Categorized | Health Insurance

Understanding Riders in Health Insurance

A rider is an additional Policy benefit that is not included in the basic plan, but you have the option to have it included in your policy by paying an additional premium. You may supplement your existing life or Health Insurance Coverage by choosing from a host of riders. There are some important riders, which you should certainly consider while buying your health policy:

Critical Illness Benefit / Policy 

Critical illness policy can either be opted as a rider or you can buy a separate policy cover. This rider is intended to ensure protection against Critical Illness that could have an adverse impact on your ability to earn for a reasonable or an uncertain period of time. The range of critical illnesses covered under this rider would vary from one insurance company to another. But the most common illnesses that are covered include cancer, stroke, CABG, major organ failure, paralysis. In some cases the critical illness benefit may also insure against accidental death and partial or total disability due to accidents. However, any congenital or Pre-existing illness is excluded from the coverage. If you are suffering from HIV, you may be denied the coverage.

The benefit received under this rider is over and above what you get under normal coverage from your basic medical insurance policy. The basic health insurance cover will take care of your Hospitalization / treatment related expenses, while critical illness benefit will provide the Insured a lump sum cash benefit intended to care of your financial needs due to loss of income during the period you have to be away from work. Most insurance provider allow this benefit only if the insured has survived for a pre-determined period after being diagnosed for the illness. So, basically if the illness results in death, then critical illness benefit is not payable.

Hospital Cash Benefit Rider

This provides fixed cash benefit in the event the insured is hospitalized. So, irrespective of what you may spend in actual terms, opting for this rider will allow you a daily cash benefit. To avail these benefits, the hospitalization period should exceed 48 hours. If you are hospitalized and you require Intensive Care Unit (ICU) facilities, you would be eligible for twice the daily cash benefit you would otherwise receive.

The rider provides a lump sum benefit in case you require a surgery for a medical reason. If there are multiple surgeries to be performed, you would still be paid for a single surgery, but for the one that attracts the highest fixed benefit.

Maternity Cover

This rider can be opted in addition to your basic health insurance cover. The maternity cover provides Reimbursement of expenses incurred during hospitalization (for child birth) and all other expenses incurred 30 days prior to and 60 days post hospitalization. It also offers Mediclaim for expenses related to resolving any complication (premature delivery, caesarean etc.) on account of pregnancy. Cost of medicines and consultation costs during regular visits are not included in the coverage.