Health Card vs. Health Insurance with OPD Coverage

Health is a very important aspect of our lives. Today, when the world is moving at a lightning-fast pace, being healthy and fit sounds like a difficult dream to achieve. Due to the increase in inflation over the years, the world has seen an unprecedented rise in costs of all the services that one may need. With such huge rises in costs, we must take a look at the alternatives at our disposal i.e. Health Cards & Health Insurance with OPD Coverage.

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    Introduction

    Health costs have gone up too and, if ever needed, it may hurt the wallet in a really bad way. To overcome such a problem, people often use Insurance. Insurance is of many types- Motor, Travel, Health, etc. and provides cover against most of the eventualities in the hour of need.

    Health insurance is an agreement between the policyholder and the insurance provider where the policyholder has to make several deposits, called premiums, to the insurance provider. If in the face of any medical emergency, a claim is made, the insurance provider covers the medical costs as mentioned in the policy documents.

    It is generally wise to be prepared for any impending eventuality that may come to one's way. As health insurance provides a variety of benefits, not restricted to financial benefits, people nowadays are preferring health insurance in larger numbers. But is it worth the cost?

    The Great Hiccup!

    What if someday you decide to go for a dental appointment? Or your kid suffers an injury that has left him with a broken finger? Even if you happen to have a full-fledged health insurance policy, it is most probably not going to cover those expenses.

    While these expenses may seem negligible at first, regular appointments to the doctor and a plethora of tests can leave your pockets burnt, completely. These expenses muddle up your savings and leave you scratching your head and asking, “What is this Health Insurance Policy for?”

    Health Insurance- Extravagant or Economical?

    Many health insurance providers include the Out Patient Department (OPD) costs, also known as Health Insurance with OPD coverage, meant for such routine appointments. But is it really smart to pay a hefty price, every year, for availing services which you seldom need and can be availed at a fraction of cost?

    Though health insurance pays for a variety of critical illnesses and other emergencies, it is wiser to ponder upon the costs incurred for having such a protection cover which you may need only in specific scenarios.

    While Health Insurance with OPD has its advantages, it also has some disadvantages too. There are a large number of expenses that are uncovered in a typical Health Insurance with OPD and the list is quite lengthy. Some of those expenses are:

    • Dental Treatment
    • Optical Equipment (Spectacles and Contact Lenses)
    • Hearing Aids
    • Medical Equipment
    • Diagnostic Examinations & Reports
    • Vaccinations
    • Psychiatric Treatments

    Generally, health insurance policy costs anywhere between a few thousand to lakhs. According to Economic Times Wealth, premiums for a cover of 20 lakhs from any general insurer for a non-smoker male without any pre-existing diseases may cost as follows:

    Age

    Annual Premium (rounded off)

    35+

    10,000-17,000

    45+

    13,000-25,000

    55+

    24,000-47,000

    65+

    37,000-71,000

    Whereas, many regular health insurances and top-up combinations are expected to cost you as follows:

    Age

    Annual Premium for Regular Plan (rounded off)

    Annual Premium for Top-Up (rounded off)

    35+

    5000-10,000

    1,000-6,000

    45+

    6000-13,000

    1,000-8,000

    55+

    11,000-21,000

    3,000-13,000

    65+

    17,000-41,000

    7,000-24,000

    As is quite evident from the data above, health insurances are indeed exorbitant which makes looking for a backup indispensable.

    Health Cards - The Reasonable Alternative

    Health care plans are exclusive schemes that have no exceptions for any medical emergency. Health care plan holders are issued with a physical card, nowadays electronic, for availing the benefits of the plan for a monthly or annual membership fee.

    These health care plans have several hospitals, clinics, nursing homes, and laboratories in their network which provide greater flexibility. The plans have coverage for almost all the medical expenses and in some cases, cosmetic treatments too.

    Most of the time, people with pre-existing diseases or older age may not be able to secure their lives with a health insurance plan. In such cases, health care plans act as a life savior.

    Following the announcement of the Ayushman Bharat Scheme, Government of India is now upgrading around 2 lakh sub-centers into wellness centers. The Government is also issuing electronic health cards to all the Indian citizens visiting these wellness centers.

    These cards also act as an electronic repository of patient's prior treatment records and medical history. Through these cards, any patient can visit any wellness center without having to maintain a medical records book.

    Even if the cardholder is in an unconscious state, the doctors can easily verify his/her identity and access his/her medical history.

    A health care card holder exercises some of the following benefits:

    • Affordable Membership Fee (ranging anywhere from a few hundred to a few thousand)
    • Discounts on OPD consultations and treatments
    • Exclusive coverage for dental care
    • Great savings and medical vouchers
    • Follow-Up medical tests and consultations
    • 24x7 Doctor-on-call
    • A second opinion before surgeries
    • Discounted ambulance charges
    • Electronic health log

    Apart from medical care and treatments, some companies also have exclusive Wellness Plans which include Diet Programmes, Gym Services, Spa Treatments, Ayurveda and Homeopathy with attractive discounts.

    The Bottom Line

    Health Care plans and Health Insurances with OPD both have several advantages and disadvantages. Which one to choose is at the sole discretion of the service seeker. Many underlying factors govern this decision such as financial condition, need of the plan, etc.

    One must choose the plans as tactfully as he/she can and completely understand the terms and conditions that apply. A perfectly chosen plan can prove to be a vital companion during any medical eventuality.

    But before going for any of the two, one must keep in mind the intricacies to process both during the registration or purchase and claim. Furthermore, it is highly advised to be aware of the company’s history regarding its plan offerings and genuineness. After all, being vigilant is of no harm!

    Written By: PolicyBazaar - Updated: 29 July 2021

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