for 2022

To know more about the top 10 health insurance plans with OPD cover in India, refer to the list below:-

1. ICICI Lombard Complete Health Insurance
2. Manipal Cigna Lifetime Health
3. Apollo Munich Maxima
4. Bajaj Allianz Tax Gain Plan
5. Max Bupa Heartbeat
6. Aditya Birla Activ Health Enhanced Plan
7. Bharti AXA Health AdvantEdge
8. Care Health Insurance Plan
9. Digit Health Care Plus OPD Insurance Plan
10. SBI Arogya Plus Plan

1. ICICI Lombard Complete Health Insurance

ICICI Lombard health insurance brings this comprehensive policy for you and your family that provides an option to include all the family members into one policy under the family floater option. Choose coverage based on your requirements such as maternity cover, OPD claims, critical illness cover, and donor expenses cover, etc. Some of the unique benefits of this policy include no limit on hospital room rent, no co-pay, no pre-medical check-up up to 45 years of age, and 2 complimentary health check-up coupons every year.

2. Manipal Cigna Lifetime Health

The new Manipal Cigna Lifetime Health plan from Manipal Cigna Health Insurance Company assures of providing a comprehensive health policy with sum insured up to Rs 3 crores for domestic and global coverage each. They also guarantee to cover Inpatient Hospitalization in India, No cap on room rent under global coverage, and Unlimited restoration of Sum Insured for unrelated illnesses for coverages in India.

3. Apollo Munich Maxima

The Maxima Health Insurance plan from Apollo Munich provides OPD insurance coverage for day-care expenses as well as a cashless facility for diagnostic tests, pharmacies, dental care, and optical care. While the minimum age to take the policy is 91 days, the maximum age for entry is 65 years. It includes in-patient treatment, pre-hospitalization/post-hospitalization expenses/ daycare procedures/ maternity expenses, etc.. Policyholders are also offered complimentary health check-up within the network hospital. 

4. Bajaj Allianz Tax Gain Plan

This health insurance plan from Bajaj Allianz provides coverage for hospitalization and OPD expenses as well. Added to it, it offers personalized service for senior citizens,  cashless claim facility, ambulance cover, co-payment waiver, etc. Tax benefits are also extended to the policyholder under section 80D of the Income Tax act. According to your healthcare needs, they also provide affordable premium options starting from Rs.5000 for you to choose from.

5. Max Bupa Heartbeat

Heartbeat is a comprehensive individual/ family floater plan from Max Bupa health insurance that offers coverage starting 5 lakhs. With a minimum sum insured of Rs.15 00,000, the plan provides a diverse set of benefits such as no room rent cap, international coverage, reimbursement of OPD treatment, Loyalty bonus, maternity cover, etc. They also provide coverage for treatments taken under Ayurveda, Unani, Siddha, and Homeopathy. 

6. Aditya Birla Activ Health Enhanced Plan

Aditya Birla Activ health enhanced plan is a unique health insurance offering from Aditya Birla as it includes Health Insurance + Wellness Benefits + Chronic Care cover in a single policy. It provides coverage for modern treatment methods like robotic surgeries, oral chemotherapy, etc. along with coverage for dental consultation and mental illness hospitalization. Through the wellness program, one can earn up to 100% of premiums by staying healthy. The sum insured of the policy ranges from Rs. 2lakh to Rs. 2 Crore.

7. Bharti AXA Health AdvantEdge

Bharti AXA Health AdvantEdge policy offers a host of benefits apart from regular hospitalization. It includes OPD cover for dental and medical expenses, vaccination for newborn baby in the 1st year, domestic air ambulance, domiciliary hospitalization, etc., in addition to wellness & value-added services. The minimum sum insured starts from 2 lacs and goes up to 3 crores.

8. Care Health Insurance Plan

Care health insurance plan assures insurance with OPD cover for coverage starting from 5 lakhs up to 6 crores with unique benefits that include hospitalization charges, daycare/ OPD expenses, Domiciliary hospitalization, Co-payment waiver, a vast network of hospitals to provide cashless treatment, etc., OPD insurance coverage is provided as an optional cover, that can be used to claim an amount equal to their medical bills at the time of reimbursement.

9. Digit Health Care Plus OPD Insurance Plan

The Digit Care Plus is a health insurance policy with OPD expense coverage that is designed to provide coverage for Outpatient Department (OPD) treatment expenses incurred by the policyholder during the policy term. The policy also covers COVID-19 coverage along with other regular features that can be availed online through their website.

10. SBI Arogya Plus Plan

The Arogya Plus plan from SBI insurance could be the right health insurance policy for you in case you are looking for OPD coverage for the entire family along with in-hospitalization expenses of the sum insured up to Rs 1 lakh, 2 lakh, and 3 Lakh with flat premium rates for a year. No medical tests are required for those up to 55 years with no medical history, and there are multiple optional covers available under the plan such as HIV/AIDS cover, Mental illness cover, Genetic disorder cover, etc.

What Is Covered Under OPD Health Insurance?

The inclusions under OPD health insurance policies include:

• Doctor’s Consultation Fees
• Diagnosis Tests or X-Rays
• Crutches, Wheelchair
• Routine Check-up, Vaccination
• Hearing Aid
• Pharmacy Expenses
• Minor Surgeries & Dressing
• Dental Treatment
• Spectacles, Contact Lenses

What Is Not Covered Under OPD Health?

The exclusions under OPD health insurance policies include:

• Physiotherapy
• Cosmetic Treatment Dxpenses
• BP Monitors, Thermometers
• Vitamins and Supplements
• Dietician Fees and Consultation

With a variety of OPD insurance plans available from insurance companies, it is up to you to decide on the beneficial policy taking into account your requirements, medical history, premium paying capacity, etc.