Level of cover in OPD plans is not very high

  • Generally, you should have a term cover of 10 times your annual income
  • Some insurances have dedicated sub-limits within the OPD sum assured for specific treatments such as physiotherapy

I have a home loan of 45 lakh from a private bank. I have a term insurance of 30 lakh and two dependants. Should I increase my cover?

Manak

Generally, you should have a term cover of 10 times your annual income. This amount should be further enhanced for any liabilities you have. Thus, your current coverage of 30 lakh is inadequate. Buy a new term plan to fill this gap.

I get health insurance cover of 5 lakh from my office. It doesn’t have any OPD (out-patient department) coverage. My parents and I spend considerably on OPD expenses. Is there any policy where we can get OPD coverage? I don’t mind paying higher premiums. Else please tell us what cover should I opt for?

—Pratishtha Ingale

A number of individual health plans provide OPD coverage. The sum assured in most of these plans range between 5,000 and 20,000 but there are plans that go much higher as well. Some insurances have dedicated sub-limits within the OPD sum assured for specific treatments such as physiotherapy.

OPD coverage is typically linked to the overall sum asured of the plan. For example, for a sum assured of 5 lakh, OPD coverage could be limited to 5,000. For higher sum assured, say 30 lakh, the OPD limit may go up to 45,000. Your premiums would thus be dependent on the overall sum assured and the OPD benefit.

The incremental premiums due to OPD are 70-100% of the total OPD limit. This means that the level of insurance in OPD plans is not high. At this time it is better to think of health insurance for hospitalisation and day care procedures rather than OPD. However, that landscape is changing as many insurers are developing innovative OPD products.

You can also consider a wellness card. These cards can be used to avail discounts on pharmacies, diagnostics and doctor consultations. If you do not have personal health insurance cover, other than the one provided by your employer, you must buy one.

Abhishek Bondia is principal officer and MD, SecureNow.in. Queries and views at mintmoney@livemint.com

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