Written by Amit Shubra
The COVID-19 pandemic has been eventful in the world in more ways than one. It has completely changed the way people think when it comes to their health, their money, the way they want to work, and even the way they want to live their lives. Every sector has undergone major changes during the COVID period, and the same is true for insurance section. And even the consumer is no longer the same as his preferences have changed in many ways.
While the pandemic has brought the importance of having health insurance Once again in focus, the policy configuration that the consumer now wants is fully developed. According to industry trends, the consumer no longer wants an operating policy that only covers the cost of hospital treatment. After COVID-19, they are more inclined towards buying a comprehensive plan that covers outpatient (outpatient) expenses as well. Outpatient expenses They are those incurred where treatment and diagnosis are made during the visit to the clinic or hospital consultation room, without the need for physical hospitalization.
Increased demand for outpatient coverage
according to Politics Bazaar data, this trend is rebounding quickly as nearly 15 percent of clients are now taking some form of outpatient coverage alongside health insurance. Previously, this number was zero. One may ask why this is. This is because while a normal health insurance policy covers the costs of medical care in the event of hospitalization, when it comes to costs related to medical care that do not involve hospitalization, they are usually not covered. Industry data shows that outpatients account for more than 70% of the cost in Health Care section. Most people usually pay this cost out of their pocket. Moreover, outpatient expenses were not covered by health insurance policies earlier. This means that despite having a health insurance plan, one still needs to pay out-of-pocket expenses such as a doctor’s consultation, medication, tests and checkups.
According to various reports, personal expenses in the case of COVID-19 treatment were in the range of 30-50 percent of the total amount spent on COVID-19 treatment. So it is only natural that the consumer becomes more aware of these expenses and wants health coverage that covers this cost as well.
Covering physical consultations through digital outpatient clinics only
Here are some interesting trends that Policybazaar data points to –
• The most popular outpatient cover among consumers is the one that also has a ‘physical component’. Clients find this to be a better option compared to just “digital outpatients” where online consultations with doctors are covered but not physical visits.
• While the trend towards opting for outpatient cover has found more contestants in Tier 1 and Tier 2 cities at the moment, it is gradually seeing traction in Tier 3 cities and beyond as well.
• Furthermore, most policyholders prefer cashless payment method as they do not have to pay anything up front and wait for the claim to be paid. Instead, they can just take the smoother cashless route.
• In terms of gender composition, more brands are choosing outpatient coverage versus female clients. In fact, of all consumers who have opted for outpatient cover, about 80 percent are male.
• The preference for choosing outpatient insurance coverage is also higher among policyholders who go for a higher sum insured. As per the available data, in general, 30 per cent of all insurance consumers go for health insurance coverage of Rs 1 crore.
• Among these consumers, 30 percent of customers choose some type of outpatient cover. Most clients who choose the additional outpatient coverage benefit from the sum insured to cover expenses related to doctor’s consultation, diagnosis and pharmacy costs. The data give a clear indication that outpatient cover is gaining popularity among consumers in the country.
General expenses covered under outpatient health insurance:
Consultation with a Physician: A regular health insurance plan does not cover the fee for a physician’s consultation when you make the occasional visit to seek medical advice. However, by choosing an OPD add-on, you guarantee that these expenses are covered by your policy. This add-on is especially useful in family plans that also include coverage for children, as visits to the doctor are likely to be frequent in such cases.
Diagnostic tests: The additional outpatient function also covers the cost of diagnostic tests regardless of whether or not you have a disease. This is applicable as long as the tests are prescribed by your doctor.
Pharmacy Expenses: These expenses on prescription drugs can add up, but are not covered under a regular health insurance plan. With outpatient cover, these expenses are covered by your policy.
Dental procedures and other aids: Dental procedures — such as root canal treatments, fillings, and tooth extractions — are not covered by regular health plans. On the other hand, if you choose the additional coverage for OPD, you will not only get protection from the expenses incurred for such procedures, but even the cost of dentures are covered with a certain limit. In fact, even the cost of hearing aids and eyeglasses – such as contact lenses and eyeglasses – is covered by a certain limit.
Outpatient cover comes with huge benefits and covers you on a wide range – from something as simple as a fever to complex daycare procedures. Moreover, it also compensates you for exorbitant pharmacy bills and diagnostic tests. Altogether, these medical expenses It can add up a lot in the long run and can cause a major financial setback in the absence of outpatient coverage. Nowadays, it is an indispensable addition, which many consumers have already recognized.
Written by Amit Shubra, Head of Health Insurance, Policybazaar.com
(Disclaimer: The opinions expressed are solely those of the author and are not necessarily shared by ETHealthworld. ETHealthworld.com shall not be liable for any damage caused directly or indirectly to any person/organization)