If you anticipate needing medical care but not an in-patient stay, purchase a health insurance policy with OPD coverage. You can submit claims for out-of-hospital medical consultation or treatment costs under an insurance policy’s Out-Patient Department (OPD) coverage. You should know that these insurance policies typically permit you to submit a claim for OPD treatments received in-network hospitals. Here is a more detailed look at health insurance plans that include OPD coverage. We’ll examine these policies’ premium prices, what is and isn’t covered, and how claims are resolved. What is the OPD protocol? OPD stands for Out Patient Department in hospital jargon. *
OPD treatment refers to doctor consultations and procedures that can be carried out under the guidance of a medical professional without requiring hospital admission. With a few notable exceptions, most OPD treatments and consultations are traditionally not covered by mediclaim or health insurance policies. OPD coverage for purposes of insurance OPD coverage provided by health insurance plans enables the insured to file claims for costs other than those incurred during hospitalisation. The phrase “OPD expenses” refers to costs associated with a trip to a clinic, hospital, or other related medical facility for a diagnosis or treatment on the recommendation of a medical professional. During these visits, the patient does not need to be admitted to the hospital as an in-patient or day patient. Some typical OPD expenses include doctor consultation fees, lab test costs, medication costs, dental treatments, fracture care, dentist visits, paediatrician visits, etc. What is excluded from OPD coverage?”OPD expenses do not apply to in-patient care, daycare procedures, or naturopathy treatments. Additionally, cosmetic procedures and injuries caused by oneself are not covered. Of course, hospitalisation costs do not fall under the OPD category because health insurance policies typically cover them. *
Daycare treatment entails procedures that necessitate hospitalisation but for a shorter period than 24 hours. These include tonsillectomy, chemotherapy, radiation, dialysis, cataract surgery, and lithotripsy. OPD expense claim resolution procedure. At an online insurance broker, “For the claim process, the expenses can be claimed after the required documents are submitted in case of OPD treatment.” To file a claim with the insurer, you must submit an OPD consultation prescription, a prescription for medications, and a properly completed claim form. You should know a few other things regarding the claim settlement process. It would help if you determined how frequently OPD expenses can be claimed. *
Should You Purchase An Insurance Plan That Covers OPD?
According to experts, health insurance with OPD coverage differs between insurers and, regrettably, does not provide uniform benefits. For instance, some products only cover immunisations, while others may only allow you to use particular hospital networks or pharmacies. Some policies limit the number of claims you can file annually to a certain number or just one. Then, only a few policies provide comprehensive OPD benefits coverage. So, should you buy one of these covers? The benefits of such a cover are relatively meagre. *
* Standard T&C Apply
Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.
