What is Consumables Cover in Health Insurance?
Medical bills are rising, and a whooping medical inflation rate of 14% is raising the cost of healthcare. But have you ever thought that your current health insurance coverage would be sufficient for any medical emergency with the rising cost incurred with everyday hospital items like gloves, syringes, and masks, which can quietly inflate your medical bills?
If not, it's time to consider obtaining consumable coverage in a health insurance policy.
This essential health insurance add-on covers the costs for single-use items, ensuring your savings stay intact while you focus on recovery.
What are Consumables in Health Insurance?
Consumables in health insurance are usually medical equipment/aids discarded after use, such as PPE kits, gloves, masks, and syringes.
A list of 199 items that are "non-payable" from the insurer's point of view was first published in 2012 and reviewed by the Insurance Regulatory and Development Authority of India (IRDAI) in 2016. The list serves as a guideline, and insurers can include or reject any or all items from this list regarding policy coverage.
What is Consumables Cover in Health Insurance?
In recent times, given the skyrocketing costs of healthcare facilities, it has become essential to have a well-researched and adequate amount of health insurance. However, even if you have sufficient health coverage, it might fall short of certain exclusions and non-payables. In such cases, a large share of the hospital bill becomes an out-of-pocket expense.
Considering such cases and the ever-increasing importance of adequate health coverage, some insurance companies have now started providing coverage for many of these non-payables.
One of these is the Consumables Cover, which many insurance companies now offer as an add-on to health insurance.
List of Items Included in the Consumables Cover
You might be wondering how a few disposables, like masks, gloves, etc., would considerably increase the hospital bill. Well, you are not entirely wrong. Consumables used to form a small portion of the hospital bill previously, and people didn't bother much. However, recently, after the pandemic, the cost has risen due to the increased use of disposables and protective equipment.
There are a total of 199 items which can be classified under four categories. Here is the list of most preferred consumable items in health insurance plans:
Here’s a catch!
The list of consumables prescribed by IRDA includes 199 items, but it generally serves just as a guideline, and insurers have the liberty to include or exclude any item in their policy.
The list of consumables might look inexpensive separately, but when combined, they increase the cost of the bill. To avoid this hit on your pocket, you must consider getting consumables covered in your Health Insurance.
Example of Consumable Cover in Health Insurance
Consumable coverage in health insurance is easy to understand.
Let's say Mrs Ankita spent three days in the hospital for her delivery. Her husband was given a ₹2.4 lakh bill after she was released from the hospital, of which ₹35,000 was for consumables like cotton, diapers, air conditioning, hospital gowns, tissue papers, baby's birth certificate fees, attendant fees, etc.
This is where the consumable cover comes in. It covers such costs, ensuring these hidden charges don’t catch you off guard. Think of it as a safety net that shields your wallet while you recover stress-free.
Why Opt for Consumables Cover in Health Insurance?
Unexpected costs for gloves, syringes, and masks can increase hospital bills and out-of-pocket expenses. That’s where consumables coverage becomes a game-changer! And, you must buy a health insurance policy with a consumable add-on to get complete coverage of these hidden items' costs.
Due to widespread use and hospital overcharging, the cost of consumables has increased dramatically after the pandemic. Earlier, the policyholder paid the cost of these non-medical products instead of the insurance company. But if you opt for consumable cover, the insurance company will cover the expenses of the items up to the total insured limit.
Most health insurance plans do not cover the cost of items listed as non-medical items. The policyholder is, therefore, responsible for covering these consumables, which raises out-of-pocket costs. Hence, policyholders can reduce their out-of-pocket expenses and protect their hard-earned money by purchasing consumable coverage in their health insurance.
Many patients do not get a chance to afford quality care due to the high cost of hospital consumables. To reduce their out-of-pocket costs, they choose hospitals and treatments that are reasonably priced. People with consumables coverage can afford the highest quality of care because the insurance company covers the total cost of the hospital stay.
How Consumable Cover Can Make a Difference in Your Medical Expenses?
Medical expenses often include unexpected costs for consumables like gloves, masks, and syringes, which aren’t covered under standard insurance. A consumable cover bridges this gap, reducing out-of-pocket expenses. Here’s how it makes a difference:
- It reimburses the costs for all the single-use items used during the treatment procedure.
- Reduces financial stress after getting the final bill for discharge from the hospital.
- The cost of adding consumable coverage to your health insurance is affordable.
- Provides total coverage along with your base policy.
Why are Consumables Typically Not Covered by Standard Health Insurance?
One primary reason insurers are reluctant to cover consumables in health insurance is that most consumables are disposable and single-use items. During any treatment, piles of these are used and discarded, which shoots up the patient's hospital bill, which the insurers generally refuse to pay.
Consumables are the essential services and items provided for a comfortable and safe stay of the patient in the hospital. A compromise on these would directly mean compromising the patient's health. Hence, it's essential to refrain from striking off the consumables from the prescribed requirements of the patient. A consumable cover ensures that these consumables' expenses do not hit a patient's pocket.
Consumable cover bridges the gap between standard health insurance and unexpected hospital expenses for non-medical items. Covering single-use essentials like gloves, syringes, and masks minimizes financial stress and ensures quality care without compromises.
Be smart and include consumable coverage in your health insurance to ensure complete coverage.
FAQs about Consumable Cover
I already have health coverage, but it does not cover Consumables. Should I buy a new policy?
In such a case, check with your insurance provider if they provide consumables cover as an add-on. If they do, buy that add-on. If they don't cover consumables in any form, wait for the policy term to end and buy a new policy from another insurance provider that covers consumables.
How do I know if my health insurance plan provides coverage for consumables?
To determine whether your health insurance plan covers consumables, thoroughly review your insurance policy document for inclusions and exclusions.
Will my insurance cover the cost of consumables if I don't have the consumables add-on?
Consumables are an exclusion. You need to buy an add-on separately to cover these non-medical expenses. Check your policy documents for complete details.
What is consumables cover in health insurance in simple words?
Consumables are non-medical products consumed or non-payable costs patients incur while in the hospital. Single-use goods, like infant food, syringes, cotton, masks, gowns, etc., are often discarded after use. Most health insurance does not cover these non-medical products without consumables coverage.
What are hospital consumable charges?
The cost of admission/registration, attendant services, surgical tapes, cotton, surgical blades, toiletries, etc., are examples of single-use products or expenses included in the term "consumables charges" when a patient is admitted to a hospital.
Can a group health insurance policy cover consumables?
Yes, consumables are covered by some Indian group health insurance plans. However, one should consult the document to find out what is and is not covered by the policy.
Is there a cap on the amount of consumables I may claim?
No, generally, there is no cap on the consumables you can claim, but you can only claim the maximum sum insured you have opted for.
Do I have to pay for consumables upfront to get my money back?
This differs depending on the healthcare provider and insurer. Some may need payment for which you can later get reimbursement, and others may provide cashless treatment in a network hospital.
Can I include coverage for consumables in my current policy?
Yes, you can include consumables coverage as an optional benefit in your health insurance policy. Some companies provide it as an add-on, while others already include it in the coverage.
Can I claim for consumables used during outpatient treatment?
Yes, but this merely depends on your policy. Some insurance covers only consumables used during inpatient treatment, while some cover the cost of consumables during outpatient treatment. Check with your insurance provider about this.