OPD Cover Plans After Kovid-19, it has been seen that instead of taking plain health insurance, people are preferring such a cover with which OPD cover is also available. Right now this trend is more in Tier-1 and Tier-2 cities.
New Delhi, Manish Kumar Mishra. The world after the Covid-19 pandemic has completely changed the way people think. From people’s health to their finances, from the way they work, there have been major changes in every field. Even the insurance sector has changed a lot. The Corona epidemic has made people very aware about the health insurance policy. At the same time, the structure of the policy that the consumer wants now has evolved a lot.
According to industry data, consumers no longer want run-of-the-mill policies that only cover hospitalization expenses. Post COVID-19, they are more inclined towards buying a comprehensive plan that covers OPD expenses as well. Covers expenses associated with visiting a clinic, hospital or related facility for diagnosis or treatment on the advice of a medical specialist inside OPD. For this the person does not need to be admitted to the hospital as an inpatient.
Amit Chhabra, Head-Health Insurance, Policybazaar.com, says, ‘An OPD cover comes with more benefits and gives you a comprehensive cover – from something as simple as fever to complex day-care procedures. Apart from this, it also compensates you for those hefty pharmacy bills and diagnostic tests. Overall, these medical expenses can add up to a lot in the long run and you may end up with a financial blow if the OPD is not covered. Hence in today’s times, it is an essential add-on which many consumers have already realised.’
Increased demand for OPD coverage
As per PolicyBazaar data, the demand for OPD coverage is increasing rapidly. Around 15% of the customers are now taking health insurance as well as OPD cover, which was nil earlier. This is because a regular health insurance policy covers medical care expenses in case of hospitalization, but when it comes to expenses related to medical care, which does not involve hospitalization of the patient, They are usually not covered. Industry data shows that OPD comprises more than 70% of the expenditure in the healthcare sector. And this expenditure is usually incurred by most of the people from their own pocket. Also, OPD expenses were earlier not covered by health insurance policies. This meant that in spite of having a health insurance policy, one was not entitled to get doctor’s consultation, medicines,
As per various reports, out of pocket expenditure in case of COVID treatment accounts for 30-50 per cent of the total amount spent on COVID-19 treatment. So it is natural that the consumer has become more aware of these expenses. And he wants health coverage that covers this expense as well.
If statistics are to be believed, the most common OPD cover feature among consumers is the ability to visit the doctor in person. Customers believe that this is a better option than “Digital OPD”, as Digital OPD only includes doctor consultations done online, but does not include in-person consultation with the doctor.
Although the trend of taking OPD cover is more in Tier-1 and Tier-2 cities, but the trend is slowly being seen in Tier-3 cities and beyond.
Also, most of the policyholders prefer the cashless mode of payment where they do not have to pay anything upfront and wait for the claim reimbursement. Instead, they can simply go the cashless route which is easier.
About 80 per cent of men are opting for OPD coverage as compared to women customers. The preference for opting for OPD cover is also high among policyholders who opt for higher sum assured cover. As per the available data, generally 30 per cent of all insurance consumers opt for a health insurance cover of Rs 1 crore.
30% of these customers opt for some sort of OPD cover. Most of the customers opting for OPD add-on cover use the sum insured for expenses related to doctor consultation, diagnosis and pharmacy cost.
Common expenses covered under OPD health cover
Doctor’s consultation: Doctor’s consultation charges are not covered in a regular health insurance policy. By opting for the OPD add-on, you ensure that this expense is also covered by your policy. This add-on is particularly useful in family plans that include coverage for children, as medical advice is often likely to be sought in such cases.
Diagnostic Tests: An OPD add-on also covers the cost of diagnostic tests, irrespective of whether you are suffering from any disease or not. This applies as long as the tests are prescribed by your doctor.
Pharmacy Expenses: Expenses incurred on prescribed medicines are huge but are not covered under regular health insurance plans. With OPD cover, these expenses are also covered by your policy.
Dental procedures and other assistance: Dental procedures – such as root canal treatment, fillings and tooth extractions are not covered by a regular health policy. On the other hand, if you have opted for the OPD add-on cover, then not only do you get protection against the expenses incurred for such procedures, but the cost of dentures is also covered up to a specified limit. In fact, the cost of hearing-aids and eyewear- such as contact lenses and spectacles are also covered up to a specified limit.
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