Health Insurance with OPD Cover

Health Insurance with OPD Expense Coverage, with Digit Health Care Plus.

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What is an OPD benefit?

Not every illness or injury needs hospitalization. Consultations, diagnosis and treatments can be done expediently and conveniently without a hospital stay. In the world of healthcare, this is termed as OPD- ‘Out-Patient Department’.

So, what an OPD cover does is, it takes care of the medical bills arising out of the OPD treatment you may need, as per your health condition.

All your doctor consultations for any health condition or injury, or that root canal your dentist suggested you just have to get done! All of these ups and downs in your personal health journey come under OPD.

What is OPD Treatment?

OPD or Outpatient Department treatment refers treatments and diagnosis done on advice of a medical practitioner or doctor, by simply visiting their clinic or even a doctor’s consultation room at a multispecialty hospital.

The important thing to note here is that OPD treatments DO NOT require hospitalization. Hence, this includes treatments for fractures, various necessary dental treatments, and minor surgeries.

Read more: Why you should go for Coronavirus Health Insurance?

Why should I get a Health Insurance with an OPD cover?

Still wondering why? Read on...

What’s great about Digit Health Insurance with OPD cover?

Easy Online Processes - From the process of buying a health insurance with OPD cover to making claims is paperless, easy, quick and hassle-free! No hard copies, even for claims!
Covers Pandemics - If there’s anything that 2020 has taught us, it is that everything is uncertain! Whether it’s the COVID-19 or any other virus, pandemics are covered!
No Age Based Copayment - Our Health Insurance comes with no age based Copayment. This means, during your claims- you need not pay anything from your pocket.
No Room Rent Restriction - Everyone has different preferences and we understand that. That’s why, we have no room rent restrictions. Choose any hospital room you prefer.
Cumulative Bonus - A reward for staying healthy! Get Yearly Cumulative Bonus.
Get Treated at any Hospital - Choose from 6400+ of our network hospitals in India for cashless claims or opt for a reimbursement.

What’s covered in Digit Health Insurance with OPD cover?

OPD Benefits
Professional Fees Fees for medically necessary consultations and examinations by medical practitioners to assess your health for any illness.	✔
Diagnostic Fees Medically necessary out-patient diagnostic procedures such as x-rays, pathology, brain and body scans (MRI, CT scans) etc... used to make a diagnosis for treatment from a diagnostic center.	✔
Surgical Treatments Minor Surgical procedure such as POP, suturing, dressings for accidents and animal bite related outpatient procedures etc. carried out by a Medical Practitioner.	✔
Medicine Bills Medication drugs and medicines as prescribed by your medical practitioner.	✔
Dental Treatments If your doctor recommends that you really need to get a specific dental treatment done, it will be covered under OPD.	✔
Hearing Aids Hearing aids required for serious hearing conditions are covered.	✔
Other Benefits
All Hospitalization, including for Coronavirus This covers for hospitalization expenses due to an Illness, Accident or even a Critical Illness. It can be used to cover for multiple hospitalizations, as long as the total expenses are up to your sum insured.	✔
Daycare Procedures Health insurances generally cover medical expenses only for hospitalizations exceeding 24 hours. This covers for medical treatments undertaken in a hospital, requiring less than 24 hours due to technological advancement.	✔
No Age Based Copayment A Copayment refers to the amount of money you need to pay from your pocket, during a health insurance claim. In our plans, there is no age based copayment involved!	✔
No Room Rent Capping Different categories of rooms have different rents. Just like how hotel rooms have tarrifs. With Digit, some plans give you the benefit of having no room rent cap, as long as it is below your Sum Insured.	✔
No ICU Room Rent Capping ICU (Intensive Care Units) are meant for serious patients. The level of care is higher in ICUs, which is why the rent is higher too. Digit does not put any limit to the rent as long as it is below the your Sum Insured.	✔
Cumulative Bonus Get rewarded for every claim free year. If you do not make any claim in a year, some plans reward you with a discount in the next year. This extra discount is called Cumulative Bonus	10% CB for each claim free year (Up to 50%)
Road Ambulance Charges	✔
Complimentary Health Checkups Annual health checkups are important to ensure you are aware of your overall health and well-being. This is a renewal benefit that allows you to reimburse your expenses towards any annual medical tests and checkups, at any hospital of your choice.	✔
Post Hospitalization Lumpsum This is a benefit you can use to cover all your medical expenses post hospitalization, at the time of discharge. No bills required. You can choose to either use this benefit or use the standard post-hospitalization benefit, through the process of reimbursement.	✔
Psychiatric Illness Cover If due to a trauma, one has to be hospitalized for a psychiatric treatment, it will be covered under this benefit. However, OPD consultations are not covered under this.	✔
Bariatric Surgery This coverage is for those facing organ issues due to their obesity (BMI > 35). However, in case the obesity is due to eating disorders, hormones or any other treatable conditions, this surgery cost will not be covered.	✔
Additional Covers
Maternity Benefit with Newborn Baby Cover If you plan on having a baby in the next two years or so, you can opt for this. It covers for child-delivery (including medically necessary terminations), infertility expenses and coverage for the newborn baby up to its first 90 days.	✔
Zone Upgrade Every city falls either in Zone A, B or C. Zone A has Delhi and Mumbai. Zone B has cities like Bangalore, Hyderabad, Kolkatta. The zones are divided as per medical costs. Zone A cities have highest medical costs therefore the premium to get a treatment under health insurance in these cities is a bit higher. If you wish to get treated in a bigger city than where you live, you can upgrade your plan for the same.	✔

