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OPD Insurance Vs Healthcard – What You Need To Know?

28 February, 2020

, Healthcard

It is an acknowledged fact that health insurance is a MUST for people, considering today’s health care costs. When it comes to senior health insurance plans, there aren’t many options to choose from, and the premium may be slightly higher. Yet, there is little to choose from among the many providers, as it comes with many riders and exclusions, as the age goes higher. However, most health insurances only cover the in-patient costs, when a person is admitted for more than 24 hours. But, there is a hitch, and that happens to be the outpatient costs, which are no less.

OPD costs and insurance

Health insurance is taken up to mitigate and address the medical expenses in the case of any untoward medical issue that needs hospitalization. However, often, people only need to consult a doctor for some small or medium health issues, or have issues with teeth, or may end up with a broken hand or leg, that does not need hospitalization. The costs, however, of specialist consultation, and such medical assistance, are no less and people do find it steep. This is the case for all dental treatments, diagnostic tests, medicines, and any specific medical equipment that may need to be purchased. This does not get covered in typical health insurance unless the person has opted for an OPD insurance rider.

While it appears that it may be wise to opt for the OPD rider on your health insurance, the steep rise in the premium cost may force a rethink. But, with age, the periodic checkups, and the odd issues that keep cropping up, etc. and the associated costs, end up putting you in a quandary. Typical health insurance that includes all diagnostic costs, medicines, dental treatments, spectacles and contact lenses, etc. may cost around 20000. 

This comes with a hitch of sub-limits on OPD expenses, and caps on the number of limits per year, and pre-existing illnesses, etc. Also, the exclusion list for in the OPD insurance needs to be read carefully and tallied against the individual’s regular health expenses to see if it benefits or not. In most cases, people conclude that the OPD rider ends up being costlier than the actual OPD expenses incurred and prefer to give it a pass.

Is there an alternative?

A positive aspect of the emerging healthcare trends in India happens to be the concept of a health card. It needs to be understood that a health card is not a replacement for health insurance. So, every individual would still need health insurance to address the hospitalization expenses. However, a health card can help offset the OPD expenses that may be recurring or even the pre and post, diagnostic tests of a hospitalization. These may also help with your dental treatments and spectacles, as well as specialist consultations and medicine expenses.

Health cards help people to get good discounts across a variety of trusted hospitals, diagnostic chains, medicine shops and more. These health cards come with a yearly renewable membership fee and are accepted across a network of hospitals as specified by them at the time of induction. This is a huge blessing for senior citizens; especially those who cannot afford the hefty premium of OPD insurance, or have pre-existing conditions because of which their health insurance policy is rejected.

Samarth Health Privilege Plan

Samarth was started with the vision to bridge the gap in the provision of adequate care and trusted support for seniors in India, and also realized this issue with the insurance and OPD costs. This prompted us to launch the Samarth Health Privilege card and covers more than 9,500 hospitals, clinics, diagnostic centers, path labs, pharmacies in many cities and offering discounts even on surgeries & hospitalization.

A minimum of 20% discount or even more, is provided on procedures in more than 500 hospitals, with a 20% discount applicable even on prescription medicines. The estimated savings for members can range anywhere from INR 10,000 to INR 100,000 per year. You could opt for a single or a couple of cards, and it comes at an incredibly affordable cost, and you could even check out the detailed comparison costs, savings, as well as the FAQs regarding this for more information. Coming as it does from Samarth senior community, which has been working in the senior care space since its inception around three years back, this option could be the wonderful alternative that people were looking out for.

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