Want coverage for consumables? Add riders to your health insurance plan

July 18, 2021 11:56 AM

Prior to COVID-19, consumables used to take up around 3%-5% of the hospital bills, however since the outbreak of the pandemic, the share of consumable in hospital bills has increased to a massive 25%-30%.

As per the available trends, the claims payout ratio amongst people who have cover for consumables is 94% while people who do not have cover for consumables is 83%.

In the last 15-16 months, treatment at private hospitals in all major cities across the nation has turned dearer, with the inclusion of essential protective gear and consumables for staff that is being passed on to the hospitalisation bills of the consumers. In fact, costs for hospitalisation have gone up by 35-40 per cent for all major private hospitals, especially with increase in consumption of consumables like PPE kits, syringes, along with addition of sanitisation costs.

While before COVID-19, the average hospitalisation bill was between Rs 50,000 and Rs 60,000, during the COVID-19 crises it has increased to Rs 80,000 – Rs 90,000. Over the last one year, costing of COVID-19 beds in private hospitals is running into around Rs 10,000 per patient per day. For 15-days hospitalisation for treatment of COVID-19, the hospital bill mostly runs into Rs 1.5 lakh – Rs 2 lakh.

Increase in Share of Consumables

Prior to COVID-19, consumables used to take up around 3% – 5% of the hospital bills, however since the outbreak of the pandemic, the share of consumable in hospital bills has increased to a massive 25% – 30%. This has left several families across the country in trouble as they are taking loans or asking for help from family and friends to pay the hospital bills.

For instance, a family in Bangalore was stumped to see 40% of their hospital bill was for consumables that included cost of PPE kits, N95 masks, sanitisation of examination rooms and many other products. The bill handed over to them by a private hospital was of Rs 2.5 lakh that included consumables worth Rs 1 lakh. The story is similar across PAN India with people worried about the high costs of consumables in their hospital bills.

In fact, as per underwriting rules of insurers, consumables are not payable by the insurance company. As a health insurance policyholder, it is important for you to know that your insurer may not cover you for consumables and the cost of such expenses will have to be borne by you only in case of hospitalisation.

Riders to the Rescue

Thankfully, considering the significantly high proportion of consumables in hospital bills, insurers have now started to come with riders that can be bought along with base plans to cover the cost of consumables in your hospital bills. For now, two prominent insurers namely Care Health Insurance and Max Bupa Health Insurance are offering such riders. The feature can be availed through any Care Health iinsurer’s plan by adding Care Shield rider and Max Bupa Health Insurance’s Safeguard rider. Both these riders cost approximately 5% of the base plan premium.

For example, if you choose Max Bupa’s Health ReAssure plan whose annual premium is Rs 8,000, the annual premium of Safeguard Rider would be Rs 400. Both these riders help in getting the claim settled for non-payable items and have no impact on NCB if the claim is up to 50,000. Both these riders can be bought with any heath cover of Care Health Insurance or Max Bupa Health Insurance to cover consumables and non-payable items like belts, gloves, braces, masks, spirometer, thermometer, and other such items. Apart from covering for consumables, the Care Shield rider also pays for preventive health check-ups, wellness, home care, doctor consultations, and diagnostics.

As per the available trends, the claims payout ratio amongst people who have cover for consumables is 94% while people who do not have cover for consumables is 83%. This means that people who have a cover for consumables, the claim payout ratio is 11 percentage points more than people who do not have a cover for consumables. These numbers are expected to increase by manifolds as COVID-19 is here to stay for long and the practise of using consumables for patients during hospitalisation will be followed in the long run as well. This makes it even more important to add consumables rider with your base plan for a comprehensive coverage against coronavirus infection.

(By Amit Chhabra, Head-Health Insurance, Policybazaar.com)

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