Initially, most insurers were keen on providing coverage only for hospitalization. However, most customers find it inadequate as no coverage is provided for outpatient department care. To cater to the expanding needs of customers health insurers now have come up with health plans with riders as well as built-in coverage for OPD treatments.
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Through this article, we will try to examine how efficient health insurance with OPD coverage is. Is it ok to pay an extra amount to cover OPD treatments or is it more beneficial to avail health card memberships from network hospitals?
A comprehensive health insurance plan is meant to cover hospitalization charges and also provide OPD coverage along with covering medical bills, diagnostic tests, outpatient treatments, and free health check-ups. You can make cashless claims in-network hospitals and clinics for any kind of treatment.
Most insurers provide OPD riders along with the basic health insurance. Since most insurance buyers do no focus on OPD cover they avail the basic health plan. However, for patients whose OPD visits are frequent, the expenses accumulate over time leading to the huge out-of-pocket expenses.
Considering the rise in the cost of treatment today; it is imperative to have a health insurance cover. Additional riders are becoming increasingly crucial so that the financial implications related to medical expenses are significantly minimized. Additional riders like OPD coverage can help you in case you want to protect your family from various health-related issues as well as save your cash outgo.
However, there are plans that have in-built OPD coverage. Also, such health plans come with a long list of exclusions. But the most important aspect of OPD cover is that a person can use on multiple occasions throughout the policy tenure. So subscribers can save more money on such policies as OPD coverage aims to reduce the everyday financial trouble of the customers associated with medical treatments and consultation.
See Also: The A - Z of Health Insurance
There can be no reasonable alternative to a health insurance cover. But health insurance cards are discounted memberships that give you additional discounts on various types of health-related expenses.
Health insurance plans help subscribers save money on medical and healthcare costs, and it also covers the cost of pre and post-hospitalization expenses. Though health insurance plans are comprehensive, they have certain exclusions and generally exclude coverage on dental treatments, pathology or radiology expenses, etc.
On the other hand, health insurance cards are known to cover all medical expenditures. Health insurance cards benefit a certain group of people such as those who have pre-existing ailments or people above a certain age group who are denied health insurance.
One of the disadvantages of health cards is that they are provided by hospital chains like Apollo, Fortis, etc which limit your choice as you can avail of facilities only from the concerned group. But with a health insurance plan, you can extend your reach since these insurance companies have tie-ups with multiple hospitals, pharmacy labs, diagnostic centers, and nursing homes.
Some healthcare companies extend these cards to ease the process of availing medical and healthcare facilities and ensure a maximum number of people. Subscribers have to pay a membership fee ranging from 1000 to 8000 depending on the plan they opt for and the number of members enrolled under the plan. Some of the companies that provide healthcare cards are Whizzcare, Sharak Healthcare, IHO, and Easy Lifecare.
Basic plans offer discounts like 10 to 20% discount on OPD treatments and up to 30% discount on doctor’s consultation. Other facilities include 50% discount on the total cost of treatments and free dental care.
Other offers include discounts on doctor consultation at selected clinics. These health cards come with add-on benefits like round the clock doctor consultation, chat service, second consultation before proceeding with a critical surgery and discounts on ambulance service.
See Also: Health Insurance Importance and Features
The Insurance industry is well established and regulated by government bodies like the IRDA (Insurance Regulatory and Development Authority of India). The insurance industry is not subjected to face regulations as they are rated based on a few important features like performance incurred claim ratio, and the overall benefits offered to the customers. It is also important to keep in mind that all grievances and consumer complaints will be addressed by a consumer court.
So before buying the membership of any such institutions raise some valid queries like is the company registered? If your insurer is not ready to answer any such queries then it is worth buying a membership or a health card from your nearby hospital.
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