Health Insurance Riders

List of Health Insurance Riders in India

Check out some of the list of health insurance riders available in India:

1. Critical Illness Rider

   The critical illness rider provides a lump sum benefit to the policyholder equal to the sum insured amount on the diagnosis of a listed critical illness, such as cancer, kidney failure, heart attack, stroke, etc. This rider usually comes with a waiting period of 90 days and ceases to exist after a claim is raised.

2. OPD Rider

   The OPD rider pays for the medical expenses incurred in the outpatient department, such as doctor’s consultations, diagnostic tests, medicines, etc.

3. Maternity Rider

   The maternity rider pays for the medical expenses arising out of pregnancy and childbirth, including delivery expenses, pre & post-natal expenses, newborn baby expenses, etc. The coverage is usually available after a waiting period ranging from 9 months to 6 years, depending on the insurance company.

4. Room Rent Waiver

   The room rent waiver rider removes the coverage limit on the hospital room rent allowing policyholders to opt for a room with higher room rent. It also removes any restriction on the room rent type enabling the insured to get admitted to a hospital room of their choice without paying extra at the time of admission.

   For example, suppose your base policy covers hospitalization expenses up to 1% of the sum insured for a twin-sharing room. With the room rent waiver, you can opt for a single private room regardless of its rent.

5. Day 1 PED Coverage Rider

   The Day 1 PED Coverage rider waives off any waiting period for pre-existing diseases like hypertension, diabetes, asthma and hyperlipidemia. This rider can be opted for at the time of buying the policy for the first time.

6. Unlimited Restoration of Sum Insured

   The unlimited restoration of sum insured rider restores the sum insured of the base policy unlimited times in a policy year in case the original amount gets exhausted on raising single or multiple claims. However, the sum insured may be restored for claims due to unrelated illnesses or the same illnesses, depending on the policy terms and conditions.

7. Reduction in PED Waiting Period

   The reduction in PED waiting period rider reduces the waiting period to cover pre-existing diseases to some extent. For example, suppose your health policy covers pre-existing diseases after a waiting period of 4 years. With the reduction in PED waiting period rider, the waiting period for pre-existing diseases can be reduced to only 2 years.

8. Personal Accident Rider

   The personal accident rider provides a lump sum benefit to the policyholder if he/she suffers from a total/partial disability or dies in an accident. In case of accidental death, the lump sum benefit is paid to the family member/nominee of the policyholder.

9. Hospital Cash Rider

   The hospital cash rider pays a daily cash allowance to the insured for each day of hospitalization. The allowance can be used to pay ancillary expenses incurred during hospitalization, such as consumables, food costs, etc. To activate this rider, the insured must be hospitalized for at least 24 hours or more, depending on the policy terms and conditions.

10. Zone Upgrade

    The zone upgrade rider allows policyholders to avail a higher medical coverage based on their city zone. It covers the difference in medical treatment costs between different city zones for a nominal premium. Usually, Zone A includes metropolitan cities, Zone B comprises of Tier II cities, and Zone C includes Tier III cities.

11. Global Cover Rider

    The global cover rider ensures that the insurance company pays for the medical expenses incurred within India and abroad. Most health insurance plans cover overseas medical costs incurred on hospitalization and day care treatments only.

Benefits of Buying Riders Under Health Insurance

Here are some of the benefits of buying different types of health insurance riders:

1. Enhanced Coverage

   Riders help policyholders to add specific covers to their base health insurance policy that are not already a part of it. Thus, they can enhance the level of coverage of their base policy as per their health needs and make it a comprehensive policy.

2. No New Policy Required

   A rider eliminates the need for buying another health insurance policy to avail certain covers that are missing from the base policy. Instead, it adds the desired cover to the existing health policy, thereby reducing the hassle of managing two separate policies.

3. Lower Premiums

   Policyholders need to buy riders additionally at the time of purchasing their base health policy. However, the cost of buying a rider is very low compared to purchasing another policy to get the same coverage. Hence, it does not put a financial burden on the policyholder.

   Besides, as per IRDAI guidelines, the cost of a rider cannot be more than 30% of the base policy premium. For example, if the premium of your base policy is Rs 10,000, then the cost of a rider cannot be more than Rs 3000.

4. Customized Coverage

   Riders give policyholders the freedom to customize their policy and choose the coverage they want in a health policy. The same freedom is not available on buying a pre-designed policy.

Things to Consider While Buying Health Insurance Riders

Take a look at the things to be considered while buying health insurance riders:

• Coverage – Make sure to carefully go through the scope of coverage offered by a rider to know exactly what you are covered for. For example, some hospital cash riders get activated only after the insured is hospitalized consecutively for 2-3 days. Thus, buy a rider only if it meets your medical requirements. 
• Premium – Make sure to check the extra premium that you will have to pay to buy a rider before making the actual payment. This will help you purchase a rider that fits your budget.
• Waiting Period - Several riders offer coverage after a waiting period. For instance, health insurance with critical illness rider offers coverage for critical illnesses after a waiting period of 90 days. Hence, read the terms and conditions of a rider carefully and check for any applicable waiting period. 
• Exclusions – Top health insurance riders also have certain exclusions that limit the coverage offered by your insurer. For example, maternity rider mostly does not cover ectopic pregnancy. Therefore, check the exclusions applicable to the rider before purchasing it.

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