Cashless OPD Services

Now OPD expenses won’t worry you anymore!!

Outpatient expenses (OPD) incur heavy costs and are mostly not covered under regular health insurance plans. At ManipalCigna make your health insurance a complete Health Care Insurance with cashless OPD COVERAGE. Protect your finances from everyday healthcare expenses like doctor consultations, prescribed diagnostics & pharmacy expenses because health issues don’t escalate to hospitalization every time.

TO BEGIN

Here's how you avail OPD benefits

  • Download MediBuddy App from IOS or play store
  • Login with your personal details and get OTP
  • Click on link your insurance
  • Select your ManipalCigna Health Insurance with which OPD rider is chosen
  • Enter the policy number
  • Your account gets linked

TO BOOK –

How to Book Doctor Consultation

  • Login to MediBuddy app
  • Select “Talk to doctor” to Book consultation
  • Enter your City and Pin code & select the specialty
  • Choose the doctor details & date of appointment
  • Enter the beneficiary details & confirm


How to Book Lab Test

  • Login to MediBuddy app
  • Select “Lab Test”
  • Enter your Pin code & select type of test
  • Upload your prescription & confirm your details
  • Select your preferred diagnostic centre
  • Select the date of appointment
  • Enter the beneficiary details & confirm


How to order Prescribed Medicines

  • Login to MediBuddy app
  • Select “Buy Medicine”
  • Enter your Pin code & upload the prescription
  • Option to choose from store pick-up and home delivery
  • Enter the beneficiary details and confirm

You can avail Cashless OPD services with our top rated product ManipalCigna ProHealth Prime- Advantage Plan or with having the Health 360 RIDER on select products as mentioned below.

ManipalCigna ProHealth Prime- Advantage Plan is not just a health insurance but a complete healthcare solution that offers you cashless OPD with Sum Insured options ranging from ₹ 20,000, ₹ 30,000 and ₹ 50,000 per policy year to cover your out-patient expenses.

Health 360 OPD RIDER is applicable with: (Sum Insured options ₹ 20,000 to ₹ 30,000 in the multiples of ₹ 5,000 and ₹ 30,000 to ₹ 50,000* in the multiples of ₹ 10,000)

  • ManipalCigna ProHealth Insurance
  • ManipalCigna Lifetime Health
  • ManipalCigna Lifestyle Protection - Accident Care
  • ManipalCigna Lifestyle Protection - Critical Care

What is Cashless OPD?

Cashless Outpatient Department, also referred to as Cashless OPD, is a health insurance service that helps reduce your financial burdens linked to outpatient healthcare expenses. Unlike traditional healthcare models where you need to pay for doctor consultations, diagnostic tests, and medications upfront, Cashless OPD allows you as a policyholder to use these services without the need for immediate out-of-pocket payments.

ManipalCigna’s Health Insurance with OPD Cover

ManipalCigna Health Insurance recognizes that healthcare extends beyond hospitalization. Keeping in mind your overall well-being as a policyholder, we offer health insurance plans with OPD cover. This extends the scope of coverage to outpatient services, ensuring that you receive financial protection not only during hospital stays but also for essential medical needs outside the confines of a hospital setting. Health insurance with OPD coverage has become a cornerstone of Manipal Cigna’s commitment to comprehensive and accessible healthcare for all.

At Manipal Cigna Health Insurance, we ensure a hassle-free experience by directly settling the bills with your healthcare provider when you need cashless OPD services, thereby creating a seamless healthcare journey for you. With our unparalleled coverage terms, we  strive to bring a new dimension to healthcare coverage in India. By including your outpatient expenses in our coverage terms, we ensure that you can enjoy a wide range of medical services so you can access timely medical interventions, while also encouraging a proactive approach to healthcare.

Medical Insurance with OPD Cover Plans from ManipalCigna

Get all-encompassing coverage for yourself and your family with Manipal Cigna’s top-rated OPD medical insurance plans.

  1. 1.  ProHealth Prime Advantage Plan

ManipalCigna Health Insurance’s ProHealth Prime Advantage plan is a comprehensive health insurance solution tailored to meet your and your loved ones’ diverse needs. This plan goes beyond traditional coverage by offering extensive benefits such as:

  • Coverage for inpatient and outpatient treatments, maternity expenses, and annual health check-ups. Coverage is provided for a maximum of ₹20,000/30,000/50,000 depending on your policy per year, on a cashless basis.
  • Coverage for consultations, prescribed diagnostics, and pharmacy. You can avail pharmacy expenses up to a limit of 20% of the OPD limit.
  • The plan also provides wellness incentives and rewards for maintaining a healthy lifestyle.

The ProHealth Prime Advantage plan stands out for its flexibility, affordability, and commitment to ensuring that you have access to quality healthcare services with financial security.

  1. 2.  Health 360 OPD Rider

Manipal Cigna introduces the Health 360 OPD rider, a valuable add-on option enhancing healthcare coverage. This rider expands traditional plans by offering coverage for outpatient expenses like doctor consultations, diagnostic tests, and pharmacy bills. You can enjoy cashless OPD services, eliminating immediate out-of-pocket expenses. Health 360 promotes preventive care, supporting regular health check-ups and ensuring financial ease for day-to-day medical needs.

