Earlier, health insurance only helped when you were hospitalized.
But now, things are changing.
More and more insurance policies are including OPD (Outpatient Department) cover, which allows you to claim insurance for regular medical expenses without needing to be admitted to a hospital.
According to a Policybazaar report, around 22% of health insurance policies now include OPD cover, compared to just 5% three years ago.
This shows that people are increasingly using their insurance for minor illnesses and everyday medical needs.
What Does OPD Cover Include?
OPD cover allows you to get a cashless facility for:
Doctor consultations
Blood tests and scans
Medicines
Dental treatments
Regular health checkups
About 90% of OPD claims are settled directly by the insurance company, so you don’t need to pay anything upfront.
How Are People Benefiting?
People now use insurance 3–4 times a year, unlike hospitalization claims which usually happen only once in a year or less.
Hospitalizations have reduced by 5–10% among people who have OPD cover, as they get treatment earlier.
More than half of the users now consult doctors online via video or phone calls.
In terms of cost:
35–40% of OPD claim expenses go to doctor visits
25–30% on tests
20–25% on medicines
Who Is Using OPD Cover the Most?
Working professionals are the biggest users of this facility.
People aged 30–45 years make up 33% of OPD policyholders.
Young adults aged 18–30 years account for 27%.
Demand is highest in major cities like Mumbai, Hyderabad, and Chennai.
