Insurance companies are fine-tuning rules to help cover consumable expenses through endorsements, to be purchased with the Basic plan
Over the past 18 months, medical expenses for hospital patients infected with COVID-19 in India have reached unprecedented levels. This has put enormous financial pressure on the families of those infected with the deadly coronavirus, forcing them to borrow money from family and friends to pay hospital bills.
Detailed analyzes of hospital bills show that the rise is mainly due to consumables which include PPE kits, syringes and disinfection products. Consumables refer to single-use items used for treatment or medical procedures.
In the pre-COVID-19 era, the average cost of treatment in a private hospital was between 50,000 and 60,000. However, during the COVID-19 phase, that figure rose to 80,000-90,000.
The cost of consumables in hospital bills has increased dramatically since the start of the pandemic. Today, the cost of hospitalization per day per patient for COVID-19 treatment is 10,000, and for a 15-day hospital stay, the cost is between 1.5 lakh and ₹ 2 lakh.
During hospitalization due to COVID-19, consumables represent a quarter of the bill and if the stay is extended for a longer period due to co-morbidities, the cost can increase considerably.
For the context, until February 2020, the cost of consumables reached up to a maximum of 3 to 5% of the total hospital bill, according to a report from the SBI.
The reason for the extremely high use of consumables in hospitals over the past 18 months is the highly contagious nature of the virus. Given the severity of the pandemic, hospitals across the country have been forced to require staff to wear protective gear such as coveralls and face shields at all times, adding to hospital bills. . While people without health insurance must pay the entire bill out of pocket, those with full health insurance must bear the cost of consumables themselves.
Changes to the subscription rules
Indeed, according to the underwriting rules of insurers, the cost of consumables within the framework of a health insurance plan is not the responsibility of the insurance company. Consumables, in health insurance jargon, are non-medical items and therefore are not the responsibility of the insurer.
With the advent of the virus, many insurers began to make changes to their underwriting rules and decided to cover the cost of consumables through additional endorsements that can be purchased with the basic plan.
“Protected no-claims bonus”
In addition to providing coverage for consumables, endorsements also protect your No-Claim Bonus (PNE), provided the claim amount does not exceed 50,000.
Some runners also pay the client for preventive check-ups, wellness benefits, home care, medical consultations and diagnostics.
The average cost of the riders is 5% of the premium for the basic plan. Suppose if you choose a basic plan with an annual premium of 8,000, the annual premium for the rider would be 400. Apart from these endorsements, there are standalone / comprehensive health plans that cover consumables without endorsement.
These plans are reasonably priced and available starting at a monthly premium of 600 for a 30 year old with 5 lakh coverage. These plans pay for consumables such as Personal Protective Equipment (PPE) kits on a case-by-case basis. In fact, based on market trends, the claims settlement rate is the highest among those covered for consumables.
Those who already have a comprehensive health insurance plan but still wish to be covered by a plan that covers the cost of consumables have the option of carrying their health insurance plan.
Policyholders can now easily transfer their existing plan to another insurer online without the need for physical papers. Carrying can help increase the sum insured, benefit from better features, reduce the wait time for pre-existing conditions, among other reasons. Carrying can be done up to 45 days before the policy renewal date.
(The author is Head-Health Insurance, Policybazaar.com)