Why OPD plans should be in your employee wellness checklist

Today’s employees expect more from their company’s group health insurance benefits than just emergency hospital coverage. Let’s say an employee develops back pain from long working hours, they will need to visit a physiotherapist. Without OPD (Outpatient Department) coverage, they’ll bear the full cost. But if your employee wellness plan includes OPD, they can use it to cover the consultation and test without needing hospitalisation.

This is where OPD plans become essential. It helps employees manage the real, day-to-day cost of staying healthy. Let’s understand why.

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OPD includes services like:

• Vaccinations or minor procedures
• Visiting a doctor for a cold or fever
• Getting a blood test done for routine check-ups
• Buying prescription medicines from a pharmacy
• General Physician Consultations
• Specialist Visits (dermatologists, gynecologists, etc.)

These are all OPD expenses. These are common, non-emergency medical needs and they happen much more often than hospital admissions. Most group health insurance policies don’t cover these costs unless OPD benefits are added.

Read more: What are the benefits of OPD?

Types of OPD in a hospital

Here are the most common types of OPD in hospitals:

1. General Medicine OPD

This is for common illnesses like fever, infections, cough, cold, weakness, etc. It’s often the first point of contact for most patients.

2. Pediatrics OPD

Specialises in treating children and infants. Covers vaccinations, routine check-ups, and common child-specific conditions.

3. Gynaecology OPD

Covers women’s health like menstrual issues, pregnancy care, PCOS, menopause-related concerns, etc.

4. ENT OPD

Specialises in Ear, Nose, and Throat conditions like sinus issues, hearing problems, throat infections, etc.

5. Dental OPD

Handles oral health like dental checkups, gum issues, cavities, root canals, and cleanings.

6. Psychiatry OPD

Mental health care like stress, anxiety, depression, or therapy sessions are handled here.

What comes under the OPD plan?

Here’s a breakdown of what’s typically covered and not covered in an OPD plan (may vary slightly depending on the insurance provider):

Inclusions- What OPD plans Usually Cover:

1. Doctor Consultations (General or Specialist):
   Visiting a general physician for a fever or a specialist like a dermatologist or orthopaedic surgeon is usually covered.
2. Lab Tests and Diagnostics:
   Blood tests, urine tests, X-rays, ECG, and other routine diagnostics are included to promote early detection.
3. Pharmacy Bills:
   Medicines prescribed by your consulting doctor are often reimbursed under OPD plans.
4. Online or Teleconsultations:
   Virtual doctor consultations, which have grown popular post-pandemic, are now part of many OPD offerings.
5. Minor Procedures & Preventive Checkups:
   Small procedures like ear wax removal or preventive screenings like cholesterol or sugar tests are often covered.

 Exclusions – What’s not covered in OPD:

1. Cosmetic or Aesthetic Treatments:
   Procedures like Botox, chemical peels, or laser hair removal are not covered since they are non-essential.
2. Over-the-Counter (OTC) Medicines:
   Medicines you buy without a prescription, like paracetamol or cough syrup, are usually not reimbursable.
3. Hospital Admissions (IPD):
   In-patient hospitalisation costs are covered under the IPD plan, not OPD.
4. Alternative Treatments:
   Ayurveda, Homeopathy, or other alternative therapies are not covered unless your plan explicitly includes them.
5. Day Care Procedures
   No, day care procedures are generally not covered under OPD. While day care treatments are covered under Group health insurance policies, they do not fall under OPD benefits.

Why HR teams should include OPD in employee wellness programs

If you’re creating a strong employee wellness strategy, adding an OPD plan should be a top priority. Here's why OPD (Outpatient Department) benefits are essential for your team:

1. OPD Plans Have High Usage and High Perceived Value

Unlike hospitalisation insurance that gets used only in emergencies, OPD plans are helpful all year round. This makes them feel the insurance is really useful, not just a backup for rare events.

2. OPD Encourages Early Health Checks

When employees can easily visit a doctor and get tests done, they’re more likely to catch health issues early. Early diagnosis means less chance of serious illness or hospitalisation later. It also lowers long-term healthcare costs for them and for your company.

3. It Builds a Culture of Health and Care

Offering OPD benefits shows employees that you care about their day-to-day well-being, not just emergencies. When employees regularly take care of their health, it improves productivity, morale, and reduces sick leaves.

How to include OPD benefits in your employee wellness checklist?

Adding OPD (Outpatient Department) benefits to your employee wellness program is a smart way to support your team’s day-to-day health needs. OPD plans cover doctor consultations, diagnostic tests, and medicines, making it easier for employees to stay healthy without major medical expenses.

Here’s a simple checklist to help you successfully integrate OPD into your employee wellness strategy:

 1. Understand employee health needs

Start by asking your employees what they actually need. Use simple surveys or team discussions to learn about:

• Common health issues
• Frequency of doctor visits
• Preferences for online vs. in-person consultations

This helps you offer OPD benefits that are truly useful.

 2. Communicate OPD benefits clearly

Even the best OPD plan won't work if your employees don’t know about it.
Make sure to:

• Share how OPD plans save money on regular doctor visits
• Explain how to use the benefit (steps, app, contacts)
• Use emails, posters, and town halls to spread awareness

Clear communication improves usage and builds trust.

 3. Partner with trusted healthcare providers

Work with experienced OPD service providers who can offer:

• A wide network of doctors and clinics
• Easy booking options (online & offline)
• Quick support for employee queries

Choosing the right partner like Pazcare ensures a smooth experience for your team.

What is the ROI of OPD plans in employee health and wellness programs?

Here’s how OPD benefits deliver strong return on investment (ROI):

1. Reduced Out-of-Pocket Healthcare Costs

63% of employees in India avoid visiting a doctor due to cost concerns (PwC Wellness Report 2023).
By covering doctor visits, lab tests, and prescription medicines, OPD plans help employees avoid unexpected expenses. This leads to more timely care and fewer serious health issues down the line.

2. Fewer Sick Days and Hospitalisations

Wellness programs, including OPD care, reduced absenteeism by 27% and overall healthcare costs by 26% in workplace studies

Why? Because employees catch health problems early—before they become severe. This reduces absenteeism and improves team productivity.

3. Higher Employee Satisfaction and Retention

78% of employees say they are more likely to stay with an employer who offers day-to-day health benefits like OPD coverage. 

OPD shows you're supporting their everyday well-being, not just emergencies. It’s a top value-driver for Gen Z and Millennial employees, who expect modern and flexible benefits.

Final Thoughts: Make OPD a Priority in Your Wellness Strategy

Your employees' health needs don’t begin and end with hospital visits. They start with everyday issues like doctor consults, tests, and medicines. By offering OPD coverage, you show your team that you care about their complete well-being, not just emergencies.

Connect with Pazcare today to explore flexible OPD solutions tailored for your workforce.

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