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Health Insurance Riders

Explore the Meaning, Types and Benefits of Health Insurance Riders to Enhance Your Coverage

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Home / Health Insurance / Health Insurance Riders

In India, when it comes to health insurance, there's more than meets the eye. We're talking about health insurance riders, simple additions that can make a big difference in your coverage. Riders or health insurance add-ons act as optional extras for your policy, giving you more benefits tailored to your needs. In this article, we'll break down what health insurance riders are all about, why they matter, and how they can benefit you. Let's make understanding health insurance riders as easy as ABC.

What are health insurance add-ons?
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Health insurance add-ons are additional options that can significantly enhance your coverage. While the base policy provides essential coverage, add-ons or riders provide an extra layer of protection and customisation, ensuring that your health insurance meets your individual requirements comprehensively.

Some common add-ons include critical illness riders, hospital cash riders, maternity riders, preventive health checkup riders, room rent capping waivers, adventure sports riders, international coverage riders, and reinstatement benefit riders. Adding appropriate riders to your base policy allows you to tailor your health insurance to your specific needs and priorities. However, they usually come at an additional premium cost. 

Evaluating your circumstances and requirements can help determine which add-ons provide the most value for your situation. 

Types of Health Insurance Riders
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Health insurance riders enhance your base policy by covering additional specific needs not typically included in standard plans. These riders provide flexibility and added protection to ensure your health insurance can adapt to changing circumstances and specific health concerns. The main types of health insurance riders:

Room rent waiver
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The room rent under a basic health insurance plan is mostly capped up to a certain amount. If one wants to stay in a room that costs more, he/she needs to pay the difference from their pocket. However, with the help of Room rent waiver add-on, one can either get a higher sub-limit or no sub-limit at all. This helps your insurance company to pay the room’s rent irrespective of the room type you choose.

Daily Cash
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Through this add-on, you can get a daily cash benefit when you are admitted for at least 24 hours. Usually, the amount paid ranges from 500-3000 rupees. For critically ill patients admitted in the ICU, the amount of daily cash can be more. One can use the amount to take care of things like buying medicines or managing other medical expenses during the stay in the hospital.

Coverage for Critical Illness
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This rider is slightly like a life insurance cover that pays a lump sum amount. Here the amount is paid if the policyholder is diagnosed with a critical illness. This type of illness can include cancer, massive heart stroke, brain tumor or multiple sclerosis. People with a family history of such illnesses should opt for a Critical Illness Rider. While buying this rider, the number of diseases covered can be from 15 to 40 depending upon the insurer and the cost of the policy.

Inflation Protect
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To avail a coverage for maternity benefits, usually, a waiting period is applicable. After which, treatment related to childbirth, pre and postnatal care, and/or coverage for a newborn baby may be included in this rider. If you buy this rider, the premium amount may increase by 15 to 20% of the base policy.

Restore Sum Insured
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This is a valuable add-on that offers you added security and peace of mind. If your sum insured gets exhausted within one policy year due to multiple claims, this feature automatically replenishes your coverage. It's like having a safety net for your health expenses, ensuring that you're never left unprotected when you need it most.

Doctor On-call
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This is a convenient solution for accessing medical expertise whenever you need it. With this feature, you can easily connect with a qualified doctor via teleconsultation to receive instant medical opinions and guidance. Whether you have questions about a health issue, need advice on medication, or require reassurance about symptoms, our teleconsultation service puts you in touch with a healthcare professional without the hassle of scheduling appointments or waiting in line.

Top-up and Super Top-up
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These plans are designed to provide additional financial support in case of medical emergencies. As the name suggests, top-up and super-top-up plans come into force when the limit of the base plan gets exhausted. People who feel that their basic health insurance coverage is not sufficient should buy top-up plans.

Benefits of Health Insurance Riders
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  1. Enhance your coverage - Riders allow you to enhance your base health plan by providing coverage for specific conditions or treatments that may not be completely covered in the base policy. For example, you can add a critical illness rider to get extra coverage for major illnesses.

  2. Customise as per your needs - Riders provide the flexibility to customise your health insurance as per your specific requirements. For instance, if you are into adventure sports, you can opt for an adventure sports rider. You can choose an international travel insurance rider if you travel frequently overseas.

  3. Available at marginal cost - Most riders come at a relatively low extra cost compared to the high costs associated with the treatments they cover. For example, while a critical illness treatment could cost several lakhs, you can buy a critical illness rider for just a few thousand rupees annually.

  4. Widen the scope of protection - Certain expenses like ambulance charges, hospital cash allowance etc may be excluded or have some limits under your base policy. Riders help bridge these gaps effectively. So you get wider health protection.

  5. Enhance financial security - Expenses from serious illnesses, accidents, or other contingencies can wipe out savings built over years. Riders provide the financial backup to prevent such adversity.

  6. Get coverage for pre-existing diseases - The base health plans often do not cover pre-existing conditions or have a waiting period before they can be claimed. But with a special rider for pre-existing diseases, you can get coverage for existing illnesses right from day one. This provides much-needed financial aid and peace of mind.

  7. Protect your family's future - There are special riders that provide your family with financial protection even after your demise. For instance, some riders pay out the entire sum insured to your nominee in case of the death of the policyholder. This way, your family remains financially secure in your absence.  

How Riders Affect Your Premiums
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Adding riders to your health insurance policy typically increases your overall premium. However, the exact premium hike depends on factors like:

  1. Type of Riders: A critical illness rider providing substantial coverage of severe diseases like cancer, strokes, etc. tends to have higher premiums than a less comprehensive value-added rider providing hospital cash allowance, etc. So, the premium increment is directly related to the scope of coverage, benefits, and risks the rider covers.

