Investing in a health insurance plan is imperative for planning a secured financial future for yourself and your family against medical emergencies. Health insurance plans from different insurance companies have different features, premiums costs, deductibles, riders and co-payments. The insurance needs of individuals are also different. In order to meet the requirements of its customers, the insurance companies provide comprehensive plans which can be customised as per your needs. They offer riders which are additional coverage benefits to widen the scope of an existing plan.
What are Health Insurance Riders?
Health insurance companies offer optional covers to extend the coverage of health insurance plans. These optional covers are called riders. They provide an added coverage benefit to the health plan. They can be bought as an add-on benefit to the basic health insurance plan. A minimal amount of additional premium is required to be paid to buy these health insurance optional riders. You can choose more than one rider depending on your coverage needs.
For Instance, Anita bought a regular health insurance plan at the age of 23 years. When she got married, she decided to add the optional maternity coverage benefit to her basic health insurance plan to ensure maternity coverage when she plans a family. Optional covers, therefore, help in customizing your policy as per your coverage needs.
Five Health Insurance Optional Covers to Spruce your Health Insurance Cover
There are different types of optional riders available under health insurance plans in the market. However, five of the most popular riders which can spruce up your health plan are as follows -
- Personal Accident Rider
Health insurance plans do not cover accidental deaths. However, if the plan offers the personal accident rider and you opt for the rider, you can avail coverage for the same. Under this rider, in case of death in an accident, the health plan pays a lump sum benefit besides covering the medical expenses incurred on hospitalisation.
For example, Mohan buys a health plan with a sum insured of INR 10 lakhs and chooses the personal accident rider. The rider coverage is INR 2 lakhs. He suffers an accident and is hospitalised. After getting treatments for two days, Mohan dies due to accidental injuries. His hospital bill amounts to INR 1 lakh. In this case, the health insurance policy would settle the medical bill of INR 1 lakh with the hospital and also pay INR 2 lakhs to Mohan’s family for accidental death.
- Room Rent Waiver
Most health insurance plans have sub-limits on room rent if you choose a low sum insured. This limits the coverage under the health plan and if you choose a higher room rent, the claim for inpatient hospitalisation would be reduced and you would incur out-of-pocket expenses. Room rent waiver cover waives the sub-limit on room rent. If you buy this room rent waiver rider, you can choose a hospital room exceeding the room rent limit and the claim would cover the excess room rent too.
For example, say you buy a health plan with a sum insured of INR 5 lakhs. The sub-limit on room rent is 1% of the sum insured which is INR 5000. If you opt for the room rent waiver benefit, the sub-limit of 1% on room rent would be waived off. Even if you get admitted in a room costing INR 6000, the insurance company would cover the entire inpatient hospitalisation claim without any deduction.
- Critical Illness Rider
Critical illness refers to any illness or disease which is severe in nature and requires advanced and intensive treatments. For example, heart attack, cancer, stroke, paralysis, etc. are called critical illnesses. Health insurance policies cover the treatment costs of critical illnesses. However, the amount might not be sufficient enough to meet the expensive treatment costs. When you add the critical illness rider to your basic health insurance plan, you receive additional protection against specified critical illnesses.
Critical illness rider provides an additional lump sum amount to the insured on diagnosis of a covered illness irrespective of the total expenses incurred during medical treatment. This benefit can be used to avail advanced treatments, supplement the existing coverage or to meet other financial needs.
For example, Ram buys a health plan with a sum insured of INR 10 lakhs and chooses a critical illness rider of INR 10 lakhs. He is diagnosed with cancer during the policy tenure and undergoes treatments. The treatment costs amount to INR 15 lakhs. His health insurance policy would cover him for INR 10 lakhs. However, the critical illness rider would pay an additional INR 10 lakhs which he can use to meet the additional costs.
- Hospital Cash Benefit
Hospital Cash is a common and popular health insurance rider. It provides coverage to the policyholder in the form of daily cash. If you add this rider to your basic health insurance plan, you will receive a fixed daily amount if you are hospitalised for 24 hours or more. This benefit would be paid in addition to the coverage offered by the health plan. Moreover, in case of ICU admission, the benefit amount gets doubled. The amount would be paid per day of hospitalisation for up to a maximum number of days specified in the policy.
For example, you buy a health plan with a sum insured of INR 10 lakhs and you choose the hospital cash rider. The rider promises to pay INR 5000 per day of hospitalisation. Now, if you are hospitalised for 5 days, you would get INR 5000 daily for 5 days. This benefit would be paid in lump sum in addition to the treatment costs covered by the plan.
- Unlimited Sum Insured Restoration
Many health plans allow sum insured restoration if the amount gets exhausted in a policy year. However, this restoration is, usually, allowed once during the policy tenure. If you choose this rider, you can get your sum insured restored multiple times during the same policy year. The rider, therefore, is beneficial if you suffer multiple claims in a policy year. It would reinstate the coverage unlimited number of times every time it gets exhausted.
For example, you have a family floater health insurance policy with a sum insured of INR 5 lakhs covering four family members. One member suffers hospitalisation and uses INR 4 lakhs of the coverage. After two months, another member suffers hospitalisation and incurs INR 3 lakhs in claim. The sum insured would be restored to pay this claim. Again if further claims are made, the sum insured would be restored every time it falls short in paying the health insurance claim.
Benefits of Health Insurance Optional Covers
Benefits of optional riders of health insurance plans are discussed below:
- Buying optional riders for a nominal increase in the amount of premium will benefit you with broader coverage and peace of mind too.
- Health insurance riders not only increase the scope of coverage, they provide additional financial assistance in a medical emergency.
- The benefit paid by health insurance riders can be used to meet other financial losses suffered like loss of job, paying off a loan, etc.
A standalone health insurance policy may not be sufficient to meet the uncertainties and changing healthcare needs of the family. Even if you have a comprehensive health insurance plan, your needs and requirements do change with time and you might need additional coverage. It is, therefore, highly recommended to opt for add-on cover to enhance the scope of your coverage by paying a low additional premium. You can buy more than one add-on rider with your basic health insurance plan as per your need and make your coverage comprehensive and customized.