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OPD (out-patient department) insurance covers have caught the attention of many insurance customers after insurers such as ICICI Lombard and Apollo Munich announced cashless facilities for OPD visits. Such policies cover consultation, dental procedures and the cost of spectacles or prescribed medicines, among other things. Typically, they are part of high-end plans sold by the insurers where the premium is higher. However, many insurance companies offer several equally useful in-built benefits that somehow haven’t got as much attention from customers. Insurers have started paying for expenses like ambulance charges, OPD, domiciliary expenses and daily allowance as they want to differentiate themselves from traditional health insurance products. Since some of these newer features are typically not covered from the first year, it also helps them retain customers. Such benefits include cover for treatment taken at home under certain circumstances, critical illnesses or allowance for miscellaneous expenses incurred during hospitalisation.

 

However,perhaps due to lack of awareness, they haven’t got many excited. This is despite the fact that many of these benefits are part of regular health insurance plans and don’t require additional premiums. Check your policy document to ascertain whether you are entitled to such little-known benefits.

Treatment Taken at Home

Some health plans cover treatment taken at home on doctor’s advice or because the insured is not in a position to visit the hospital. The admissible expenses include nursing charges and other medical bills. However, some policies exclude treatment for conditions like arthritis, asthma and diabetes, in addition to imposing sublimits. For instance, there could be an ad-hoc cap like . 50,000 or a sub-limit of 10% of the sum insured. This is different from preand post-hospitalisation expenses, which arise out of the insured’s hospitalisation. Oriental Insurance, Apollo Munich, Religare Health and Bharti-AXA General, among others, cover these expenses as part of their regular health insurance policies.

Daily Cash Allowance

It is a pre-fixed payout meant to take care of miscellaneous expenses incurred by the policyholder or her relatives. While such covers are generally offered as riders or separate products, certain companies like Oriental Insurance, Religare Health, Tata-AIG and Bharti-AXA General offer inbuilt cash allowance, ranging from . 200-2,000 per day for up to seven to 90 days. You don’t have to produce bills to claim it and the pre-determined amount is handed over to you once the claim is made.

For Accompanying Persons

This allowance is typically offered to parents of the insured child, but some companies also extend it to any person accompanying the patient. The cover is meant to take care of food, commuting or other ancillary expenses incurred by the attendant. Again, it is pre-fixed, ranging from . 250-500 per day for five to 10 days.

 

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