Archive · 26 Jun 2025
Should You Buy OPD Insurance? Coverage Overview
Imagine you go to the doctor and need medicine or tests, but your regular insurance doesn't pay for it.
OPD insurance steps in to help with those costs.
Many Indian health plans don't cover these "outpatient" visits.
Now, companies are offering special OPD plans, like the ones your job might provide, or you can buy one directly.
Some plans cover all costs upfront, some help you get money back, but some might have limits.
Think about the doctors and hospitals you like to visit and if the plan helps you there, as well as how much it costs.
OPD insurance covers outpatient expenses like doctor visits and tests, which are often not included in standard health insurance.
The OPD market in India is growing, with insurers and healthcare startups offering various plans.
Plans vary; some offer cashless services, others reimbursement, and some have limitations on coverage for specific procedures.
OPD coverage is also available through employers, sometimes at no cost or with co-payment.
Consider the network of providers, sub-limits, and your individual needs when deciding if an OPD plan is right for you.
- Who
- Consumers seeking health insurance, insurance providers, and healthcare startups.
- What
- OPD insurance, which covers outpatient expenses.
- When
- Insurers and startups have begun offering OPD coverage recently.
- Where
- India.
- Why
- To cover medical expenses not included in standard health insurance plans.
Benefits
Drawbacks
Accessibility
Benefits
Offers coverage for expenses not covered by traditional plans, providing financial protection for outpatient care.
Drawbacks
May be restrictive due to sub-limits, a limited choice of doctors, and sometimes only available through certain networks.
- OPD Spending (FY24)
- $37.7 billion
- Retail OPD Insurance Market Share (FY24)
- Less than 0.1%
- ICICI Lombard Elevate (35-year-old male)
- ₹4,980 annually for ₹10,000 OPD coverage
- Bajaj Allianz Health Prime (35-year-old individual)
- ₹2,062 for ₹15,000 coverage
- Niva Bupa Acute-Best Care (35-year-old individual)
- ₹4,801 for ₹10,000 coverage
- Star Health Insurance (35-year-old individual)
- ₹4,802 for ₹25,000 coverage
- LivLong Eldercare Plan
- ₹12,000 annually