MYTH

This is a myth that health card offers only discounts on the doctor. But today we are going to tell you that you have half knowledge which can not win the battle.

There are many Health cards available in the market which payback 100 percent, on all doctors fee. Surprisingly, these opd cards are not insurance schemes. That is not only a key benefit in such an OPD Card or Health card since it provides your additional support against prescribed medicine expense and or lab tests expense.

 

Case Study

When Lalit Prasad’s 12-year-old daughter was diagnosed with dengue, just the cost of physician consultations, medicine, and medical tests crossed ₹6,000. But his insurance policy could not cover her daughter since it was opd treatment, not a hospitalization.

However, there are many opd cards which can reduce the cost but can not bear the cost.

These are kind of health plans that can give some privileges to the patient on their doctor visit expenses. Although discounts rates applied to their network doctor. But there is the most doctor who is not registered under such panel or network.

Challenge to Switch the Doctor

If you are new to the city then you can adjust but Lalit belongs to the same city whereas he knows the doctor to whom he has to visit for his family wellness. Unfortunately, due to this reason could not decide to buy such discount card. Although, these cards offer good discounts on medicine and doctor consultations.

But the biggest hurdle was to change the doctor. There is plenty of company who offer such opd card, IHO, medhealth and so on. They display a list of their network where a patient bound to get the advantage.

Confusion v/s Confess?

Mr. Lalit was confused since he could not find the good opd card wherein he should not change the doctor, or not ready become depending to buy a medicine from a network pharmacy. Usually, a doctor prescribes a medicine nearby of his clinic/hospital. Finding the same salt medicine in another area is a big challenge. Lalit was very much aware of the pharmacy problem. Last time, his wife met an eye specialist and but thought she will purchase the medicine from a chemist in her local area. But after could not find those eye drops, and she went and enquire almost 10 to 12 pharmacy. Then her husband went to the same clinic building where her wife was taken consultations. Finally, he got the eye drops. And this is the main reason is cautious to see the prime feature before purchasing any health card.

Health Care Philosophy

“Healthcare in India typically play parallel side of curative and preventive care. Wherein an insurance scheme in India covers predominantly curative side, especially in hospitalized. And in that too there is grey zone such as waiting periods for critical illness, pre-existing diseases and senior citizens care,” said Sunita Chabriyal, Co-Founder at Root India Healthcare Limited.

She also told, As RIHL recently launched an Innovative and unique OPD (health) card. Briefed, that Doctor visits and opd treatment costs such as medicine and lab test costs account for 70-100 percent of overall doctor visit-cum-medical spends which insurers do not cover.

Insurance OPD Hurdle

Sanjay Datta, Chief of Underwriting and Claims (ICICI Lombard General Insurance) he also added, that while health insurance policies overseas cover both pre-and post-hospitalization costs. And Insurers in India, are not comfortable to cover OPD as the sector is largely unorganized which makes it prone to fraud. Therefore, OPD covers offered by insurance companies are typically very expensive and come with limits on the amount for each treatment, unlike opd cards.

Sunita adds that Root India Healthcare’s OPD cards provide a healthcare solution to high-risk people. Such as those with pre-existing health conditions, and those who are denied health policy. Especially senior citizens, who have to pay extremely high premiums for a policy loaded or face exclusions with too many clauses and t&c.

However, the main disadvantage of such opd cards is that companies offering them are not regulated by any regulator forum. But insurance companies are regulated by the IRDA (Insurance Regulatory and Development Authority of India.)

Sometimes consumers find the health card wanting when they want to use and the only resort to resolve complaints is at consumer courts, she says.

Said, the best bet for consumers is probably to first check with neighborhood hospitals and nursing homes on whether indeed they can get the promised discounts at these centers.

And if they do not cover you with your nearest doctor, pharmacy or labs then you have to decide whether you are ready to follow their available network. if Still you are not ready to change the doctor or do not have to time check whether they give such discount or not. Then there is only one option which Root India OPD Cards since they cover all doctors without forcing you to switch the consultant.