regular-article-logo Thursday, 05 October 2023

Increasing need for outpatient department cover in a health insurance plan

According to Economic Survey 2023, share of government expenditure in total health expenditure has increased over time

Prasun Sikdar Published 05.06.23, 04:43 AM
Representational image

Representational image File picture

Healthcare costs in India are on the rise and the need for a comprehensive health insurance coverage is a necessity. While most health insurance plans primarily focus on hospitalisation expenses, people are now realising the importance of outpatient department (OPD) cover.

According to the Economic Survey 2023, the share of government expenditure in total health expenditure has increased overtime.


However, out-of-pocket medical expenditure is still higher at 48.2per cent of the total expenditure, making it prohibitively expensivefor a person to access quality healthcare.

Hence, there is an increasing need for cashless OPD cover in India and it’s important for customers to consider opting for it in their health insurance plans.

Changing landscape

The healthcare landscape in India has undergone significant transformations in recent years.

The Centre and state governments have focused on expanding health insurance coverage with various schemes offering hospitalisation coverage to help the economically weaker sections of society.

There has also been a shift towards preventive healthcare, with an emphasis on early detection and management of diseases.

Many medical conditions can now be treated effectively in an outpatient setting without requiring hospitalisation.

However, OPD expenses such as consultations, diagnostic tests, medications, and minor procedures can accumulate and pose a financial burden on individuals and families.

Therefore, having OPD coverin a health insurance plan can provide the much-needed relief and financial security.

Financial benefits

Today many people are being diagnosed early with diabetes, hypertension, and heart disease, which involves tests and costly over-the-counter medication.

Doctor consultation fees and medication costs for minor ailments also make a dent in the pocket.

These medical expenses can add up over time, making it increasingly difficult for individuals to manage their healthcare costs.

Opting for OPD cover offers several financial benefits to policyholders.

It helps individuals manage routine medical expenses effectively as the insurance company covers the cost of OPD consultations, diagnostic tests, and prescribed medications on cashless basis via their unique App at just a click of a button.

This can significantly reduce out-of-pocket expenses and provide a safety net during unforeseen medical situations.

Improved accessibility

With an OPD cover, individuals gain greater accessibility to healthcare services. They can seek consultations and medical advice from qualified doctors without worrying about the cost.

Moreover, many parts of India need help with good healthcare infrastructure and qualified medical professionals, often resulting in long waiting times for qualified doctor appointments and making it difficult for individuals to access quality medical care.

With cashless OPD cover, policyholders can access quality healthcare without worrying about increasing their financial burden, ultimately leading to better health outcomes.

Regular check-ups, vaccinations, and preventive screenings become more accessible, promoting a proactive approach to healthcare.

Enhanced wellness

OPD cover plays a crucial role in promoting overall wellness and disease management.

Cashless OPD health covers typically take care of most expenses related to doctor’s consultations, pharmacy expenses, and diagnostics.

By covering expenses related to preventive care and follow-up consultations, it encourages individuals to seek medical attention promptly, leading to early intervention and better health outcomes.

It also enables comprehensive management of chronic conditions, reducing the risk of complications and improving the quality of life for policyholders.

Future-proofing plans

Incorporating cashless OPD cover in health insurance plans helps individuals future-proof their healthcare needs.

As medical costs continue to rise, comprehensive coverage that includes OPD benefits ensures that policyholders are prepared for a wide range of medical scenarios.

By opting for OPD cover, customers can mitigate the financial burden associated with routine medical expenses, ultimately providing peace of mind and a sense of financial security.

The increasing need for OPD cover in India is evident as healthcare trends evolve and individuals seek comprehensive health insurance solutions.

With its financial benefits, improved accessibility, and emphasis on wellness and disease management, cashless OPD cover proves to be an essential component of any health insurance plan, offering customers a complete healthcare insurance solution for better coverage, better control and better care.

The writer is MD and CEO, Manipal Cigna Health Insurance

SCSS settlement

I am a retired central government employee and so was my wife, who has recently passed away. Both of us had opened a Senior Citizen Savings Scheme account separately with the post office after superannuation. How will the settlement of my wife’s account take place in her absence?

S. Majumder, Calcutta

Rule 7 of SCSS Rules 2019 states that in case of the death of the account holder before maturity or extended maturity, the account will be closed and the deposit refunded through an application (Form 3) along with interest to the nominee or legal heir as the case may be. The interest rate will be according to the savings account rate for the period from the death of the account holder till the final closure of the account. In your case both spouses operate separate accounts. Under clause 3 of rule 7, the account standing in the name of the deceased account holder shall not be continued and has to be closed. The nominee to your wife’s account will be the beneficiary.

Cheque book

Will the post office charge any amount for the issue of the cheque book for savings bank account?

A. Sen, Calcutta

Under the schedule of fees available on the Department of Posts website, there is no fee for a cheque book with up to 10 leafs in a calendar year. Thereafter, there is an additional cost of Rs 2 per cheque leaf.

Back from US

I have recently left my job in the US and come back to India and am a resident at present. My previous employer had opened a defined contribution retirement savings plan. Do I have to disclose income in that account in my tax returns in India? If so, then how can this disclosure be made?

Mahesh Gupta, Calcutta

It would be prudent if you disclose the income while filing a tax return in India. Schedule FA under ITR 2 can be utilised to disclose details of foreign accounts held under various heads.

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