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OPD Coverage Health Insurance Plans
 
Last Updated On- 05, April 2012
(1) Who offers OPD Coverage as a part of Health Insurance Plan   (2) Policy Wording/ Proposal Form/ Brochure
(3) Product details of Various Companies for OPD Coverage Insurance Policy
 
General/Health Insurance Companies Products
 
 
 
 
1- Who offers OPD Coverage as a part of Health Insurance in India
The maximum benefit allowable for 1 adult is Rs. 8,500 [350*3 + 500*1 + 1,000 + 2,000 + 1,000 + 1,000 + 2,000(estimated)]
In addition, both the policies do not allow, an insured person to claim OPD cost within 90 days of commencement of the policy.
If we go for a normal health insurance policy, the premium paid is much less compared to these policies, as a result we end up paying more than the benefits we may receive.
Let us see the choice with examples:
Example 1:
Mr. X aged 30 years buys individual Health Advantage Plus plan from ICICI
Sum Insured Rs. 3,00,000
Premium paid Rs. 16,545
Less: Tax saved Rs. 4,964 (30%)
Net premium Rs. 11,581
Now if he takes normal healthcare policy from New India
Sum Insured Rs. 3,00,000
Premium paid Rs. 3,871
Less: Tax saved Rs. 1,161(30%)
Net premium Rs. 2,710
So, to avail OPD coverage of Rs. 8,800(which he will not be able to claim without unnecessary visits etc.) he pays a premium of Rs. 8,871extra.
Example 2:
Mr. X aged 30 years buys individual Maxima plan from Apollo:
Sum Insured Rs. 3,00,000
Premium paid Rs. 15,216
Less: Tax saved Rs. 4,565 (30%)
Net premium Rs. 10,651
Now if he takes normal healthcare policy from New India:
Sum Insured Rs. 3,00,000
Premium paid Rs. 3,871
Less: Tax saved Rs. 1,161 (30%)
Net premium Rs. 2,710
So, to avail OPD coverage of Rs. 8,500 (which he will not be able to claim without unnecessary visits etc.) he pays a premium of Rs. 7,941 extra.
The conclusion drawn is by having these policies you are getting the benefit in the ratio of 1:1 only.
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