Quick Summary
With 14% medical cost inflation, there are ways in which HRs can strategically get OPD cover for their employees to tackle rising costs, protect employee finances, and build a healthier, more engaged workforce.
Why are rising medicine costs a growing concern for Indian employees?
Let’s start with a story.
It’s about an everyday corporate employee who, after a routine health check-up, discovers a medical condition that requires daily medication. But here’s the reality: every month, thousands of Indian employees face the same tough choice: either skip their medicines or spend a large part of their salary on them.
Take Rajesh, a 42-year-old marketing manager in Mumbai. His diabetes medicines alone cost ₹3,500 a month. Even though he has group health insurance, it only covers hospitalization not his daily medicines. So, like many others, Rajesh pays for them out of pocket.
This is the reality for millions of working professionals across India. Healthcare costs in India are rising at nearly 14% every year, making it one of the biggest expenses for families today. Even worse, about 62% of all medical expenses are still paid directly by patients, not by group health insurance.
What’s driving the rise in healthcare and medicine costs in India?
1. The inflation reality
In 2024, India’s medical inflation reached 14%, the highest in Asia.
To put it simply if your blood pressure medicine cost ₹500 last year, it’s ₹570 now. Multiply that across all the medicines a family needs, and it adds up fast.
Healthcare costs have been climbing regularly, some treatments have even doubled in price since 2018.
2. The out-of-pocket burden
Most Indians are paying for healthcare from their own pockets.
Even though some progress has been made, 62% of healthcare expenses are still out-of-pocket. Around 23% of families borrow money to pay hospital bills which means almost one in four families goes into debt to afford treatment.
And for employees, things are even tougher. Many group health insurance plans only cover hospital stays, not doctor visits, lab tests, or medicines. So even those who have insurance still pay thousands every month for regular healthcare needs.
What does it mean for employees?
Let’s take a look at what a typical employee spends each month:
- Diabetes medicines: ₹2,500–₹4,000
- Blood pressure tablets: ₹1,200–₹2,000
- Doctor consultations: ₹800–₹1,500 per visit
- Routine blood tests: ₹1,500–₹3,000
- Vitamins or supplements: ₹800–₹1,500
These routine expenses add up quickly and most of them are not covered under group health insurance policies.
What’s driving these costs?
1. More chronic diseases
Long-term illnesses like diabetes, high blood pressure, heart disease, and asthma have become more common. About 35% of people in surveys say they or someone in their family now deals with such conditions.
These diseases require daily medicines often for life increasing the overall demand and cost of drugs.
2. Expensive medical advances
New technologies, diagnostic tests, and modern treatments are improving healthcare but they’re also raising costs.
Newer medicines and therapies tend to be more effective, but also much costlier, especially when generic versions aren’t available yet.
3. Shortage of doctors
India has only 0.7 doctors per 1,000 people, and rural areas face an 80% shortage of specialists. This imbalance means higher consultation fees and more expensive prescriptions.
Can rising medicine costs harm employee wellbeing?
As medicine prices rise, employees face difficult choices: skip treatment, self-medicate, or delay doctor visits. This leads to:
- Delayed diagnosis and treatment of health issues.
- Higher long-term medical costs due to unmanaged conditions.
- Poor mental health and financial anxiety.
- Reduced productivity and absenteeism at work.
India’s growing burden of chronic diseases such as diabetes, hypertension, and obesity worsens the issue. Routine medications for these conditions can cost thousands per month, creating sustained financial stress for employees.
When employees can’t afford routine care, it doesn’t just affect their health, it impacts your organization’s performance and morale too.
The good news? OPD cover directly addresses this gap. By covering outpatient expenses including prescribed medications, it removes the financial barrier between your employees and the healthcare they need. In the following sections, we'll explore exactly how to leverage OPD coverage to solve this problem strategically and sustainably.
What is OPD?
OPD (Outpatient Department) refers to healthcare services where a patient visits a doctor, gets diagnosed, or purchases medicines without being admitted to the hospital. It includes doctor consultations, lab tests, preventive check-ups, and prescription medicines.
Traditional health insurance typically covers only hospitalization costs, leaving employees to bear routine medical expenses. This is where OPD cover or OPD insurance plays a crucial role, it reimburses or pre-pays for these day-to-day healthcare needs, making medical care more affordable and accessible.
Examples of OPD cover HRs can offer
Modern group health insurance plans often include:
- OPD Wallets: Preloaded digital allowances for doctor visits or medicines.
- Cashless OPD: Direct payment to clinics or pharmacies via insurance partners.
- Wellness Integrations: Including teleconsultation, mental health counseling, and fitness benefits.
These digital-first solutions make OPD claims simple, transparent, and employee-friendly.
Why should HRs offer OPD benefits to employees?
Offering OPD benefits has become one of the most effective ways for HRs to enhance their health benefits strategy. Here’s why:
- Reduces employee out-of-pocket expenses.
Employees spend less on medicines and consultations, improving financial wellness. - Improves access to preventive healthcare.
Encourages early detection and regular check-ups. - Boosts employee satisfaction and retention.
A thoughtful benefits package builds trust and loyalty. - Enhances productivity and reduces absenteeism.
Healthy employees are more focused, energized, and engaged.
How can HRs implement OPD benefits?
- Partner with insurers offering flexible OPD insurance or digital OPD wallets.
- Combine OPD with telemedicine and corporate wellness programs.
- Educate employees on how to use OPD cover for routine check-ups and prescriptions.
- Track utilization data to measure ROI and optimize future benefits.
By integrating OPD into your benefits policy, you create a sustainable healthcare model that supports both employee wellbeing and company performance.
At Pazcare, we help HRs design employee health benefits that include OPD cover, mental wellness, and preventive care. Get in touch to make healthcare accessible for your team.
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