What’s not covered?

The OPD cover excludes expenses incurred towards Spectacles, Contact Lenses and Physiotherapy, Cosmetic Procedures, Ambulatory Devices like Walkers, BP Monitors, Glucometers, Thermometers, Dietician Fees, Vitamins and Supplements.

How to file a Claim?

Reimbursement Claims - Let us know in case of a hospitalization within two days of admission at 1800-258-4242 or email us at [email protected] and we'll send you a link where you can upload your hospital bills and all relevant documents to process the reimbursement.
Cashless Claims - Choose the network hospital. You can find the complete list of network hospitals here. Display e-health card to the hospital helpdesk and ask for the cashless request form. If all is good, your claim will be processed then and there.
If you have claimed for Coronavirus, make sure you have a positive test report from an authorized centre of ICMR – National Institute of Virology, Pune.

Who should buy a Health insurance with OPD cover?

Fitness Enthusiasts

We’ve customized a health insurance with OPD cover called the Fit Option for fitness enthusiasts given that, while people like you are extremely fit and less prone to illnesses, you are still prone to gym and workout-related injuries which is where your OPD cover may be very useful for you. Additionally, a health insurance will always help you in your annual tax savings as well.

People between the age group 25-40 years

Most young people today are opting for a health insurance given the cheaper premiums, to complete waiting periods early and of course, to save on tax too. If you’re one of them too- you can opt for a health insurance with an OPD cover. This way, even though you may feel you’re less likely to use other benefits from your health insurance, you will definitely need your OPD benefit for something or the other.

Senior Citizens

Senior citizens are one of those people who probably require a health insurance the most. However, it is important to consider taking one with an OPD cover since apart from what a regular health insurance offers, seniors are usually more likely require OPD treatments like dental treatments and minor surgeries. Hence, a health insurance with an OPD cover will help cover for both regular health insurance benefits and OPD treatments as well.

Working professionals with limited group medical insurance coverage

If you’re someone who already has a group medical insurance from your employer but, want an additional health insurance coverage for better protection, you can opt for a top-up health insurance plan or a health insurance with an OPD cover since a lot of group medical insurance plans don’t include OPD benefits. Hence, an additional health insurance can give you benefits beyond your employer plan and help in your annual tax savings too!

FAQs about Health Insurance with OPD Cover

✓ What are the most common workout injuries?

No matter if you’re a beginner or a workout pro, some of the most common injuries one does face while working out include; muscle pulls, sprained ankles, shoulder injuries, knee injuries, shin splints, tendinitis, wrist sprains and wrist dislocations. While all of these don’t necessarily require hospitalization, they do require a prescribed treatment.

✓ I’m not a fitness enthusiast, can I still get a health insurance with an OPD cover?

Yes, while a health insurance with an OPD cover makes the most sense for fitness enthusiast, anyone needing it can get one too.

✓ What is the difference between OPD and Daycare Procedures?

The primary difference between OPD and Daycare procedure has to do with hospital admission.

OPD refers to all medical treatments and doctor consultations one may require without having to be admitted at the hospital, whereas daycare procedures refer to minor surgeries or other treatments that do require one to be admitted to the hospital, however – for less than 24 hours only.

✓ Can I only buy an independent OPD insurance?

This depends on your health insurer. With Digit, we offer this benefit along with our Smart Health Insurance option since this proves to be more beneficial for most people; so that you’re not only covered against minor treatments and doctor consultations but are also protected through any unfortunate circumstance such as an accident or any other illness.

✓ Will I get tax reduction with a health insurance with OPD cover?

Yes, tax reductions are applicable on a health insurance with OPD cover as well.

✓ What are some examples where I can use my OPD cover?

Think of that one time even though you’re such a great fielder, the ball still hurt your thumb so bad you needed to get it checked.

Or that time when your strenuous workout routine pulled your back! Although these ouches aren’t serious enough for a hospitalization (we hope it never gets that bad!) or a grand treatment, they still do end up costing quite a bit.

For example, a leg fracture can cost one anywhere from Rs 5,000 to 50,000 depending on the severity of the condition.