BETTER TOGETHER

WITH OUT-OF-POCKET EXPENSES LIKE DOCTOR CONSULTATIONS, DIAGNOSTICS AND PHARMACY BILLS NOT COVERED UNDER REGULAR HEALTH INSURANCE POLICIES, INSURANCE PLANS WITH OUTPATIENT COVER ARE SLOWLY GAINING TRACTION

- TEENA JAIN KAUSHAL

NEHA DIXIT, 33, is N susceptibility to allergies, it is not uncommon for her to regularly consult her doctor, which is often followed by various lab tests and long medical bills. "A regular visit to a doctor costs me upwards of 1,500 considering the pharmacy bills and consultation charges. I have a health insurance policy but it doesn't cover outpatient expenses, so I end up paying a lot towards my medical bills. The family budget goes awry if other family members also fall ill at the same time," complains Dixit. 

Dixit's case is not an aberration. Her situation is representative of the plight of millions of families, for whom out-of-pocket medical expenses constitute as high as 63 per cent of all hospital expenditure-among the highest in the world, per a 2021 NITI Aayog report. On top of that, an increase in medical inflation along with rising lifestyle diseases has only added to the burden of such families. For most of them, their health insurance policies cover only hospitalisation expenses and not outpatient expenses like allergic to dust. Whenever she has an allergic reaction, her nasal passage swells up, giving her a runny nose, a sore throat and bouts of coughing. With her doctor consultations, lab tests, pharmacy bills, etc. Hence, these expenses are met by the patients from their own pockets.

To cover this gap in health coverage, many insurers have now started offering comprehensive outpatient department (OPD) health plans. The need for having such comprehensive health plans that not only cover hospitalisation but also OPD expenses became apparent during the pandemic. That was also a time when many people were getting treated at their homes as hospitals were running full. Following the harrowing experience that patients underwent during the pandemic, demand for such policies is going up.