  2. Your Age: If you are on the higher side of age, premiums for specific riders like critical illness rider, personal accident cover, etc., which rely more on health condition, would be more expensive than premiums for a younger person for the same riders. 

  3. Pre-existing health status: If you suffer from pre-existing illnesses, premiums could be higher for relevant riders providing coverage for existing diseases or associated health risks. Someone with a clean medical history is likely to get such riders at lower premiums.

  4. Tenure and Sum Insured: A rider providing coverage for a longer tenure and higher sum insured leads to higher premiums than a lower tenure and sum insured. For the same rider, a person opting for an SI of ₹30 lakh may need to pay a higher premium vs someone going for a lower ₹10 lakh SI.

  5. Insurer: Premium rates for the same kind of rider can vary significantly across different health insurers. So comparing premiums across 2-3 health providers before zeroing in on a specific rider is wise. Sometimes, a slightly less comprehensive rider from one insurance firm is more economical than a higher variant from another provider.  

While riders increase overall costs, they provide targeted protection against contingencies better than any other instrument. Also, the premium increment is often marginal compared to the coverage enhancements. Hence, going for relevant riders proves to be a prudent financial decision for most health insurance buyers rather than relying solely on the basic policy.

What is covered under a basic health insurance policy?
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Depending upon the type of health insurance policy you opt for, you will be financially covered for the following:

Pre-existing diseases
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Many times, a policyholder might already suffer from a medical condition before buying a health insurance plan. Illnesses like diabetes, kidney failure, cancer, respiratory diseases, etc. are common. Usually, a waiting period is applicable if a policyholder wishes to get a pre-existing condition added under health insurance.

Surgery
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Surgery and hospitalization arising out of a medical condition are covered under a health insurance policy. Specifically, the cost of pre-hospitalization, hospitalization, and post-hospitalization, including the following is covered:

• Room rent

• Nursing Expenses

• ICU Charges

• Doctor’s visits

• Anesthesia charges

• Blood tests

• Oxygen cylinder

• Surgical appliances

• Medicines and drugs

Health Insurance for Senior Citizens
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These are comprehensive plans that are specifically designed for elderly people. Their requirements can differ from youngsters. Keeping this in mind, health insurance for senior citizens may include annual health check-up, domiciliary hospitalization cover, cashless hospitalization, lifetime renewability of the health insurance policy, and more.

Health Insurance for Children
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Children are more delicate and susceptible to diseases than adults. Thus, it is a good idea to get a health insurance policy for them as soon as it is available. Some health insurance companies in India allow babies as young as 16 days to be covered under an insurance plan, otherwise, a baby covered under insurance when he/she crosses 90 days.

ACKO Personal Health Insurance Plans
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This is how we make your health insurance journey easy.

ACKO Platinum Plan
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Sum insured: Rs.1 Cr and Unlimited

Zero Deduction on claims: Rest easy knowing that all hospitalisation expenses, including consumables for medical or surgical needs, are fully covered. Say goodbye to out-of-pocket expenses.

No Waiting Period: No more waiting around. From the moment your coverage begins, you can make claims for hospitalisation costs without any waiting period.

ACKO Standard Health Plan
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Sum insured: Rs.10L, 25L, 50L and 1 Cr.

No Room Rent Capping: Enjoy the flexibility of choosing your hospital room without any restrictions on rent limits. Your comfort matters, and we ensure it's prioritised.

Zero Deductions on Claims: Get every paisa of your claim amount without any deductions. We believe in providing full support when you need it most, without any hidden costs.

The Bottom Line
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The main aim of buying health insurance is to get a complete financial cover in case of medical emergencies. If you feel that your basic plan is not sufficient, consider buying additional coverages. The entire process of buying a policy becomes easier when you opt for online health insurance. You get a chance to review every aspect of the online health insurance policy and decide a better coverage for yourself and your family.

Frequently asked questions (FAQs)
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Here are some common questions about Health Insurance add-ons.

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What are add-ons in health insurance?

Add-ons in health insurance refer to additional benefits or coverage options that policyholders can choose to enhance their basic insurance plan. These extras offer tailored protection beyond the standard coverage, allowing individuals to customise their insurance to better suit their needs.

What are examples of add-ons in health insurance?

Examples of add-ons in health insurance include Critical Illness add-on, Room Rent Waiver, Doctor on-call, etc. These additional options can provide comprehensive protection for specific healthcare needs beyond what is typically included in a basic health insurance plan.

Is health insurance add-on coverage expensive?

The cost of add-on coverage can vary depending on the type of coverage and the insurance provider. It's essential to compare prices and consider the value of the benefits provided before deciding if it's worth the investment.

Can I add-on more coverage to my existing health insurance plan?

Yes, many insurance companies offer add-on coverage options that can be added to your existing health insurance plan for an additional premium.

How do I purchase add-on coverage in health insurance?

You can usually purchase add-on coverage directly from your insurance provider. Contact them to inquire about available options and how to add them to your policy.

Will add-on coverage in health insurance affect my premiums?

Yes, adding supplemental coverage to your health insurance plan typically results in an increase in premiums. However, the benefits provided by the additional coverage may outweigh the extra cost for some individuals.

Is health insurance add-on coverage worth it?

Whether add-on coverage is worth it depends on your individual healthcare needs and financial situation. Evaluate the cost versus the benefits provided to determine if it's the right choice for you.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on industry experience and several secondary sources on the internet, and is subject to changes. Please go through the applicable policy wordings for updated ACKO-centric content, and before making any insurance-related decisions.