Commercial healthcare cost is expected to grow to its record high in 13 years, as per a report by PwC’s Health Research Institute (HRI) report. The medical cost is projected to grow on an 8 per cent year-on-year (YoY) basis in 2025 for the group market and 7.5 per cent for an individual.
What Are Deductibles, Co-Payments, Riders, Add-On In Health Insurance? Read This Before Buying Policy
Health insurance is tricky as it is, but the process can be seamless if one properly reads the fine print. Here are a few things like riders, add-ons and more to know before making a purchase
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About 23 per cent of this hospital cost in India is funded through borrowings and a whopping 62 per cent is paid out of pocket, according to the Acko India Health Insurance Index 2024.
Not only is this adding financial strain on families but it is also preventing them from getting quality medical care. Amidst all this health insurance policies are supposed to build the financial bridge, but buying a policy can be a trick if one is not well prepared before making the purchase.
One of the few critical components of buying health insurance is choosing the right package for one’s needs.
Deductibles in Health Insurance: If an individual signs up for deductibles, they end up paying for some part of their treatment, depending on their clause. This is usually done to reduce the premium cost.
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Co-Payments: A copay is a predetermined fee one pays for specific covered services. This fixed amount typically does not always contribute toward an individual’s deductible.
Here Are Types of Health Insurance Riders That Individual Should Ask For:
Critical Illness Rider: If one of the members or policyholders is diagnosed with critical illness like cancer, or kidney failure, this rider helps in covering an individual.
Person Accident Rider: This rider offers financial benefits, in situations like accidental death, or permanent or temporary disability.
Pre-existing Disease (PED) Coverage: This offers coverage for pre-existing diseases like hypertension, diabetes, thyroid, etc.
Maternity Rider: This rider is supposed to cover pre-natal and post-natal care costs for an individual planning to start a family.
OPD Rider: This rider covers the OPD treatments cost like consultations, diagnostic processes, and medicines. However, every insurance provider has separate rules like capping the cost and listing doctors one can consult with, it varies from company to company.
Hospital Daily Cash Rider: This helps cover the cost of a family member’s expenses incurred at the hospital while they are taking care of a patient during their hospitalisation. It usually covers transportation and food costs.
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PED Waiting Time Reduction Rider: As per IRDAI guidelines, the usual waiting period is 3 years for diseases that develop slowly. This rider can help reduce the waiting period to give coverage between 1-2 years.
Types of Add-ons in Health Insurance
Inflation Shield: This add-on is supposed to hedge against inflation in the country by multiplying your base sum insured annually.
Consumables: This covers the unexpected cost of disposable items like gloves, PPE Kits, syringes, cotton, etc.
No-Claim Bonus Safeguard: This add-on can increase the base coverage in case one doesn’t use the base cover in a year. The base cover can get around double in case one hasn’t used it in a year.
At-Home Care Treatment: This add-on ensures the cost of the treatments that can be done at home.
Annual Health Check-Up: This add-on covers policyholders’ annual comprehensive check-up.
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