Health awareness and management in India continue to be poor in several ways. It, therefore, isn’t surprising to find that several employees are still unaware of the fact that you can cover doctor consultations and medical expenses with employee health insurance.
How? Through OPD coverage - better known as ‘outpatient department’ coverage. You can opt for this by paying an added premium. The aim and intention are to help employees reduce their overall health expenditure and to claim benefits outside of hospitalization.
For organizations, providing health insurance with OPD cover can include several benefits as well. It helps you enable your employees to seek timely medical help, detect illnesses within time, and achieve better financial and mental security.
This is just the tip. For these reasons and more, buying health insurance with OPD benefits is essential in today’s times. Let’s learn more about what is OPD coverage in health insurance and discuss the top health insurance plans with OPD benefits in this article.
What Is OPD Coverage In Health Insurance?
As stated above, OPD stands for the outpatient department, which several health insurance plans include in the coverage they provide. Typically, it entails doctor visits you require for specific medical treatments along with allied medical expenses you incur.
An OPD treatment requires you to visit a doctor’s clinic or a medical practitioner’s consultation room in a multispecialty hospital. However, it is pertinent to note that such visits do not require hospitalization.
Some common examples of OPD coverage include treatments for fractures, dental treatments, minor surgeries, pharmacy expenses on prescriptions, expenses for running diagnostic or investigative tests, and so on.
These look like minor costs, and do you really need an OPD cover for this? If you’re thinking about this, here’s why you should buy medical insurance with OPD benefits.
The Cost Of Healthcare In India
The government of India provides medical coverage for all Indian citizens, however, the quality and extent of coverage aren’t great. Getting access to quality care can mean more expenses, which can burn a hole in your pocket.
Statistically speaking, the current rate of medical inflation stands at 15% while health expenditure amounts to 5% of your private final consumption expenditure.
In simple terms, this means healthcare could potentially be unaffordable for many. This brings into the limelight the importance of health insurance and especially one with OPD benefits. Let’s understand in detail why you must purchase a mediclaim policy with OPD coverage.
Benefits Of Purchasing Medical Insurance With OPD Benefits
Given the stressful lives, everyone goes through today, there are higher chances of medical conditions affecting you. This sometimes means costly expenditure that can prolong over a few days or sometimes months. For companies, this could mean downtime, low productivity, and employee absenteeism in some cases.
Further, you may fail to account for the money spent on routine medical check-ups and non-fatal ailments assuming it’s not much. However, if you tally it all, you end up spending a big chunk of your income in the long run.
From an employee's perspective, this could make them feel financially drained and thereby have an impact on their work productivity.
Read to know: How To Increase Productivity In The Workplace In 10 Easy Ways
To steer clear of such avoidable circumstances and to reduce medical expenditure during health contingencies, it is prudent to opt for mediclaim with OPD benefits.
Some of the most crucial benefits of an insurance policy with OPD benefits are as follows:
1. Reduced medical expenditure
On average, OPD costs in India amount to nearly 62% of the total healthcare costs. However, not everyone can afford these ongoing and sometimes cumbersome health expenses, causing you to feel burdened.
In the case of companies, this means poor mental and financial health of employees, sometimes leading to a compromised performance at work. A health insurance plan with OPD coverage can help them manage medical expenses with ease and avoid dipped productivity levels in the office.
2. Coverage for future medical ailments
According to research, doctor visits are increasing with each passing year. The data points out that the need for medical consultations is on the rise, which could translate to added expenditure in the future.
An insurance plan with OPD expenses coverage can enable employees to meet these rising costs and be prepared for future ailments.
3. Illness/disease prevention
Illnesses and delayed disease detection are prime reasons for absenteeism within companies. With the help of an insurance plan with OPD benefits, employees can seek immediate medical help and prevent illnesses and diseases from scaling up.
That’s also another advantage of employee health insurance with Loop. We have an in-house team of specialized, knowledgeable doctors trained in various specialties who help employees stay healthy rather than treat them when they’re only sick. With this preventive care approach, your employee will be healthy and show better results at work.
