Star Out Patient Care Insurance Policy

STAR OUT PATIENT CARE INSURANCE POLICY

Health Insurance with OPD Cover

Buying a health insurance policy is usually not at the top of our priority list. It is often looked at as an unnecessary expense. Rarely do we understand the safety that health insurance policies offer. As humans, we certainly don’t expect to be admitted for major illnesses/diseases and often feel we don’t need a health insurance policy. But unfortunately, we do fall sick. These conditions would have certainly taken you to a clinic or a hospital, from the common cold to the cough to diarrhoea or allergies.

What is OPD?

Did you know that OPD expenses in India account for over 60% of total health care costs? Yes, you read that right. And while paying Rs 500 per consultation may not seem like a lot, the cumulative expenses incurred over the year certainly cannot be taken for granted. Understanding what is OPD in health insurance is crucial for choosing the right plan.

There could be various reasons for spending on health care, and one way to mitigate these expenses is by buying an OPD insurance policy. You need not be hospitalised or require an inpatient stay to avail of the benefits provided by the policy.

Keeping all this in mind, we have devised the Star Outpatient Care Insurance Policy. This OPD insurance policy will help you overcome OPD costs, so you need not stress and worry if you happen to fall sick.

While you may need to be admitted to a hospital for some conditions, most illnesses do not require hospitalisation and treatments for such ailments fall under outpatient care. Outpatient care involves all treatment that a patient receives without being admitted to the hospital. E.g., Consultation fees, vitamin supplements, and antibiotics.

Just imagine the amount of money you could save on the most common outpatient procedures like tests, scans, having a consultation in a hospital with a specialist or getting a tooth filled at a dentist’s clinic, etc.

What is Outpatient care?

Outpatient care is a healthcare that does not require an overnight stay in a hospital. It can be provided in a variety of settings, including clinics, hospitals and outpatient surgery centres.

Outpatient care is becoming increasingly popular in India, as it offers numerous benefits to patients, health insurance providers, and healthcare providers. It is a cost-effective, convenient, and time-saving option that can improve patient outcomes, enhance patient satisfaction and reduce healthcare costs.

Choosing an OPD cover health insurance plan can significantly reduce your annual healthcare expenses by covering routine medical needs.

OPD Full Form in Medical Insurance

The full form of OPD in medical insurance is “Outpatient Department”. It is the feature in medical insurance policies that offers coverage for the costs of medical treatments and services obtained on an outpatient basis.

OPD coverage in health insurance helps you pay for medical expenses outside the hospital. It includes diagnostic tests, consultations, medications, and minor procedures.

The benefits of OPD coverage include financial relief, comprehensive coverage, preventive care promotion, flexibility, expense management, preventive health check-ups and screenings, minor procedures performed in an outpatient setting, physiotherapy sessions and alternative therapies, diagnostic fees, medicine bills, dental procedures and treatment, consultation fees, cost of hearing aids, lenses, dentures, crutches, eyewear, etc. But, depending on your insurance provider, additional coverage may be available.  We have discussed the full form of OPD in medical insurance; let's see other things about it. 

Why is OPD important?

OPD full form in medical insurance stands for Outpatient Department, which is a section of a clinic where patients receive medical consultations. It provides access to healthcare for routine needs and initial assessments without the need for costly and lengthy hospitalisation. It is a key component of medical insurance coverage, with some policies offering add-ons for OPD expenses like healthcare experts’ fees and test bills.

Types of Expenses Covered Below OPD Coverage

In general, the OPD cover includes expenses associated with the following: 

• Diagnostics: It refers to the costs for tests and screenings.
• Consultations: These are the fees for doctors' and medical specialists' visits.
• Therapies: These are the expenses for physiotherapy and other therapeutic treatments.
• Medications: These are the expenses for prescribed drugs.
• Minor Treatment Procedures: These are the expenses for minor surgeries and treatments.
   

