OPD vs IPD: Difference Between Inpatient and Outpatient Care

Health insurance plans are designed to provide financial support against medical expenses incurred on availing inpatient and outpatient care. While most plans offer coverage for IPD expenses, only a few cover the cost of OPD care. Knowing the difference between OPD and IPD care can help you manage your healthcare and out-of-pocket expenses. Read on to understand what is IPD and OPD care and their differences.

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      What is IPD?

      IPD full form is inpatient department. An IPD or inpatient hospitalization occurs when you are admitted to a hospital for at least 24 hours for medical treatment. IPD treatment involves an overnight stay at the hospital for in-depth monitoring and observation. In-patient hospitalization is usually required during a medical emergency or for a pre-planned surgery or treatment, such as severe burns, open heart surgery, childbirth, organ transplant surgery, etc.

      Let's understand in-patient hospitalization with the help of an example.

      Suppose Ram has been diagnosed with 90% blockage in his heart and requires major open heart surgery to clear the arteries. The doctor asked him to get hospitalized immediately and operated on him. He was kept in the ICU under constant observation for 2 days and was discharged after a week. In this case, Ram's hospitalization is categorized as IPD or in patient care.

      What is OPD?

      OPD full form is outpatient department. An OPD or outpatient care is provided when you receive medical treatment without getting admitted to a hospital. These treatments are conducted in the outpatient department of a hospital, a clinic or a diagnostic centre. OPD care includes doctor consultations, medical tests like MRIs, dental procedures, minor surgeries like LASIK eye surgery and procedures for chronic illnesses like chemotherapy and dialysis.

      Let's understand outpatient care with the help of an example.

      Suppose Pooja developed a fever and a cold and went to a nearby clinic. The doctor diagnosed viral fever, prescribed some medicines to her, and advised her to rest. In this case, Pooja's doctor consultation and medicine bills will be categorized as OPD or outpatient care.

      What is the Difference Between OPD and IPD?

      Take a look at the main difference between IPD and OPD care in the following table:

      Categories IPD or Inpatient Hospitalization OPD or Outpatient Care
      Meaning When a patient is admitted to a hospital (for at least 24 hours) for medical treatment When a patient receives medical treatment from a health professional without getting admitted to a hospital
      Medical Care Requires long-term medical care, like in complex surgery cases Requires short-term medical care, like diagnostic tests
      Monitoring and Observation Requires constant monitoring and in-depth observation Does not require constant monitoring and in-depth observation
      Treatment Cost In-patient hospitalization costs are much higher than outpatient care OPD treatment costs are way lower than in-patient hospitalization
      Health Insurance Coverage Covered if the hospital admission is for a minimum of 24 hours Covered if the policy offers OPD benefit
      Healthcare Professionals Requires specialists and a group of medical professionals Requires a general physician and medical specialists

      Once you have understood inpatient and outpatient difference, know how to decide the type of medical care suitable for your healthcare needs.

      How to Decide If You Need IPD or OPD Treatment?

      The medical care you need for a symptom, medical condition or disease determines whether you need inpatient or outpatient care. Check out when you would need IPD and OPD care below:

      • If you require major surgery or treatment for an illness that involves round-the-clock monitoring or intensive care, then your doctor will recommend in-patient hospitalization.
      • If you need a doctor consultation, health screening, medicines for an illness or minor surgery/ treatment that does not require an overnight stay at the hospital, then OPD care will be suitable for you.

      Usually, your doctor or healthcare professional decides if you need an IPD hospitalization or OPD care.

      What are the Costs for Inpatient vs Outpatient Care?

      IPD is more costly than OPD.

      In-patient hospitalization involves boarding charges, constant monitoring, medical tests, medicines and major surgeries/procedures over a few days. Since it involves longer medical intervention and services from a group of caretakers, it is more expensive than outpatient care. Besides these medical expenses, IPD hospitalization also involves the cost of consumables or non-medical items, like syringes, gloves, housekeeping charges, surgical blades, etc., that can add to the bill.

