Health insurance is a crucial aspect of financial planning. It not only offers financial support during a medical emergency but also assists individuals in preparing for potential future challenges. When selecting health insurance, it is vital to choose an appropriate plan with sufficient coverage. However, escalating medical expenses have made it difficult for individuals to secure extensive health insurance plans. This is where riders or add-ons become relevant.

Health Prime Rider is an add-on that can be appended to a health insurance plan to enhance its coverage.

What is Health Prime Rider?

Health Prime Rider is an additional cover linked to an existing health insurance policy. It provides extra coverage for medical costs not included under the base policy. The rider encompasses costs such as OPD expenses, diagnostic testing, and wellness benefits.

Benefits of Health Prime Rider

Below is a list of benefits under the Health Prime Rider:

1. Tele-Consultation Cover
If the insured individual falls ill or is injured, they can conveniently consult a registered doctor listed on the digital platform via video, audio, or chat channels.

2. Doctor Consultation Cover
The policyholder who suffers from an illness or injury can easily consult a licensed doctor/physician in person at the designated network center. If needed, it is also possible to consult individuals outside the prescribed network center within the limits defined in the terms and conditions.

3. Investigations Cover – Pathology and Radiology Expenses
If the insured is unwell or injured, they can travel to the specified network center or other locations and utilize this medical insurance add-on for pathological or radiological examinations within the limits stated in the terms and conditions.

4. Annual Preventive Health Check-up Cover
The insured can enjoy a complimentary preventive health check-up every policy year for the following tests:

• Fasting blood sugar
• Blood urea
• Electrocardiogram
• HbA1C
• Complete blood count and ESR
• Lipid profile
• Liver function test
• Serum creatinine
• T3/T4/TSH
• Urinalysis

These health check-ups can be availed through cashless claims at any of the specified hospitals or diagnostic centers during the duration of the Health Prime Rider. Once the rider expires, it cannot be extended.

Eligibility for Health Prime Rider

To qualify for the Health Prime Rider, individuals must meet the following criteria:

1. Age
The Health Prime Rider is available for individuals aged between 18 and 65 years.

2. Policy Type
The Health Prime Rider can be added to an individual health insurance policy or a family floater policy.

3. Pre-existing Conditions
Policyholders with pre-existing conditions might need to undergo medical underwriting before obtaining the Health Prime Rider.

4. Waiting Period
There is a waiting period of 30 days from the date of attachment of the Health Prime Rider before policyholders can access the benefits.

Exclusions of Health Prime Rider

The Health Prime Rider does not cover the following expenses:

1. Cosmetic Treatments
It excludes coverage for cosmetic procedures, such as plastic surgery, unless they are necessary due to an accident.

2. Non-allopathic Treatment
Treatments that are non-allopathic, including Ayurveda, Homeopathy, or Unani, are not covered.

3. Maternity Benefits
Maternity-related expenses, such as prenatal and postnatal care, delivery fees, and newborn care, are excluded.

4. Pre-existing Conditions
The Health Prime Rider excludes pre-existing conditions during the first 48 months from the date the rider is attached.

Key Considerations Before Purchasing Health Prime Rider

When purchasing the Health Prime Rider, individuals should evaluate their healthcare requirements and financial capacity. The premium for the rider depends on age, health status, and the amount of coverage. Thus, individuals should compare premium rates among various insurance providers before selecting a mediclaim provider.

The Health Prime Rider is an additional policy that offers enhanced coverage to an active health insurance plan. This rider addresses costs such as OPD charges, wellness benefits, and cashless hospitalization. It qualifies for tax deductions under Section 80D of the Income Tax Act. Nonetheless, the rider comprises specific exclusions like cosmetic procedures, non-allopathic treatments, and pre-existing conditions. Individuals are advised to thoroughly review the terms and conditions associated with the rider before making a choice.

Conclusion

Health Prime Rider serves as an excellent alternative for individuals looking to expand their health insurance coverage. It can also be an advantageous choice when selecting health insurance plans for families. It offers coverage for expenses that are not included in the primary policy. However, it is crucial to grasp the terms and conditions of the rider before making a purchase. Policyholders must also accurately disclose their medical history to prevent future claim denials. Given the increasing medical expenses, maintaining sufficient health insurance coverage is vital. The Health Prime Rider takes a step toward ensuring financial stability and peace of mind during medical crises.