Understanding Health Insurance With OPD Cover

Coverage for health check-ups with OPD cover

Initially, health insurance policies covered only hospitalization charges. However, with time it has evolved and expanded its scope to provide financial protection against a much wider range of health requirements. Today there are health insurance plans that also offer an OPD cover that covers smaller medical interventions that do not require hospitalization like consultations for minor health issues, diagnostic tests, pre-emptive check-ups, etc. In certain cases, an OPD cover also acts as a supplement for another add-on covers. For instance, if you don’t have a maternity insurance, your OPD cover at least covers the costs of the regular check-ups you need to go in for.

Why opt for health insurance with OPD cover?

Today no one is willing to take any chances with their health. With environmental hazards and lifestyle diseases increasing at an alarming rate, people are visiting hospitals more and more frequently for smaller medical interventions like consultations for minor health issues, diagnostic tests, pre-emptive check-ups, etc. However, these visits aren’t cheap, especially in bigger cities. It is estimated that almost 62% of an individual’s healthcare expenditure consists of payments for an outpatient visit. It makes eminent sense to buy an OPD cover in such a situation.

What is OPD insurance?

OPD cover is an add-on cover offered by certain health insurance companies in India. You can opt for it by paying an additional premium.

Benefits of health insurance with OPD cover

• Minor expenses are covered- Emergencies that require hospitalization are rare. Our health expenditure usually comprises of expenses made on routine health check-ups, diagnostic tests and X-rays etc. A plan with OPD benefits covers such costs which are excluded in ordinary plans.

• Pharmacy expenses are covered- An OPD cover is extremely beneficial for old people, young children, or others suffering from ailments requiring recurrent medication.

• Value for money- With the OPD cover allowing for multiple claims, it provides great value for money, especially for those who need to see the doctor frequently, since the OPD premium in such cases works out to be lesser than OPD expenses incurred.

• Tax benefits- Plans with OPD benefits offer more tax benefits than basic health insurance policies as per Section 80D of the Income Tax Act, 1961.

• Attractive discounts- If no OPD claim has been filed in the previous policy period, health insurance providers offer a discount on the OPD premium upon renewal.

• Shorter waiting period- OPD health insurance plans come with a shorter waiting period than regular health insurance plans.

Consideration to keep in mind before purchasing OPD cover

Features such as a shorter waiting period and pharmacy benefits may make it a viable alternative that cushions at least a part of your medical expenses in case you have been unable to purchase plans with more stringent features such as a maternity plan. However, while an OPD cover does offer some valuable benefits, purchase it only if your potential use of the cover is likely to get the benefits to outweigh the costs.


ManipalCigna Health Insurance Company Ltd (Formerly known as CignaTTK Health Insurance Company Limited) | CIN U66000MH2012PLC227948 | IRDAI Reg. No. 151 
Reg. Office: 401/402, 4th Floor, Raheja Titanium, off. Western Express Highway, Goregaon (East), Mumbai- 400 063 | Toll free number – 1800-102-4462 | Website address –
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