Gone are the days of one-size-fits-all health insurance. With skyrocketing health care costs, different lifestyles and different family structures, the right coverage needs to be as unique as you are. Enter add-ons (or riders) – additional coverage that you can tack onto a base policy that fills in coverage gaps without needing a whole new plan.
Here is how you can customise the best health insurance plan, when you should pay the extra premium and what to be cautious of.
Add-ons allow you to:
|
Add-On |
What It Does |
Ideal For |
Typical Cost Driver |
|
Critical illness cover |
Pays a one-time lump sum on diagnosis of listed life-threatening illnesses, irrespective of the actual hospital bill |
Families with a history of cancer, heart disease or young breadwinners worried about income loss |
Number of illnesses covered & sum assured |
|
Room-rent waiver |
Removes or raises per-day room cap so you can pick single AC or suite rooms without proportional deductions |
Residents of metro cities |
Hospital zone & chosen limit |
|
Hospital daily cash |
Fixed daily allowance (often 500–5,000₹) during hospitalisation to meet non-medical costs like food, attendant stay |
People without salaried sick leave or freelancers |
Daily cash amount & maximum days |
|
Personal accident cover |
Lump-sum for death or total/permanent disability; partial payout for partial disability |
Frequent travellers, commuters, and high-risk professions |
Sum assured & occupation risk class |
|
OPD cover |
Reimburses consultations, diagnostics and medicines without 24-hour admission |
Families with chronic conditions requiring regular follow-up |
Annual OPD limit |
|
Co-pay waiver |
Insurer bears the co-payment otherwise applicable in senior-citizen or budget plans |
Parents above 60 or zones with high hospital tariffs |
Age & co-pay percentage removed |
|
AYUSH benefits |
Covers Ayurveda, Yoga, Unani, Siddha, Homeopathy, and inpatient costs |
Policyholders preferring alternative therapy |
Sum insured for AYUSH |
|
PED waiting-period reduction |
Shortens 2–4-year lock-in for pre-existing diseases like diabetes or hypertension |
Middle-aged buyers with known ailments |
Years reduced & disease profile |
How to Choose the Right Combination
Some comprehensive family health insurance plans already bundle restoration, AYUSH or free health check-ups. Don’t duplicate benefits.
IRDAI caps add-on price at 30% of base premium, but even a 10% extra can feel steep if the rider rarely triggers.
Riders follow their own clock. A critical illness payout may require a 90-day waiting period plus a 30-day survival; OPD covers usually carry sub-limits per visit.
Add-ons co-exist with the core policy. Renewing without them is allowed, but mid-term addition generally isn’t; plan ahead at purchase or renewal.
Suppose you hold a ₹10 lakh base mediclaim policy. A single hospitalisation for cardiac bypass in a metro can cost ₹5–6 lakh, eating half your sum insured. If the same event triggers heart failure again within the year, you’re underinsured. Two simple riders – Sum Insured Restoration (auto top-up after first claim) and Room-Rent Waiver – could have doubled the cover and prevented proportionate deductions for choosing a private room, all for maybe 12–15% extra premium.
Rule of thumb: First, ensure an adequate base sum insured (at least 10–15 times monthly income for urban families). Then pick two or three riders who plug the biggest gaps.
HDFC ERGO’s Optima Secure plan doubles your base cover from day one, and restores 100% after a claim. Adding crucial add-ons to this plan can act as a one-stop solution for your healthcare needs.
