Health Insurance Was Built for the 1% Chance You’re Hospitalised. What About the Other 99%?
prime.care is a cashless OPD plan for the everyday medical expenses that happen outside a hospital: doctor visits, medicines and diagnostics. One cashless OPD wallet, zero paperwork, from day one.
Plans from ₹833/month
Zero waiting period
100% cashless partner network
15-day refund promise
Backed by the Healthcare Names You Already Trust
prime.care is completely network-agnostic and can be used across any system or location. Every plan runs on partnerships with Apollo 24|7, Tata 1mg, Redcliffe Labs, Agilus Diagnostics, fit.pass, and Fortis. Established names, not an unverifiable list of “1,000+ partners”, so your wallet works at places you’d choose for your family anyway.
The gap nobody warns you about
Your mediclaim only wakes up when you’re admitted.
You call the doctor: consultation fee, cash. You stop at the pharmacy on the way home: medicines, cash. Two days later, the doctor asks for a blood test, just to be safe: cash again. Your health insurance card sits in your wallet the entire time, completely irrelevant, because none of this happened inside a hospital.
But the problem isn’t your health insurance; it’s what it was built to cover. Most family floater and corporate health insurance plans in India are built around hospitalisation for 24 hours or more. Everything that happens before that point is the part nobody insured you for, and it’s the part every Indian family pays for, over and over. Add it up across a year, though, and they’re quietly spending far more on outpatient care than they realise, entirely out of pocket, entirely unplanned.
| Everyday Expense | Paid For By Regular Health Insurance? | Paid For By prime.care? |
|---|---|---|
| Fever/viral consultation | No | Yes, cashless |
| Monthly prescribed medicines | No | Yes, cashless |
| Routine blood test or check-up | Rarely | Yes, from Day 1 |
| Dental cleaning or filling | Almost never | Yes, on every plan |
| Eye check-up or new glasses | Almost never | Yes, on every plan |
| Surgery or hospital admission | Yes | Not applicable |
What your policy covers
Room rent, surgery, ICU charges, and a short window of pre- and post-hospitalisation expenses, only if you were admitted.
What it quietly skips
Doctor consultations for a fever or a sprain, monthly prescriptions for a chronic condition, routine blood work, a dental filling, or a new pair of glasses.
How families pay for it today
Cash or UPI: ₹500 here for a consultation, ₹1,200 there for a lab test, with no way to plan or claim it back.
What an OPD plan changes
One annual OPD wallet, spent cashless across consultations, pharmacy, diagnostics, dental, and vision. Hence, the everyday bills stop being a surprise.
What Exactly Is an OPD Plan?
OPD stands for Outpatient Department: any care you receive without an overnight hospital stay. Think consultations, medicines, diagnostics, dental and vision.
An OPD plan is purpose-built to pay for that care, through a cashless OPD wallet you spend directly at partner clinics, labs and pharmacies. It isn’t a substitute for your health insurance. It’s the missing half.
| If You Need This... | Look To... |
|---|---|
| Surgery, ICU, hospital admission | Your existing hospitalisation health insurance |
| Doctor visits, medicines, tests, dental, vision | A cashless OPD plan like prime.care |
Where the Current System Breaks Down
Here’s where the current system breaks down for most families:
- Hospitalisation policies only activate on admission; everything else is paid entirely out of pocket.
- Employer group insurance rarely includes OPD, and where it does, it’s usually a reimbursement process, not a cashless one.
- Reimbursement means paying first, saving every receipt, filing a claim, and waiting weeks to see the money again, only if the claim isn’t rejected on a technicality.
prime.care sits between no cover and full insurance: an affordable, purpose-built OPD plan that works alongside whatever hospitalisation policy you already have.
| Comparison Point | Hospitalisation Health Insurance | Reimbursement-Only OPD Rider | prime.care OPD Plan |
|---|---|---|---|
| Doctor consultations | Hospitalisation Health Insurance | Reimbursement-Only OPD RiderCovered, pay first | prime.care OPD PlanCashless |
| Claim experience | Hospitalisation Health InsuranceNot applicable | Reimbursement-Only OPD RiderPaperwork, weeks to settle | prime.care OPD PlanPay from your wallet, no paperwork |
| Dental & vision | Hospitalisation Health InsuranceRarely covered | Reimbursement-Only OPD RiderRarely included | prime.care OPD PlanOn every plan |
| Waiting period | Hospitalisation Health Insurance30–90 days typical | Reimbursement-Only OPD RiderOften applies | prime.care OPD PlanNone |
| Best suited for | Hospitalisation Health InsuranceSurgery, ICU, admission | Reimbursement-Only OPD RiderEmployees with existing group cover | prime.care OPD PlanEveryday care for individuals & families |
Everything a Family Actually Uses, From Day One
No sub-clauses hiding what’s excluded. Just the everyday care you already pay for, made cashless, around one annual wallet you actually use.
In-Clinic Doctor Consultations
Cashless access to consultations across the partner clinic network, for the visits you can’t postpone.
Unlimited 24/7 GP Tele-Consultation
Instant consultation; a doctor on call at 11 p.m. on a Sunday, included on every plan.
Prescribed Pharmacy
Prescribed medicines redeemed cashless at partner pharmacies, no waiting for a refund.
