How OPD Cover in Health Plans Can Cut Your Costs

Posted on: Jun 17, 2025 | 3 mins | Written by: HDFC ERGO Team

How OPD Cover in Health Plans Can Cut Your Costs

Healthcare costs can add up quickly, even without a hospital stay. Routine doctor visits, diagnostic tests and medications can be expensive, and some may end up burning a hole in your pocket. That's why having the outpatient department or OPD cover in your health insurance can be a smart move. It helps take care of these everyday expenses, making it easier on your wallet. In this article, we will explain how OPD cover in health insurance can help you save money on your day-to-day healthcare needs.

How OPD Cover in Health Plans Can Cut Your Costs

Here's how OPD cover in your health insurance can help:

• Covers doctor visits:

Whether it is a common cold, a dental check-up or even a maternity consultation, OPD cover takes care of routine doctor visits that don't require hospitalisation.

• Helps with medicine bills:

Medicines can be expensive, but if you have health insurance with OPD cover, you can claim back those big pharmacy bills.

• Helps find health problems early:

OPD cover pays for tests and check-ups, so you can spot issues early and treat them before they get serious.

• Encourages regular check-ups:

OPD cover pays for things like screenings, dental visits and health check-ups, so you can take care of your health before any problems start.

• Goes beyond hospital stays:

Unlike many health plans that only help when you are admitted to a hospital, OPD cover also takes care of outpatient visits, i.e., when no hospital stay is required.

• Cuts down out-of-pocket costs:

Without the OPD cover, you might have to pay for everything yourself. With it, you can save on regular medical expenses that can otherwise add up fast.

OPD Health Insurance Cover - Inclusions

The following are typically covered under OPD health insurance coverage:

• Charges for diagnostic tests, such as blood tests, X-rays, etc.

• Doctor consultation fees for general or specialist visits

• Costs of investigative procedures and screenings

• Pharmacy bills for prescribed medicines

• Dental treatments and related expenses

• Minor medical procedures done without hospital admission, like stitches or applying a plaster

• Preventive health check-ups to monitor your overall well-being

• Fees for physiotherapy sessions

• Costs of vaccinations

OPD Health Insurance Cover - Exclusions

The following is not covered under OPD health insurance:

• Hospital stays or treatments that require admission

• Daycare procedures, even if they don't need a full day in the hospital

• Injuries caused by self-harm

• Treatment for alcohol or drug addiction

• Surgeries or treatments related to obesity or weight loss

• Cosmetic or plastic surgery, unless it is medically necessary

• Treatments that are not scientifically proven or approved

Conclusion

OPD cover helps you save money on everyday medical costs that don't require a hospital stay. It is a valuable part of your health insurance, as it covers routine medical expenses and helps reduce what you need to pay from your own pocket. If you are looking for a health insurance plan that offers more than just hospital coverage, OPD cover is worth considering.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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