What is OPD?

OPD is the Outpatient Departmentwhere basic cases that require optimum medical attention are treated. The diagnosis is well conducted by a doctor. You are simply required to visit the clinic and pay the consultation charges. In a hospital, it is the general OPD ward where patients are provided medical assistance and treatment.

Under an OPD category, you are not required to stay or get admitted to the hospital. Modern OPDs provide a wide range of services such as illness diagnosis, medical tests and minor surgical injuries.

Features Of OPD

Mentioned Below Are The Features Of OPD - Outpatient Department:

  • First point of contact in medical treatment.
  • Stepping stone for health promotion and disease prevention.
  • Facilitates screening and investigations for admission to the hospital.
  • Easy access to doctors/medical practitioners.
  • Ideal for general illness prevention/vaccinations.

Benefits of OPD

Mentioned Below Are The Benefits Of Outpatient Department:

  • Less expensive in comparison to inpatient hospitalization.
  • Suitable for minor surgical procedures.
  • Access to a wide range of clinics/doctor’s/medicines.
  • Ideal for accidental related emergencies/Ambulance-on-call.
  • Control and surveillance of communicable diseases.
  • Provides a database of medical history and research.
  • Provides a training ground for medical, para-medical, nursing staff, and future doctors.

What Is Covered & Not Covered In OPD? (Outpatient Department)

What Is Covered In OPD? (Outpatient Department)

This Varies From Policy To Policy, The General Cover Includes:

  • Doctor on call/chat consultations.

  • Outpatient consultations by a general Medical Practitioner(s) or a specialist Medical Practitioner(s) in a policy year

  • Clinical visits to the doctor for medical treatment.
  • Family members aged 91 days to 65 years.
  • Discounts on diagnostic and lab tests.

    What Is Not Covered In OPD? (Outpatient Department)

  • Any claim resulted due to involvement in illegal activities.
  • Any claim resulted due to substance abuse.
  • Inpatient treatment, day care procedures and naturopathy treatments.
  • Cosmetic treatments.
  • Self-inflicted injuries.

List of Health Insurance Plans that Cover OPD Expenses

Health Insurance Plans With OPD coverage:

ICICI Lombard - Health Protect Plus, Health Smart, Health Smart Plus

ICICI Lombard provides three health care plan which offer OPD cover (Health Protect Plus, Health Smart and Health Smart Plus). Reimbursement for the medical expenses incurred as an Outpatient (OPD) depends on the plan chosen.

Apollo Munich Maxima

This plan provides unique outpatient coverage expenses. You can avail the benefits via the mobile app as well. There is no waiting period, you are covered from day 1, and the cost of each outpatient consultation or diagnostic test is limited to INR 1000/-. This policy is purely on cashless basis. There is no reimbursement available under this policy. It covers unlimited Outpatient consultations by a general Medical Practitioner(s) or a specialist Medical Practitioner(s) in a policy year.

Bajaj Allianz Tax Gain Plan

This is a Family floater health policy which covers outpatient (OPD) expenses & hospitalization expenses and helps you in your tax management too. There are no restrictions of waiting periods to claim under Outpatient expenses. You can also claim for dental procedures and treatment under the OPD expenses. Additionally, spectacles, dentures, crutches can also be claimed under OPD expenses. The OPD expenses are applicable for self and spouse.

Max Bupa Heartbeat

This is a one-of-a-kind Heartbeat Family Floater Plan offered by Max Bupa Life Insurance which comes with a comprehensive cover of upto ₹1 crore. Customary expenses for medically necessary consultation with a doctor is covered under OPD expenses.

Eligibility Criteria for OPD (Outpatient Department)

There is no such specific eligibility criteria for OPD as any individual who is ill can go to a doctor’s clinic and avail medical treatment. The eligibility for OPD cover depends on the health policy you have purchased. If your health policy covers OPD expenses, you can avail all benefits for the same.

Tax Benefits under OPD (Outpatient Department)

You can claim tax benefits under Section 80D of the Income Tax Act, 1961.

What Is IPD (In-patient Department)

In-patient department refers to the services availed for medical emergencies/treatment arising out hospitalization. When you are admitted to the hospital for more than 24 hours. Example: General surgery.

Click Here To Know More:What is Difference between Day Care Treatment and OPD Treatment


In conclusion, medical health cover is best when it is comprehensive. Your health policy should cover every phase of illness prevention. Thus, it is suitable to purchasehealth insurance planwhich provides cover for OPD expenses.

Reviews of OPD (Outpatient Department) Service

OPD may be an add-on but it is as important as your overall health insurance in dealing with medical emergencies. OPD will help you take care of all expenses arising out of doctor’s visits/consultation. This is ideal for people who have a chronic illness and are required to visit the doctor on a regular basis. Due to this reason, many insurance companies have floated health plans with OPD expenses cover. Another reason for its high demand is because of the tax-saving benefit.


What Is Full Form Of OPD?

Fullform of OPD is Outpatient Department.

What Is OPD Limit?

The OPD limit is usually part of the sum insured or as defined by the health policy. If you make any reimbursement claims under OPD, it is deducted for the overall sum insured.

Does Health Insurance Cover OPD Charges?

Not all health insurance policies cover OPD expenses. The ones who do, it is usually deducted from the overall sum insured.

What is OPD in a Hospital?

The Outpatient Department in a hospital refers to the general section where patients visit for doctor’s consultation. It can be for a check-up, diagnostic test, follow-up to a previous appointment and micro surgical procedures. Under an OPD, you are not required to get hospitalized.

What is OPD Care?

The healthcare services obtained in the OPD is known as OPD care.

Is OPD covered in individual health insurance?

Yes, OPD expenses are covered in individual health insurance.

Can I buy OPD insurance cover?

Yes, you can buy OPD insurance cover as an add-on to the individual health plan or as a separate health product.