Top 8 benefits of outpatient care

1. Cost-effective: It is generally less expensive than inpatient care, as it does not require an overnight stay in a hospital.
2. Convenient: It is more suitable for patients, as it allows them to receive medical care without disrupting their daily routine. Patients can schedule appointments for outpatient care at a time that works best for them without having to take time off work or school.
3. Time-saving: Outpatient care is typically faster than inpatient care, as patients do not have to wait for hospital beds or undergo lengthy hospital admission procedures. This means patients can receive medical care more quickly.
4. Improved access to healthcare: Outpatient care can improve access to healthcare for patients who live in rural or remote areas, as it can be provided in clinics or outpatient facilities that are closer to patients' homes. This can reduce travel time and expenses for patients and their families.
5. Better patient outcomes: It can lead to better patient outcomes, as patients are more likely to receive timely and appropriate medical care. This can result in better management of chronic conditions and improved overall health.
6. Enhanced patient satisfaction: Outpatient care can lead to higher levels of patient satisfaction, as patients appreciate the convenience, time-saving and reduced risk of infection that outpatient care provides. This can help to improve patient retention and loyalty to healthcare providers.
7. Reduced healthcare costs: Outpatient care can reduce healthcare costs for health insurance providers, as it is generally less expensive than inpatient care.
8. Improved efficiency: It can enhance the efficiency of healthcare delivery by allowing healthcare providers to focus on patients who require inpatient care. This can help to reduce the overall workload for healthcare providers and improve the quality of care.
    

Overall, outpatient care offers numerous benefits for patients, healthcare providers, and insurance companies in India. It is a cost-effective, convenient, and time-saving option that can improve patient outcomes, enhance patient satisfaction, and reduce healthcare costs.

The benefits of OPD coverage are numerous. For one, it can provide peace of mind, knowing that they are covered in Health Insurance.

Additionally, it can provide financial protection in the event of an unexpected medical bill. OPD coverage can also help you access specialist care, as many of the services associated with OPD are typically covered.

Furthermore, most OPD coverage can be opted for only in-network hospitals.

Inclusions in OPD Cover In Health Insurance

This policy is ideal for those seeking OPD-covered health insurance that includes a variety of medical expenses, but it depends on the insurance company. Additional covers may also be available. Let’s have a look at what OPD coverage includes generally:

• Consultations with healthcare professionals, like doctors and specialists.
• Prescribed medications by the doctors.
• Preventive screenings and health check-ups.
• Diagnostic tests like X-rays, blood tests, and ultrasounds.
• Physiotherapy sessions and alternative therapies.
• Minor procedures are performed in an outpatient setting, like suturing a wound.

What are the Exclusions in OPD Cover in Health Insurance?

There are some exclusions in the OPD coverage in health insurance. Here are a few exclusions: 

1. Pre-existing Medical Conditions: Any type of expense associated with pre-existing medical conditions is generally excluded from the coverage scope up to a particular waiting period. This action prevents misuse of insurance and ensures that the health insurance policy is used for new health problems arising after the policy's start date. 
2. Cosmetic Procedures: Cosmetic treatments, like plastic surgery or Botox injections, are generally excluded from OPD coverage. This is because they are considered non-essential.
3. Experimental or ineffective Treatments: If the treatment taken is ineffective or experimental, then that will be excluded from the health insurance plan. Most insurers avoid covering this option. 

How to Choose the Correct OPD Cover?

One can choose the right OPD cover considering some factors. Some of those factors include:

1. Network Hospitals and Clinics: In the list of Network Hospitals and Clinics provided, check the availability of cashless services.
2. Coverage Limits: Understand the sub-limits and overall insurance coverage offered. 
3. Premium Costs: Analyse the additional premium for OPD coverage.
4. Exclusions: Be aware of any exclusions or limitations

What is OPD cover in health insurance?

Health insurance policy is an important tool for managing medical expenses, and there are different types of policies offered by Health Insurance companies. Outpatient Department (OPD) cover is one of the major benefits covered by the Insurers.

