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What is OPD Cover in Health Insurance?

Explore the benefits of OPD cover in health insurance, including consultations, tests, minor procedures, pharmacy charges, and alternative therapies for reduced out-of-pocket expenses.

  • 13 Feb 2024
  • 3 min read

With the number of insurance options available, it is natural for you wonder ‘What is OPD cover in health insurance?' OPD (Outpatient Department) cover caters to services outside hospitalisation such as consultations, doctor's examinations, pharmaceutical expenses, physiotherapy, dental treatments, and diagnostic tests. It saves patients from spending their out-of-pocket cash. 


With OPD services, the patient gets tested and treated and returns home. Usually, there's no need for an overnight admission in a hospital. 

OPD Cover in Health Insurance

What is OPD cover plan? Typically, the OPD cover plan in health insurance caters to any of the following categories: 

  • Consultations with Medics

If you're consulting with doctors, general practitioners, medical specialists, or making follow-up visits, the OPD cover pays for the amount charged for the consultations.

  • Diagnostic Tests

OPD cover also caters to diagnostic tests that enable doctors to establish a patient's medical condition. The tests include X-rays, blood tests, ultrasounds, CT scans, and MRI scans. It may also cover other medical imaging procedures such as colonoscopy, gastroscopy, Electrocardiogram (ECG), Electroencephalogram (EEG), biopsy, and more.

  • Minor Procedures

OPD medical cover may also cater to minor procedures done in an outpatient scene like stitching open wounds or incisions, dental procedures, or removing foreign material lodged in the eye.

  • Pharmacy Charges

They often cover the cost of prescribed medicines. It caters to either short-term or long-term drug prescriptions for both acute and chronic conditions.

  • Alternative Therapies

OPD insurance may cover alternative treatments such as chiropractic services and acupuncture.

Also read:


Given that outpatient medical services are more common, OPD cover is essential to our health insurance plan. It helps patients cut costs they could otherwise incur for all the minor treatments. Please note that the OPD insurance coverage benefits may differ from one insurance to another. So, ensure you check your health insurance carefully to understand its benefits. Also, remember to fill in the claim form and inform your insurer in advance when seeking hospital services.

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