OPD Cover in Health Insurance

​​​OPD cover in health insurance is an invaluable feature. It addresses the often overlooked costs associated with outpatient care. This coverage includes a variety of services, including doctor consultations, diagnostic tests, minor procedures and prescribed medications.

Thus, with our health insurance plans with OPD coverage, we ensure that you can access essential healthcare without facing significant financial burdens.

By adding our OPD cover to your Reliance health insurance plans, you are better equipped to manage your day-to-day healthcare expenses. This approach also encourages regular medical check-ups and timely interventions.

With us, you ultimately lead to improved health outcomes and seek necessary medical attention without worrying about unexpected costs. You can, therefore, experience a sense of security and overall well-being with our OPD health insurance plans.

OPD Cover Health Insurance Meaning

OPD cover meaning in health insurance, is an add-on offered to cover the expenses incurred for outpatient treatments. OPD treatment means visiting a hospital or clinic and getting treatment from doctors without being admitted to the hospital. These expenses are not covered by standard health insurance.

This add-on is ideal for those who need to visit the doctor for a consultation or get medicines frequently. With this add-on, you can save significant medical expenses related to doctor consultations, medicines and diagnostic tests.

Thus, to understand the OPD cover meaning and its importance in your healthcare plan, you must understand its inclusions and exclusions in detail.

Who Should Buy Health Insurance with OPD Cover?

The best health insurance with an OPD cover helps manage the costs of routine check-ups, specialist consultations and minor treatments that do not require hospitalisation. Health insurance that covers OPD (Outpatient Department) is ideal for:

• It is particularly beneficial for individuals and families who frequently seek medical consultations or diagnostic tests.

• This coverage can greatly benefit senior citizens, families with young children and those with pre-existing health conditions.

• Individuals already diagnosed with chronic conditions and require ongoing, frequent outpatient care will find it essential.

• Those who prioritise early diagnosis and timely consultations will also appreciate OPD cover.

• This cover will greatly benefit people who actively participate in sports or are fitness enthusiasts and require frequent OPD visits.

• People who have a compromised immune system have higher OPD expenses due to frequent illness treatment.

By addressing these diverse needs, our OPD cover ensures better access to healthcare while keeping costs manageable.

OPD Benefits in Health Insurance

If you are wondering whether you want a health policy with OPD cover, you must know the benefits of our OPD cover. Here are the top reasons explaining the importance of the OPD cover policy:

• The costs of OPD consultation and treatment have been on the rise and often account for most of an individual’s healthcare costs. According to the outpatient care market in India is expected to grow at a rate of 8.96%.

• Our OPD cover provides extensive coverage, offering financial protection against consultation charges, X-rays, blood tests, other diagnostic tests, minor surgeries, dressing for accidents, prescription medicines and dental treatment.

• When you opt for OPD cover with our health insurance plans, you get access to improved health care. Moreover, you get your regular check-ups done without any financial burden.

• The best medical insurance with an OPD cover aims to encourage preventive healthcare and early detection for better disease management.

• Finally, it reduces the financial burden of frequent outpatient medical expenses and allows better financial management.

Reliance General OPD Cover in Health Insurance

Key Features of Reliance General Medical OPD Cover

Reliance OPD Cover: Inclusions

• Coverage for doctor consultations

• Coverage for diagnostic tests, such as X-rays, blood tests, etc.

• Coverage for prescribed medications

• Coverage for minor medical procedures, such as POP, suturing, dressings for accidents, etc

• Coverage for allopathic treatment

• Coverage for dental treatment- extractions and root canal treatment

• Coverage for consultations with super specialists

  • Cardiologist

  • Endocrinologist

  • Neurologist

  • Nephrologist

  • Oncologist

  • Orthopedist

  • Pulmonologist

  • Hepatologist

  • Gastroenterologists

  • Maxillofacial Surgeon

• Available for both individual and family floater policies

OPD Cover: Reliance Health Insurance Exclusions

• Dental implants

• CAD/CAM restorations

• Bone graft

• Cosmetic procedures

• Routine preventive health check-ups

• Dietary supplements

• Substances that can be purchased without a prescription, such as Vitamins, minerals and organic substances

• Self-inflicted injuries

• Expenses for diagnostic tests and prescription drugs outside of outpatient treatment

• Fraudulent claims

• Incomplete or incorrect documentation

*Refer to the for a detailed list of inclusions and exclusions.

How to Buy OPD Health Insurance?

With Reliance General Insurance, purchasing a health insurance plan online is quick and convenient. Buying our health policy with OPD cover online also gives you an opportunity to get up to a 40% discount on your premium. Follow these simple steps:

1. Visit the official Reliance General Insurance and navigate to the health insurance section.

2. Enter your name, mobile number and pin code, then click ‘View Prices.’

3. Select the health insurance plan that best suits your needs. Then, add OPD insurance cover from our list of add-ons.

4. Enter the required details, including the sum insured and policy tenure.

5. Review your information, confirm the plan, and complete your purchase of OPD cover in health insurance by paying the premium online.

Factors to Consider while Buying OPD Cover in Health Insurance

Premium Cost

Assess the affordability of the premium compared to the OPD benefits provided. Ensure that it fits your budget. Our health insurance premiums start at just ₹243/month*.

Coverage Requirements

Understand the maximum claim limit for outpatient expenses like consultations, tests, and medicines. This helps you understand your coverage requirements and choose an adequate sum insured.

Wide Network of Hospitals

Check if your preferred healthcare providers are part of the insurer’s network for hassle-free claims and high-quality healthcare. We have a huge network of 10,000+ empanelled hospitals, giving you reliable and quick healthcare services.

