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Evaluate OPD plans on sum insured, coverage, sub-limit, and network

Business Standard

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July 03, 2025

Visit Health, a digital healthcare and outpatient department (OPD) insurance platform, in partnership with India InsurTech Association, has released a report estimating India's OPD market at $37.7 billion.

- SANJAY KUMAR SINGH & KARTHIK JEROME

Insurance coverage in the segment, however, remains below 0.1 per cent. The report also notes that 61 per cent of corporate employees use OPD benefits when available, indicating strong latent demand.

What OPD plans cover

OPD plans, usually offered to retail customers as an add-on to the base health insurance policy, cover medical expenses that do not require hospitalisation.

"OPD benefit covers expenses related to medicines, pharmacy, diagnostic tests, doctor consultations, etc., which are not covered in regular health insurance plans if the insured is not hospitalised," says Parthanil Ghosh, executive director (subject to Irdai approvals), HDFC ERGO General Insurance Company.

Cost-effective cover

This cover is cost-effective.

"Typically, if the sum insured on your OPD cover is ₹100, the plan will be priced between ₹50 and ₹70, so it can save you money," says Kapil Mehta, co-founder, SecureNow Insurance Broker.

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