      On the other hand, OPD care involves limited medical intervention in terms of doctor consultations, medical screening, minor procedures & treatments and medicines. Hence, they are more affordable than IPD care.

      Does Health Insurance Cover Inpatient Hospitalization?

      Yes.

      All health insurance plans cover IPD or inpatient treatment if the insured has been admitted to the hospital for at least 24 hours. The extent of coverage offered by insurance companies for in-patient hospitalization is limited to expenses incurred on:

      • Doctor's fees
      • Room rent
      • Cost of medicines and drugs
      • Intravenous fluids, injection and blood transfusion charges
      • Diagnostic tests' charges
      • Cost of consumables or non-medical items
      • Operation theatre charges
      • Intensive Care Unit (ICU) charges
      • Cost of prosthetics and other equipment/devices implanted internally during surgery

      People also read: Can Health Insurance be Claimed in Less than 24 Hours?

      Does Health Insurance Cover OPD Care?

      A health insurance policy covers outpatient treatment expenses only if it comes with the OPD benefit. While some plans may have an in-built OPD cover, others may offer it as an add-on cover or rider on payment of an additional premium. As part of the OPD benefit, the insurance company will pay for the OPD expenses incurred on:

      • Doctor consultations
      • Diagnostic tests, such as X-rays, blood tests, CT scans, MRIs, etc.
      • Dental procedures and surgeries, such as cavity removal, root canal treatment, tooth extraction, etc.
      • Minor surgeries that do not require overnight observation
      • Chemotherapy, dialysis and other treatments for long-term diseases
      • Medicines
      • Physiotherapy
      • Rehabilitation

      However, the exact scope of OPD coverage may vary from one medical insurance plan to another.

      People also read: What is the Difference Between Day Care Treatment and OPD Treatment?

      FAQs

      • Q1. What is OP and IP in hospital?

        Ans: OP means outpatient and IP means inpatient in hospitals or medical industry. In patients and out patients are differentiated based on their need to stay in a hospital overnight for medical treatment.
      • Q2. What is an IPD patient?

        Ans: An IPD patient is a person admitted to a hospital for treatment for at least 24 hours.
      • Q3. What does OPD mean?

        Ans: OPD means the outpatient department of a hospital or clinic. Patients can avail an OPD treatment without getting hospitalized.
      • Q4. What is an example of an outpatient?

        Ans: Undergoing a PET scan for cancer or an MRI for a foot injury are examples of outpatient care.
      • Q5. What are the outpatient benefits?

        Ans: Outpatient benefit in health insurance refers to the medical coverage provided for doctor consultations, medicines, dental procedures and diagnostic tests without having to stay overnight at a hospital.
      • Q6. What is IPD used for?

        Ans: IPD hospitalizations are required in case of major surgeries or treatments like brain surgery, heart surgery, laparoscopy treatment, knee-replacement surgery, etc.
      • Q7. What is the difference between OPD and hospitalization?

        Ans: OPD allows people to avail medical treatment on an outpatient department basis without being admitted to a hospital. However, hospitalization is required for major procedures and surgeries involving intensive care and constant monitoring.
      • Q8. Does maternity come under IPD or OPD?

        Ans: The regular visit to your gynaecologist, ultrasounds and medicines taken during pregnancy come under OPD. However, the procedure of childbirth, including normal and C-section deliveries, comes under OPD.
      • Q9. Does emergency come under IPD?

        Ans: Medical emergencies may or may not come under IPD, as not everyone who visits a hospital for an emergency gets admitted for over 24 hours. In several emergency cases, patients are discharged after providing immediate medical attention and advised to show a physician under OPD the next day.
      • Q10. What is IPD and OPD insurance?

        Ans: IPD insurance covers the medical expenses incurred during in-patient hospitalization. On the other hand, OPD insurance covers the cost of outpatient treatments.
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      Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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