Will health insurance riders matter in a post-Covid world?

Consumables, at times, are not covered under the underwriting guidelines of insurance companies. and, as a health insurance Policy holders, you should be aware that your insurer may or may not cover consumables.

So, is it necessary to buy health insurance riders?

“Before Covid-19, consumables accounted for about 3-5% of hospital expenses; But now the share of consumables in hospital bills has increased to 25-30%. This has put countless families across the country in financial trouble, forcing them to take loans or seek help from relatives and friends to pay for their hospital expenses,” said Amit Chhabra, Head – health insurance, policybazaar.com.

Fortunately, given the high proportion of consumables in hospital bills, insurance companies have begun offering riders that can be purchased in addition to base health policies to cover the cost of consumables on your hospital bills. Is.

“At present, Care Health Insurance and Max Bupa Health Insurance offer such riders. Both cost around 5% of the base plan premium and can be added to any Care Health Insurance or Max Bupa Health Insurance policy, covering consumables and non-payable items such as belts, gloves, braces, masks and spirometers Can go,” Chhabra said.

Other add-ons that can be included in your health policy are Accidental Death Benefit Rider, Critical Illness Rider, Maternity Rider, Outpatient Department (OPD) Rider and Permanent Disability Rider.

Pros: Being a rider can give you comprehensive control over your out-of-pocket expenses while making a claim. The main advantage of having a rider is that it is economical and provides additional coverage under the base health policy. However, policyholders should be very careful while choosing riders in a health policy.

Shortcoming: The primary disadvantage of being a rider is the marginal increase in premium, coverage limit and waiting period. For example, most insurance companies have coverage limits for maternity benefit riders, and certain conditions must be met in order to receive benefits. Therefore, it is necessary to ensure that the product being purchased conforms to the requirements of the buyer.

John Mayne, executive director of Coverfox, said, “Some special riders can prove costly. For example, OPD covers are usually heavy on the wallet, costing 15% of the basic premium. The annual OPD cost is less than that additional cost. Maybe that’s what you pay for adding a rider.”

Further, Subramaniam Brahmajosula, Head – Reinsurance & Product Development, SBI General Insurance Ltd., said, “A comprehensive insurance policy, even if it costs you a little more, will give you peace of mind that you are fully covered, while a A health policy with multiple riders as with basic insurance will require you to carefully evaluate each one to decide which one is appropriate and it is possible that there may be gaps in coverage, which will only become apparent at the time of claim.”

price ceiling: Various riders can help insurance buyers to significantly save on their out-of-pocket expenses during hospitalization. For example, suppose you have purchased a health insurance policy of Sum Assured ₹5 lakh for a premium of ₹7,000 If you add the Hospicash insurance rider to your policy, you will get a benefit of a certain amount ( ₹1,000-1,500) per day hospitalization. Hospicash covers the policyholders for hospitalization expenses for up to 30 days.

You this rider. can be added at an estimated cost of less than ₹500.

Mayne said, “The average cost to riders is 5-15% of the base premium. From a regulatory standpoint, the Insurance Regulatory and Development Authority of India (Irdai) has capped the cost of any rider to 30% of the base premium.”

Choosing a Rider: Rakesh Goel, Director, Probus Insurance said, “First of all, we must understand what are consumables and how the cost has increased in the last one and a half years. Typically, they are medical devices that are discarded after use. From last year, as the Covid-19 cases increased in the country, the cost of consumables also increased. In the coming months, as things normalize, we may see a reduction in the cost of consumables.” Thus, the decision to add a rider to one’s health insurance policy should be based on specific needs.

“It is advisable to include riders like Hospicash or Room Rent Waiver in your base health policy, as these can prove beneficial in times of need,” said Mayne. Specific coverage, such as critical illnesses, can be covered under your health insurance policy by adding a special rider on an individual need-gap basis. But there are various limits to the usage of riders like OPD cover. Hence, policy buyers looking for these benefits should go with policies that cover these riders as an ‘in-built cover’ under their basic health plans.”