Top Companies Offering OPD & Dental Insurance

By Ashwini Nathany

Posted on February 28, 2023

In India, the coverage for Outpatient Department (OPD) visits under health insurance policies can vary. Some health insurance policies provide coverage for OPD expenses, while others may not.

The cost of Out-Patient Department (OPD) care and diagnostics in India can vary widely depending on various factors, including the frequency and type of medical services required, the location of the healthcare provider, and the provider’s fees. However, I can provide some approximate figures based on available data.

According to the National Sample Survey Office’s (NSSO) 75th round report on ‘Key Indicators of Social Consumption in India: Health’, which was conducted during the period of July 2017 to June 2018, the average out-of-pocket (OOP) expenditure per capita per year on OPD consultations and diagnostics was Rs. 727 for rural areas and Rs. 1,210 for urban areas. This includes expenses for both medical consultation and diagnostics tests, such as blood tests and imaging scans. Based on this data, if we assume an average family size of four, the average Indian family may spend around Rs. 2,900 to Rs. 4,840 per year on OPD care and diagnostics. However, it’s important to note that these figures are only averages and may not reflect the true cost of healthcare for every family, and healthcare costs have been rising in recent years post the COVID 19 pandemic.

In a report published by the Indian Dental Association in 2015, the average cost of a dental consultation in India can range from Rs. 200 to Rs. 500. The cost of more complex dental procedures such as fillings, root canals, and extractions can range from Rs. 500 to Rs. 5,000 or more, depending on the complexity of the procedure and the materials used. Based on these figures, if we assume an average Indian family size of four, and a conservative estimate of one dental consultation per person per year, the average Indian family may spend around Rs. 3,200 to Rs. 8,000 per year on basic dental care. However, if family members require more complex dental procedures, the cost can be significantly higher.

Typically, basic health insurance policies may not cover OPD expenses, but some policies may offer OPD coverage as an optional add-on. Policyholders who opt for OPD coverage may be able to claim reimbursement for expenses such as doctor consultations, diagnostic tests, and prescription medicines.

It’s important to carefully review the terms and conditions of a health insurance policy to understand what is covered and what is not. Policyholders should also check the list of network hospitals and clinics to see if the OPD services they need are covered by their insurance. Overall, while OPD coverage is not always included in health insurance policies in India, policyholders have the option to add it to their coverage if they wish.

There are several insurance companies in India that provide OPD, diagnostic, and dental insurance. Here are some of the popular ones:

1. Max Bupa Health Insurance – Max Bupa offers OPD insurance plans that cover outpatient expenses, including doctor consultations, diagnostic tests, and pharmacy bills. They also have dental insurance plans that cover expenses for dental treatment, including preventive care and major dental procedures.
2. HDFC Ergo Health Insurance – HDFC Ergo offers an OPD insurance plan that covers outpatient expenses, including doctor consultations, diagnostic tests, and pharmacy bills. They also offer a dental insurance plan that covers dental treatments such as scaling, fillings, root canal treatment, and extractions.
3. Bajaj Allianz Health Insurance – Bajaj Allianz offers an OPD insurance plan that covers expenses related to doctor consultations, diagnostic tests, pharmacy bills, and wellness services. They also have a dental insurance plan that covers expenses for dental treatments such as fillings, root canal treatment, and extractions.
4. ICICI Lombard Health Insurance – ICICI Lombard offers an OPD insurance plan that covers expenses related to doctor consultations, diagnostic tests, and pharmacy bills. They also have a dental insurance plan that covers expenses for dental treatments such as fillings, root canal treatment, and extractions.
5. Apollo Munich Health Insurance – Apollo Munich offers an OPD insurance plan that covers expenses related to doctor consultations, diagnostic tests, and pharmacy bills. They also have a dental insurance plan that covers expenses for dental treatments such as scaling, fillings, root canal treatment, and extractions.
6. Bajaj Finserv Health Aarogyacare – Offers one of the best health insurance packages with pre-hospitalization OPD cover. You can get free consultations with doctors, Free Lab tests and much more. It has built a hassle-free claim process through the app and your health claim is just a few clicks away.

It’s important to note that the coverage and premiums of these plans may vary depending on the specific policy and the insurance provider. It’s always a good idea to carefully review the policy terms and conditions before purchasing any insurance plan to ensure that it meets your specific healthcare needs.

Top Companies Offering OPD & Dental Insurance