What are Add-Ons in Health Insurance?

Add-ons (also known as rider options) in health insurance coverage is an optional benefit that you can purchase at the cost of an additional premium. At times, your comprehensive health insurance plan will not be sufficient enough to provide adequate financial cover. This is why riders were introduced to health insurance.

Just think about it, isn't it better to enhance your existing base healthcare policy with a rider by paying an extra premium instead of buying a health scheme altogether? In addition, medical inflation in India is at an all-time high. Modern-day surgeries can cost lakhs of rupees in a private hospital! Therefore, it is ideal to go for suitable rider options.

What are the types of add-ons?

Here is a comprehensive list of rider options (add-on covers) that you can choose from.

TypeBenefitWaiver of PEDsFacilitates treatment of certain pre-existing diseases that were not covered by your medical plan due to the applicable waiting period.AYUSHProvides cover for expenses arising out of alternative medicine - Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homoeopathy.SI RestoreWith this cover, your entire sum insured is restored in case it is depleted in a policy year.Critical illness coverCritical and terminal illness by default is not covered under a standard health scheme. With this rider, you will obtain a one-time lump sum amount as payment if you contract a critical disease.

This list of critical illnesses is generally defined in your policy document.Personal accident insuranceThis rider provides financial assistance for injury arising out of a personal accident or death from an accident.Super top-upProvides additional sum insured amount over and above your base plan.Newborn baby and maternity coverCaters to the expenses related to childbirth, newborn baby, pre/postnatal,  and pregnancy.HospicashThis is a very popular add-on. With this cover, you get a daily cash allowance for the number of days you were admitted to the hospital.Room rent waiverMost primary health plans come with a room rent limit. This rider removes such restrictions and helps you stay in the room of your choice without paying for extra charges arising out of proportionate deduction.OPDOut-patient department treatment is usually not included under medical cover. With an OPD cover, you can make claims for regular doctor consultations and visits.Second opinionAt times, there are instances when you are not happy with your current hospital treatment. If yes, this rider will help you get medical advice from another set of doctors/hospitals.Ambulance coverWith this add-on, you can claim the bills for transporting you via ambulance from an accidental site to the nearest hospital. This includes emergency evacuation via airplanes and helicopters from a remote location.Global coverDid you know that the (your) health insurance offered is applicable only in India. With this rider, you can easily make claims for medical treatment taken outside India.Zonal upgradeCities in India are classified into a specific zone based on the cost of medical expenses. With this rider, you can get higher financial coverage for medical treatment. This has an impact on the cost of premiums and health insurance claims.

Note: 

The riders mentioned above are from a general/standard list. You should check the add-ons that can be added to your base plan (terms and conditions) with your insurer before buying a policy.

Each rider is separate and comes at an additional cost. As per the IRDAI (Insurance Regulatory and Development Authority of India), the collective premium of the riders cannot be more than 30% of the total premium amount.

Yes, you can avail tax benefits for riders as per Section 80D of the Income Tax Act, 1961 :D

Want to learn more about health insurance add-ons and their types? Say hi to Plum today!

FAQ

Q. How do insurance companies determine the additional premium cost for each rider?

A. Insurance companies calculate the premium for riders based on several factors. These include the rider's coverage extent, the policyholder's age, and health conditions. Therefore, the cost varies, reflecting the added risk the insurer takes.

Q. Can riders be added or removed from the policy at any time during the policy term, or are there specific enrollment periods?

A. Generally, riders can be added or removed at the time of policy renewal. Some insurers might allow changes during the policy term, but this varies. Therefore, it's crucial to check with your insurer for specific terms.

Q. Are there any limitations or exclusions specific to certain riders that policyholders should be aware of?

A. Yes, each rider has its own set of limitations and exclusions. For example, critical illness riders might not cover all diseases. Therefore, policyholders should carefully review the rider terms to understand the coverage scope fully.