Customisation

Determine if the medical insurance with OPD cover is flexible enough to meet your unique medical needs, like specific treatments or frequent doctor visits to super specialists.

Understand Benefits vs. Costs

Assess the policy's premium and coverage and compare it with the actual usage of OPD services. Then, ensure that the benefits of the OPD insurance cover features suffice your costs.

Quick Claim Process

Quick processes are one of the most important factors for OPD cover. Thus, ensure the claim process is smooth and user-friendly, especially for outpatient services.

What is the Claim Process for OPD Cover?

Health insurance with an OPD claim process can be completed in a few simple steps on a reimbursement basis.

Reimbursement Claims

• Step 1: Intimate and register your OPD insurance cover claim by:
  • Contacting us on +91 22 48903009
  • Send an email to
  • Logging into the
• Step 2: Visit any preferred clinic or hospital for OPD treatment and pay for the applicable expenses.
• Step 3: Collect all medical records and receipts after treatment. You can submit the bills and receipts of OPD treatment twice in a policy year.
• Step 4: Submit the documents and to us within 7 days to Reliance General Insurance, No. 1-89/3/B/40 to 42/ks/301, 3rd Floor, Krishe Block, Krishe Sapphire, Madhapur, Hyderabad 500081. Send scanned copies within seven days to expedite claim processing.

Documents Required

• Original copy of duly completed and signed Claim Form
• All consultation bills and prescriptions of Super Specialist/Medical Practitioner (depending on Plan opted)
• Diagnostic test bills, along with copies of reports
• Medicine bills along with the Super Specialist/Medical Practitioner Prescription
• Proof of age
• Proof of identity
• Address proof
• KYC documents
• Medical reports (if applicable)

OPD vs Daycare Coverage: Difference Between Daycare and OPD in Health Insurance

Frequently Asked Questions

• What is OPD coverage in health insurance?

  OPD (Outpatient Department) coverage refers to the OPD benefits in health insurance that help cover medical expenses incurred without requiring hospitalisation. This can include doctor consultations, diagnostic tests, minor medical procedures and prescribed medicines.

• What expenses are covered under OPD in health insurance?

  OPD coverage typically includes:

  • Doctor consultations, including both general physicians and specialists.
  • Diagnostic tests like blood tests, X-rays, scans, and other investigations.
  • Prescribed medicines and drugs.
  • Minor medical procedures that do not require hospitalisation, such as wound dressings or minor surgeries.
  • Follow-up visits after major treatments.

  Coverage limits vary across different insurance policies, so it is essential to review the details of the specific plan to understand precisely what is included.

• How does the claim process work for OPD cover?

  The claim process for Reliance OPD cover is very straightforward. There are two primary methods:

  • Cashless Claim: Here, we settle the bills directly with the healthcare provider.
  • Reimbursement Claim: You pay for the services upfront and submit the bills, prescriptions and other relevant documents to us later.
  • Is there a waiting period for OPD cover?

  This cover may be subject to an initial 30-day waiting period upon policy purchase.

• Are there any exclusions in OPD cover?

  Yes, OPD cover often comes with a set of exclusions. Common exclusions include cosmetic treatments, preventive health check-ups and non-prescription supplements. Read the carefully to learn more details about the coverage of this add-on.

• What is the difference between OPD coverage and regular hospitalisation insurance?

  OPD coverage is designed to cover outpatient treatments that do not require hospital admission. This includes routine doctor visits, diagnostic tests and minor treatments.

  Regular hospitalisation insurance covers expenses related to hospital admissions for at least 24 hours, such as surgeries, inpatient care and treatment that requires longer medical supervision. ce

• Can I buy a health insurance plan with only OPD coverage?

  OPD coverage is available as an optional add-on to comprehensive health insurance policies. Thus, it cannot be purchased as a standalone product. You can add this cover to our plan and benefit from its additional features.

  Moreover, it is essential to select a policy that offers a balance of OPD and hospitalisation coverage to meet your healthcare needs comprehensively, such as our Health Infinity Plan.

• What is the best OPD health insurance plan?

  The best OPD health insurance plan depends on your individual needs, such as how often you visit doctors, the types of outpatient treatments you require, and your budget.

  To find the best fit for your requirements, look for plans that offer extensive OPD coverage, a wide network of hospitals, affordable premium costs, easy claim processes and waiting periods.

Disclaim​er​

*T&C Apply. For more details on risk factors, terms conditions, brochure, and exclusions, please read the policy wording and CIS carefully before concluding a sale.

Claim Settlement Ratio: This is the overall claim settlement ratio for FY 2023-24 without claim outstanding at the start of the financial year as per public disclosure of Reliance General Insurance Co. Ltd.

Customer Count: The total no. of customers insured data is for FY24 and has been picked up from the number of lives insured for Health, Personal Accident, Overseas Travel, Domestic Travel, Workmen Compensation and Crop Insurance, Weather LOB & Fire LOB provided by IRDAI count that is master policy count. Other than these LOBs, we have also provided data for the number of certificates issued.

Premium: The premium mentioned is excluding taxes for single person aged between 5 years to 20 years with individual health policy for Sum Insured of ₹3 lakhs considering no adverse health conditions/pre-existing disease/medical conditions with waiting period of 3 years. For more details, please refer to the policy wordings. Premium used is 2,919/year converted into a month which gives us Rs.243/month (2,919/12).

Health Infinity UIN: The details mentioned above are for Reliance Health Infinity Insurance UIN: RELHLIP23120V042223​