OPD cover is a type of health insurance that covers the cost of medical treatments or services that do not require an overnight stay in a hospital. This type of coverage is ideal for people who want to make sure they can access medical care on an OPD basis.

OPD coverage can be used to cover a variety of medical expenses, such as doctor visits, tests, and other outpatient services.

A good plan will provide a wide range of coverage at an affordable premium. It is also important to consider any exclusions that may be included in the policy, as these can limit the amount of coverage you receive.

Finally, it is important to understand the claim process for OPD coverage. 

Difference between Daycare treatment and OPD treatment

Day Care Treatments:

Generally, in order to make a claim against your health insurance, you must be hospitalised for a minimum of 24 hours. However, certain treatments no longer require 24 hours of hospitalisation as they used to due to technological advancements. In the past, for example, a patient receiving a cataract operation would be required to stay in the hospital for several days after surgery. As a result of technological advancement, surgery can now be performed on the same day as the patient is discharged from the hospital.

Such a type of treatment falls under the policy definition of covered treatment if it is included in your policy.

OPD Treatments:

Outpatient Department, or OPD, treatment refers to the situation in which a patient may visit a doctor or medical practitioner for the purpose of seeking advice, tests, X-rays, investigations, diagnostics, physiotherapy, etc.

It might seem that Day Care and OPD treatments are similar because they involve a shorter amount of time.

Hospitalisation is the most significant difference between the two. A Day Care procedure, even if it takes less time, is performed in a hospital, and only then will you be able to claim your medical expenses under a Day Care treatment. Treatments for OPD do not require hospitalisation. The nature of OPD treatment is that it is possible to get the treatment without being admitted to a hospital or clinic.

Root canal treatment is a good example to understand the same. A root canal can be done either in a hospital or clinic without actually being admitted and therefore falls under the OPD category. Dental surgery done in the event of an accident, however, may result in a day care treatment.

Why is OPD Health insurance needed?

Medical insurance with OPD or an OPD Health insurance provides coverage against medical expenses for doctor's consultations, outpatient treatments, and diagnostic tests. OPD health insurance in India will aim to prevent you from spending out of your pocket for such payments.

Why choose the Star Outpatient Care Insurance Policy?

Here are the advantages of this policy review in short form, which will give the answer to the above question:

• Cashless facility at Network Hospitals

We provide access to an ever-increasing network of hospitals where you can opt for a cashless facility. Our aim is that you should have easy access to a network hospital near you in times of planned or unplanned medical expenses. Star Health Insurance has a network of over 14,000+ hospitals. For the complete list, visit here.

• Online discount

You can enjoy a 5% discount for direct online purchases from starhealth.in . Renewal discount – 25% on the premium after every block of 2 continuous claim-free years

• Hassle-free claim process

Insurance processes can often be long and document-heavy. However, Star Health Insurance offers digital-friendly, zero-touch, quick and convenient options that work better for you during this pandemic situation. The cashless OPD health insurance feature allows you to access outpatient services without worrying about reimbursement delays.

• Tax benefits

Individuals and family members below 60 years can get Rs. 25,000 deductions from taxable income, and the deductible amount can extend up to Rs. 50,000 for senior citizens on premiums paid as per Section 80D of Income Tax Act, 1961. If two family members above the age of 60 are insured under one policy, then the deductible amount extends to Rs 1 lakh. In contrast, if there is one family member below the age of 60 and his parents are also insured under the same policy, then they can avail of a deduction of Rs 75,000.

The Star Out Patient Care Insurance Policy is a mediclaim policy that covers outpatient procedures. It pays for a range of outpatient expenses, including doctor fees, physiotherapy, diagnostic tests, pharmacy bills, etc, as mentioned in the policy.

One of the significant benefits of this policy is the option to renew it for a long period of time. If the insured renews the policy within the due date, they may be able to enjoy reduced waiting periods on coverage of PED’s and cumulative bonus.