One goes the whole nine yards to ensure a fully cashless hospitalisation claim in the course of getting medical treatment. But when you await full settlement of the hospital bill by the health insurance provider, you notice that there is a 20 per cent hole in the amount sanctioned by the company. In other words, you are asked to pay 20 per cent of the total bill from your own pocket as your policy does not cover ‘consumables’ used during your treatment.

This can be frustrating, to say the least, and financially draining as well. We will go into what constitutes consumables and how you can stay covered for these in a bit.

Before the Covid-19 pandemic struck, consumables used to constitute up to 5 per cent of the total medical treatment bill. But during the pandemic and the period afterwards, the cost of consumables increased to 20 per cent of the total hospitalisation bills for many. There have been cases when consumables accounted for as much as 40 per cent of the total medical bill.

And most insurance companies generally do not cover a good part of consumables. Enter consumables cover or add on with your health insurance policy.

But first, what are consumables?

As indicated by the name itself, consumables are those items that are used during the course of your treatment and discarded later. These are single-use products — syringes, needles, cotton, gauze swabs, catheters, PPE kits, gloves, masks, sanitisers and so on.

While the above items are commonly referred to as consumables, there are a few other categories as well.

Administrative: These include the costs involved in maintaining medical records, birth and death certificate arrangement, documentation, discharge procedure, visitor’s pass and the like.

Housekeeping: Charges could be those needed for arranging or using toothbrush, toothpaste, sanitary pads, diapers, slippers, baby food, carry bags, caps, shampoos, powders, sanitisers, combs and so on.

Room services: The levies under this head could be on room services, attendant charges, air-conditioning, cable television, telephone and luxury tax, among others.

Thus, consumables encompass a wide variety of tangibles and intangibles and could add up to a pretty large sum in the overall medical bill, resulting in an unnecessary extra burden on your pocket.

Insurance companies generally exclude consumables from the overall hospitalization bill or allow very select items and settle the amount to policyholders when they make a claim. All this is made worse by the fact that there is considerable wastage on many items as well. Say, just needing one gauze swab rather than a pack, a little bit of cotton rather than an entire bundle and so on. But you still end up paying for the entire pack though usage may be limited.

Covering yourself with an add-on

Given that consumables can burn a hole in your pocket, some insurers are either including it as a part of their regular health insurance policy or are offering it as a separate rider or add-on. Though comprehensive data is not available on the additional premium charged for the consumables rider, a rough estimate of the cost would be around 5 per cent of the main health premium amount.

Right now, HDFC Ergo, Tata AIG, Care Health and Niva Bupa are among a few offering consumables cover.

The Optima Secure policy from HDFC Ergo pays for a host of items. This policy pays for consumables that include listed non-medical expenses such as gloves, masks and nebulizer kits. A key point to note here is that this feature comes as a part of the health insurance policy itself and is not a separate add-on. There are thus no additions to the health premium on this count.

Tata AIG MediCare also provides a comprehensive health insurance that includes consumables, rather than offering a rider. The company offers to pay for consumables as a part of the main policy and not as a separate add-on. It covers all consumable expenses related to the patient’s medical and surgical needs.

Care Health offers the consumables cover as a part of its Care Shield Add-on plan. Apart from having many other features, the plan covers 68 non-payable items up to the sum insured. The consumables list covered includes a whole host of charges under various heads mentioned earlier. Even items such as oxygen cylinder used outside the hospital, cervical collar, diabetic footwear, private nurse charges and ambulance equipment, among many others, are covered.

Niva Bupa, too, offers consumables cover via a Safeguard Rider upon making an additional payment along with the premium.

Ideally, taking a comprehensive policy that covers most consumables is a good idea, If not, buying an additional rider for the purpose at extra cost is desirable for policyholders.

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