Diagnostics & Annual Health Check-Up
Lab tests and one annual check-up covered from day one, not after a waiting period.
Dental Care
Cashless dental treatment, the category most health insurance ignores completely.
Vision Care
Eye consultations and check-ups paid from your wallet as standard, not as an add-on.
fit.pass Gym Access
Up to 45% off fitness memberships for the primary member.
Concierge Desk Support
Whenever you need help booking, paying or understanding a benefit, a real person is there to help.
What Makes It a Cashless OPD Plan
Every benefit is tied to your cashless OPD wallet: a digital balance on your phone, linked directly to your annual cover.
Use your wallet at any network clinic, pharmacy or diagnostic centre- Your bill is settled instantly from your OPD wallet, no cash upfront
- No reimbursement form, no scanned receipts, no waiting for a claim to clear
- Family plans share one wallet across up to 6 members
How prime.care works
Pick a plan
For yourself, your family (up to 4) or your family with parents (up to 6).
Add your details and pay
A few details for each member, then pay. No medical test, no waiting period.
Start booking in seconds
Your OPD wallet is live as soon as you pay. Book visits, tests and medicines in the app.
Built Around Indian Regulation, Not Around Fine Print
- DPDPA 2023–compliant data handling, with clear rights to access, correct, or erase your data
- A 15-day free-look refund window if the plan isn’t the right fit
- A named grievance officer and published Terms of Service for every plan
- Clear exclusions stated upfront: no hospitalisation cover, no cosmetic or fertility treatment, no cash payouts
Start With One Plan and Cover Your Whole Family
Same tiers for every family size. Prices include GST.
Bronze
₹833/ month
₹10,000 / year · ₹20,000 OPD wallet
Not available for Family cover
Not available for Extended family cover
Doctor visits up to ₹5,000 a year- Medicines up to ₹7,500
- Diagnostics up to ₹7,500
- Dental ₹1,000 · Eye care ₹2,000
- 6 specialist teleconsults
Silver
₹1,424/ month
₹17,085 / year · ₹30,000 OPD wallet
₹1,764/ month
₹21,165 / year · ₹30,000 OPD wallet
₹2,125/ month
₹25,500 / year · ₹30,000 OPD wallet
- Spend the full ₹30,000 on any care
- Unlimited specialist teleconsults
- Doctor consultations
- Medicines
- Diagnostics
- Annual health check-up
Gold
₹1,787/ month
₹21,440 / year · ₹40,000 OPD wallet
₹2,213/ month
₹26,560 / year · ₹40,000 OPD wallet
₹2,667/ month
₹32,000 / year · ₹40,000 OPD wallet
- Spend the full ₹40,000 on any care
- Unlimited specialist teleconsults
- Doctor consultations
- Medicines
- Diagnostics
- Annual health check-up
Platinum
Most popular₹2,094/ month
₹25,125 / year · ₹50,000 OPD wallet
₹2,594/ month
₹31,125 / year · ₹50,000 OPD wallet
₹3,125/ month
₹37,500 / year · ₹50,000 OPD wallet
- Spend the full ₹50,000 on any care
- Unlimited specialist teleconsults
- Doctor consultations
- Medicines
- Diagnostics
- Annual health check-up
Advanced
₹2,931/ month
₹35,175 / year · ₹75,000 OPD wallet
₹3,631/ month
₹43,575 / year · ₹75,000 OPD wallet
₹4,375/ month
₹52,500 / year · ₹75,000 OPD wallet
- Spend the full ₹75,000 on any care
- Unlimited specialist teleconsults
- Doctor consultations
- Medicines
- Diagnostics
- Annual health check-up
The same tiers come as Family and Extended family plans, with one shared OPD wallet for up to 6 members.
“But What About…” Answered Before You Ask
Built for the People Who Actually Need This
Salaried Employees
Your group insurance covers hospitalisation but skips OPD entirely. This fills the exact gap without touching your existing policy.
Freelance & Gig Workers
No employer cover at all. An affordable way to handle routine healthcare costs on your own terms.
Young Families
When your calendar is full of paediatrician visits, vaccinations and check-ups, a shared wallet keeps it predictable.
Anyone Managing a Routine Condition
Regular consultations and monthly medicines add up fast. An OPD wallet smooths that spend out.
First-Time Buyers
No medical test, no complicated underwriting, and a 15-day refund window to try it risk-free.
Why prime.care, Not Just Any OPD Cover
Genuinely Cashless
Not a reimbursement plan wearing a cashless label; every benefit settles instantly at the point of care
No Medical Tests
Sign-up needs a few details, not a health check-up
Real Network
Apollo 24|7, Tata 1mg, Redcliffe Labs, Agilus Diagnostics, Fortis, and fit.pass, not an unnamed list of “partners”
Transparent Pricing
5 tiers, published wallet limits, no hidden sub-clauses
Fast Activation
Buy today, and your plan activates in seconds once your details are in
Try It Risk-Free
Full refund within 15 days if you haven’t used any benefits
Your Next Doctor’s Visit Shouldn’t Be a Budgeting Decision
Your bills don’t start at the hospital; they start with a fever, a routine check-up, a prescription refill, or the appointment you’ve been putting off. With a cashless OPD plan, none of that has to be an unplanned expense. Know more about prime.care
From ₹833/month. Live from day one. Full refund in 15 days if it's not for you.
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