Healthcare costs are spiralling, thanks to medical inflation. From hospital fees to diagnostics, pharmacy, and equipment, all are getting expensive. In this scenario, the average Indian finds it hard to cover the costs of healthcare solutions required to identify, prevent and recover from diseases. The rising healthcare costs impact both, the quality of life and the savings routine.
Health insurance is widely regarded as the most effective tool to counter medical inflation. But it has its share of gaps. Even the most comprehensive health policies fail to cover tooth filling, fractured fingers, and other common treatments. The individual is also required to bear out-of-pocket expenses for preventive checkups and routine doctor consultations. Insurers require you buying health insurance with OPD cover to pay for these regular checkups and consultations.
OPD cover explained:
OPD stands for the Outpatient Department. In this arrangement, the patient visits the medical facility/doctor for checkups, consultations, diagnosis, and treatments. The patient need not get hospitalized, and hence the name. OPD cover pays for expenses incurred in OPD treatments, including doctors’ consultations and more, depending on the policy. The OPD cover doesn’t come with the basic health cover. You need to fetch it separately at an additional cost.
The OPD cover offers multiple benefits, including:
- The policyholder can claim expenses incurred on consultations, checkups, diagnostics, pharmacy, and medical equipment. Hospitalization expenses aren’t covered, however.
- Tax rebates on the premium paid for the health insurance with OPD cover are available. The claims are free of any Tax Deductible at Source (TDS).
- The reimbursement can be claimed many times across the policy period. The monetary value of such policies is high, as they involve multiple services and transactions.
- Cushions your savings and frees you from out-of-pocket expenses. You get the required OPD healthcare solutions in time without bothering about the associated expenses.
Unfortunately, the perfect health cover doesn’t exist. There are always trade-offs.
- Costs Outweigh Benefits:
An OPD cover provides financial protection for OPD care expenses but it’s always a costly affair. You pay more than what you bargained for. A typical health cover worth 3 lakhs for a family of 4 (2 adults and 2 kids) costs INR 8,000. But with the OPD cover, the costs escalate to INR 32,000.
Now, a single routine health check-up costs, say INR 1000. For 8 checkups, the reimbursement amount is INR 8,000. You receive INR 7,000 for medication, diagnostics, dental care, and eye care. That totals to INR 15, 000, which is INR17, 000 lesser than what you pay for OPD cover.
You are simply bleeding money, more so when you require more than 8 consultations a year. The standard OPD covers restrict consultations to 8 a year, and the rest requires out-of-pocket expenses. The consultations at a non-network hospital fetch a lower reimbursement. It’s capped at INR 400. Also, a sub-limit of INR 7,000 on diagnostics and medicines is applicable.
Maternity benefits are a fixture across all OPD covers though, limitations are pretty evident. You have to endure the 4-year waiting period to claim maternity benefits. Also, a sub-limit on maternity OPD care is applicable. The tests involved in maternity are quite cheap and available everywhere. You need not rely on the on-network labs and hospitals to get them done.
- It doesn’t cover everything:
OPD covers aren’t as comprehensive as they are advertised to be. A standard OPD cover excludes dental care, X-rays, pathological investigations, psychiatric disorders, and vaccination. Eye care products, including spectacles and contacts, as well as hearing aids are not included either, leaving you to make out-of-pocket payments for them. Even the covered treatments require you to wait for 90 days of availing policy to claim the first reimbursement.
Thankfully, a more economical way to bear your healthcare costs, including OPD care, is readily available in the form of Bajaj Finserv Health Card. A health card might not be an alternative for a hospitalization cover, but it eliminates the need for an OPD cover outright. The health card reduces healthcare expenses significantly, allowing you to avail healthcare solutions without hurting your savings.
Health cards explained:
Call it a discount card for your entire healthcare needs, including medicines, routine checkups and consultations, diagnostics, and more. You get it all for a monthly or yearly membership fee, ranging between INR 99 and INR 8,000. The fee is subject to the plan availed and the number of members covered. Specifications may vary, but a standard health card offers up to 10% rebate on treatments and 5% on diagnostics. If you choose well, 100% cashback on card fees can be availed.
Why it matters?
A health card is an advantage that you cannot let pass up.
- Savings, Savings and Savings:
A health card is all about savings. The health card membership fee is quite reasonable, unlike an OPD cover that requires you paying over the odds. An average Indian spends INR 2,494 out of pocket for healthcare. With discounts galore, a health card helps bring down your spending on healthcare considerably. You save on treatments, pre and post hospitalization, pharmacy, diagnostics, and regular checkups and consultations at network hospitals. Savings also come in form of specials, such as cash backs on card fees, if you choose your health card wisely.
- A Full Spectrum Coverage:
Bajaj Health offers a Health Card, which consists of a diversified and comprehensive inclusions list compared to an OPD cover. Think critical illness treatments, regular preventive checkups, consultations, diagnostics, medical devices, and more. An OPD cover conveniently ignores dental care, vision care, weight management, hair transplant, stem cell banking, and cosmetic surgeries, but a health card has them all covered. Even gym services, diet plans, spa treatments, and Ayurveda treatments can fetch you lucrative discounts with a health card.
- Something for Everyone:
Health policies are discriminatory towards the ageing population and those with pre-existing conditions. Even if they offer them a cover, huge premiums and an endless number of exclusions might apply. On the contrary, health cards have no such onerous restrictions. They are available to all, regardless of age, health status, occupations and other considerations.
- More for Less:
Depending on the health card, you can expect add-ons to cover your unique healthcare requirements. Need a doctor 24x7on-call, an ambulance at a discounted price or a second opinion just before going under the surgeon’s knife? There’re add-ons for it all and more.