You may purchase the Health 360 OPD rider along with the following standard health insurance plans:

  • Manipal Cigna ProHealth Insurance
  • Manipal Cigna Lifetime Health
  • Manipal Cigna Lifestyle Protection – Accident Care
  • Manipal Cigna Lifestyle Protection – Critical Care

Benefits of OPD Expenses Coverage in Health Insurance:

Following are the key benefits of getting OPD coverage from Manipal Cigna Health Insurance:

  • Comprehensive Healthcare Access

Cashless OPD coverage widens the scope of health insurance by including outpatient services, ensuring that as a policyholder you have access to a broader range of medical care.

  • Financial Ease

By cutting out the need for immediate out-of-pocket payments, you can experience financial ease during outpatient visits, encouraging you to be regular with your OPD visits and on top of your health.

  • Preventive Care

OPD coverage encourages preventive healthcare, as you can consult doctors and undergo diagnostic tests without the financial burden, leading to early detection and management of health issues.

Inclusions and Exclusions of an Outpatient Insurance Cover in Health Insurance:

Following are the inclusions and exclusions in Manipal Cigna’s plans:

Inclusions

Exclusions:

Doctor Consultations: Coverage for expenses incurred during visits to general practitioners and specialists.

Cosmetic Procedures: OPD coverage typically excludes elective cosmetic procedures, unless recommended by a medical practitioner.

Diagnostic Tests: Reimbursement for costs related to diagnostic procedures and laboratory tests.

Non-Prescription Medications: Expenses for over-the-counter medications are outside the scope of coverage.

Pharmacy Bills: Coverage for prescribed medications, typically following a medical diagnosis as part of the treatment plan.

Experimental Treatments: Experimental or unproven treatments are typically not eligible for OPD insurance coverage.

Maternity expenses: Coverage for maternity expenses including pre, and post-delivery costs.

Who Should Buy Health Insurance With OPD Coverage?

If you have diverse healthcare needs and have to seek regular medical consultations, diagnostic tests, and medications, then you can benefit significantly from investing in medical insurance with OPD cover. This plan is also suitable for individuals with chronic conditions, families with children, and those who wish to undergo preventive healthcare tests to diagnose medical conditions from the outset.

Cashless Claim Settlement Process for OPD Cover

With ManipalCigna in your corner, the claim settlement process for cashless OPD cover is designed to be straightforward and user-friendly.

  1. The hospital TPA will submit your medical records and preauthorization form to ManipalCigna.
  2. ManipalCigna gives an initial approval after assessing your request to start OPD the procedure.
  3. In case the amount needs to be increased, you must submit the relevant documents to the hospital TPA, who will forward them to ManipalCigna for approval.
  4. The hospital TPA shall submit the final bill to ManipalCigna at the time of discharge.
  5. ManipalCigna gives a final approval after doing a final assessment.

At ManipalCigna, we offer OPD in Health Insurance Coverage on a cashless basis at our network hospitals across India. You cannot utilize this facility at medical facilities outside of ManipalCigna’s network of hospitals and file a reimbursement claim for OPD coverage benefits later. Note that any amount that has not been used the OPD in health insurance rider cannot be carried forward to the next year of the policy.

What Are The Eligibility Criteria For Health Insurance With OPD Cover?

To be eligible for ManipalCigna health insurance with OPD cover you must fulfil the following criteria:

  • Age

You should be in the age group of 18 to 65 to apply. If you wish to buy OPD coverage for your dependent  children aged, they should be in the 90 days to 25 years age bracket.

  • Medical History

You can get coverage for the treatment of ailments like Asthma, Diabetes, Hypertension, Dyslipidaemia and Obesity related conditions.

  • Waiting Period

You should be willing to ride out a waiting period of 24 months before you file an insurance claim. You can reduce the waiting period to 90 days by purchasing a waiting period reduction rider.

FAQs

How much is the limit for OPD expenses under health insurance?

The limit for OPD expenses under Manipal Cigna health insurance varies per the sum insured amount applicable to your policy and can range from ₹10,000 to ₹50,000 and in multiples of ₹10,000 thereafter. They also depend on sub-limits based on the covered medical situations, including doctor consultation fees, costs of diagnostic tests, medications, etc.

Can I buy OPD insurance plans online?

Yes, you can purchase OPD health insurance online from the Manipal Cigna website. You must fill out the application form and submit documents online to complete the purchase process.

Is it possible to avail of tax deductions on health insurance plans with OPD cover?

Yes, you can claim tax deduction benefits under Section 80D on purchasing medical insurance with OPD coverage. You can claim tax deductions of ₹25,000 to ₹100,000 per annum on premiums paid towards purchasing insurance plans for yourself, your spouse, dependent children and parents, including for preventive health check-up costs undertaken in a year.

Do I have the option to buy an insurance plan that covers only OPD treatment?

Standalone OPD treatment insurance plans are not very common in India. OPD coverage is typically included as a feature in comprehensive health insurance plans. You may check with insurance providers for the latest offerings and inquire about specific OPD-focused plans.

How can I buy a health insurance with OPD cover?

To buy health insurance with OPD cover, you just need to visit the official Manipal Cigna Health Insurance website, Choose your preferred OPD coverage plan, fill out the application form with your details, and pay the premium. We shall mail the policy to your registered email address instantly.

Why must I consider adding OPD Cover in Health Insurance to my policy?

Opting for an OPD cover in health insurance is beneficial as it helps cover costs for regular check-ups, consultations, and diagnostic tests. This practical approach promotes preventive healthcare, reduces out-of-pocket expenses, and ensures comprehensive coverage beyond hospitalization, thereby contributing to your overall well-being.

Disclaimers: OPD rider is available only on a cashless basis from the network providers of ManipalCigna Health Insurance Company Limited. Any unutilized amount under this benefit shall not be carried forward to subsequent policy year.