About Aditya Birla Health Insurance OPD Care
Aditya Birla Health Insurance (ABHI) OPD Care is an add-on cover that provides coverage for outpatient medical expenses incurred by the insured. It covers the insured for physical outpatient doctor consultations as well as virtual consultations. This rider can be purchased along with Aditya Birla Activ Health, Activ Assure and Activ Care plans.
Aditya Birla Health Insurance OPD Care: Key Highlights
| Categories | Specifications |
|---|---|
| Pre-existing Diseases Waiting Period | Not applicable |
| Co-payment | Not applicable |
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Key Benefits of Aditya Birla Health Insurance OPD Care
Aditya Birla Health Insurance OPD Care Inclusions & Exclusions
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Unlimited Physical Outpatient ConsultationsIt covers the medical expenses incurred on availing physical outpatient consultations from a general physician for an illness/injury an unlimited number of times.
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Unlimited Virtual ConsultationsIt covers the medical expenses incurred on availing virtual consultations from a general physician for an illness/injury an unlimited number of times. Virtual consultations include both teleconsultations and video consultations.
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Physical Specialist ConsultationsIt covers the medical expenses incurred on availing physical outpatient consultations from two specialists for an illness/injury. The specialist can be a gynaecologist, paediatrician, orthopaedic, ophthalmologist, nutritionist and physiotherapist.
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In-patient hospitalization expenses
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Pre & post-hospitalization expenses
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Domiciliary hospitalization
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Intentional self-injury
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Treatment for alcohol or drug addiction
In case of emergency we are just a call away. Take care of your family, we will do the rest. Our claim specialists will reach your location & complete the formalties from filing the claim to documentation to coordinating with insurer, TPA & hospital. Available in New Delhi and 114+ cities View cities list ›Policybazaar Claim Process
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Aditya Birla Health Insurance OPD Care: FAQs
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Q1. Can I buy ABHI OPD as a standalone policy?
Ans: No. You cannot buy ABHI OPD Care as a standalone policy because it is a rider. It can only be purchased along with a base health insurance policy, such as Aditya Birla Activ Assure, Activ Care and Activ Health plans. -
Q2. Will ABHI OPD offer unlimited outpatient consultations with all doctors?
Ans: No. The ABHI OPD Care add-on offers unlimited outpatient consultations only with doctors listed within the network of Aditya Birla Health Insurance Company. -
Q3. Can I buy ABHI OPD if I have the optional OPD cover under my Aditya Birla Activ Health policy?
Ans: No. You cannot buy the ABHI OPD add-on if you have already opted for the OPD cover under your Aditya Birla Activ Health policy. You can either opt for the ABHI OPD Care or the optional OPD cover under your base policy.
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Q. What is the advantage of selecting a policy with a duration of more than 1 year?
Ans: If one buys Aditya Birla Health Insurance for more than a year, one can save 7.5 % and 10% on the 2 and 3 years premium, respectively.
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Q. How is an Individual cover different from a Floater cover?
Ans: In an Individual cover, coverage is offered to each individual in the family separately. In a Family Floater health insurance plan, each family member is covered based on a floater sum insured.
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Q. How is an Individual cover different from a Floater cover?
Ans: In an Individual cover, coverage is offered to each individual in the family separately. In a Family Floater health insurance plan, each family member is covered based on a floater sum insured.
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Q. What is a waiver of a mandatory co-pay cover?
Ans: This benefit is covered on payment of an additional premium. Therefore, any mandatory co-payment that is applicable under the Aditya Birla Activ Health Essential Plan will be waived off.
Aditya Birla offers two types of claim settlements – cashless and reimbursement. Follow the steps to raise a claim:
- Find the nearest network hospital of Aditya Birla
- Get admitted to the hospital
- Notify the insurance company about the hospitalization
- In case of pre-planned hospitalization, intimate the insurer before hospital admission.
- Fill up the pre-authorization form and submit it to the hospital staff
- The pre-authorization form will be sent to Aditya Birla for approval.
- Once approved, obtain medical treatment.
- At the time of discharge, sign all the medical documents.
- Pay for the items/services not covered under the Aditya Birla policy
- The network hospital will send the hospital bill to Aditya Birla.
- After review, the insurance company will pay the bill amount directly to the network hospital.
- Inform the insurance company about the hospitalization
- In case of planned hospitalization, notify the insurer before hospital admission.
- Receive medical treatment
- At the time of discharge, pay the entire hospital bill in full.
- Collect all the medical documents, bills and payment receipts
Our Claim specialists in below cities will reach your hospital or home in 30 minutes to support your health insurance claim
