With Apollo DKV's Maxima and ICICI Lombard’s Health Advantage Plus have now started covering OPD expenses within their coverage heads.
This is being seen by many in the industry as a gradual shift towards inclusion of this most-common cost head in medical bills of patients.
OPD charges refers to the cost incurred by a policy holder where in the covered individual is NOT admitted. Typically most Health Insurance policies in the country have covered hospitalisation & related expenses & the OPD charges were borne by the policyholder on her own.
Most companies have feared large scale misuse when it comes to OPD charges. Hence even these plans come with some riders, mainly
1. The OPD claim can be done only once in the whole year
2. The Claim cannot be done within 90 days of policy commencement
3. There is a pre-defined cap on the OPD amount, that one can claim in such policies.
Hence we recommend that if you intend to go in for any of these polcies, do understand the OPD coverage (& the riders therein very clearly)