4. Coverage for minor surgical procedures
It’s frustrating to find the right doctor when it comes to minor yet urgent surgeries such as root canals or hairline fractures. However, with OPD benefits in health insurance, you can easily have access to medical care and get on the path to faster recovery.
5. Quick access to doctors/clinics
As mentioned above, a robust insurance plan with OPD benefits can give employees access to a wide range of doctors and clinics, in addition to network hospitals.
This ensures that they receive better (and sometimes 24 hours) medical attention and enables them to cure health contingencies faster.
Loop customer support team is always around to help employees find the nearest hospital, even in a remote location. This way both in-office and remote employees are cared for.
6. Early detection and prevention of communicable diseases
If there is anything that the COVID-19 pandemic has taught us, it is how proper care and prevention can help curb the spread of communicable diseases. Employees often delay getting regular medical check-ups done due to the costs it comes with them.
By providing them a plan with OPD cover, you can push them to get themselves checked even in case of a common cold/flu. This way, you can ensure early detection of communicable diseases and ensure you maintain work productivity.
7. Tax benefits
In addition to the above benefits, a health insurance plan can enable both employers and employees to claim several deductions under the Income Tax Act of 1961.
Employers can claim the premiums paid on medical insurance as a business expense, while employees too can enjoy income tax benefits by claiming the amount that they contribute towards premium payments.
Good to know: How Does Health Insurance Claim Process Work?
What Are The Inclusions Under OPD Health Insurance Plans?
Now that you know about the various benefits of buying health insurance with OPD benefits, let’s understand what it includes.
1. Doctor consultations
Professional fees for doctor/in-clinic visits are covered under OPD benefit health insurance plans.
2. Diagnostic tests
Expenses incurred on any diagnostic tests such as blood tests, x-rays, scans, etc. that are suggested by the doctor during OPD treatments are also covered under OPD benefit health insurance plans.
3. Pharmacy expenses
Expenses on medical bills or purchasing medicines on prescription during OPD treatments are covered under OPD benefit health insurance plans.
4. Minor surgical treatments
Small surgical treatments that do not require hospitalization such as dental filling, root canals, and treatment for fractures are also covered by some OPD benefit health insurance plans.
Top Health Insurance Plans With OPD Benefits
1. Individual OPD health insurance plan
An individual health insurance plan with OPD benefits covers the individual policyholder and you can opt for it by paying an additional premium over the standard health insurance plan.
It is less common as compared to the family floater and group health insurance plans. However, it is a good option for those who do not have dependents, such as senior citizen parents, spouses, and children.
2. Family floater plan with OPD cover
A family floater plan with OPD benefits is one of the widely accepted and booming OPD health insurance plans in the country. It provides OPD cover to the insured individual as well as the family members. Like others, you can opt for this plan by paying an additional premium.
It is a good option for those who have dependents, such as parents, spouses, and children, to look after.
3. Group health insurance plan with OPD coverage
Another OPD health insurance plan that is ideal for companies is a group health plan with OPD coverage for employees. It enables employers to extend greater health and financial security to the workforce and achieve higher productivity and revenues in the long run.
With an OPD group health insurance plan, employees can do away with the burden of paying premiums while still securing the health of themselves and their dependents. It is for this reason that OPD GHI is also referred to as one of the best health insurance for OPD benefits today.
Buy A Comprehensive OPD Health Insurance Plan With Loop
While hospitalization is a huge health expense, it isn’t the only one. Often, we overlook the energy, time, and money that is expended on treating regular or ongoing ailments.
However, on closer analysis, you can see that OPD treatments amount to a heavy financial and mental burden, which you, as an employer, can share with your employees. The first step is to buy a group health insurance plan with OPD coverage.
If you are looking for the best group health insurance plans in India, you have come to the right place. Along with comprehensive health coverage, our group health plans cover a range of complementary yet useful benefits, such as free doctor consults, wellness benefits, access to mental health practitioners, and more.
You can also customize group health plans as per your budget and requirements. So you have access to a plethora of benefits for your employees at affordable costs.
We hope you found this post informative. With this knowledge, you can make the most of your health insurance plan and get the coverage you need. So what are you waiting for? Contact us anytime!