November 28, 2022

Marriot Plaza

The health authority

All About Consumables Benefits in Health Insurance

Things You Need to Know about Consumables Benefits

When buying health insurance, it is critical to know what forms the different parts of your insurance policy — the diseases covered, the treatments for which the insurance company can pay, and the exclusions of the insurance plan. But apart from that, there are certain costs that are required in the treatment of an illness which are usually excluded by the insurance policy’s scope. These are known as the general exclusions of an insurance policy. Consumables are one such component that is usually required during a medical procedure. Once used, they are discarded right after. Since it forms part of the treatment, its cost is directly billed to the patient if not covered by your health insurance policy.

What are consumables used in medical treatments?

If you go through your health insurance policy, consumables are listed as specific components used in the treatment of an insured individual. They are the medical aid or equipment that needs to be replaced after use. The regulatory body, the Insurance Regulatory and Development Authority of India (IRDAI), reviewed the list of 199 items (that were originally listed in 2012) as ‘non-payable expenses’ from an insurance company’s perspective. However, this list serves as a guideline and the insurance companies have the freedom to include or exclude certain items when it comes to issuing an insurance policy. Hence, it is essential for you to thoroughly read the policy document at the time of purchase. 

Some examples of consumables include:

  • Administrative charges, such as admission kit, documentation expense, discharge procedure, medical records, birth/death certificate, entrance/visitor’s pass, daily chart charges, etc.
  • House-keeping items, such as mineral water, shampoo, powder, caps, belts, toothbrushes, toothpaste, slippers, sanitary pads, tissue paper, combs, diapers, baby food, cradle, carry bags, etc.
  • Room charges, such as charges for telephone, television, DVD player, air conditioner, attendant charges, IV injection, luxury tax, etc.
  • Surgical items, such as razors, needles, cotton, syringes, gloves, masks, gowns, sutures, surgical tape, thermometers, slings, braces, collars, etc.

* Standard T&C Apply

While the above list is illustrative, there are similar items that form part of the list. 

Why is consumables coverage needed in health insurance? 

If you choose a health insurance policy without considering these costs, it may burn a hole in your wallet. These items may seem like minuscule expenses, but in aggregate, they can form a significant part of your insurance claim. On average, these expenses make up 5% to 15% of your total bill which, without a consumable cover in your individual plan or family health insurance policy, would be required to be paid by you.  

With an add-on cover for consumables, you can cover these expenses in your health insurance policy. Some insurance companies offer this as standard, while a few make it available as an optional rider. Having coverage for consumables helps save significant costs that are incurred for your medical treatment. 

Here’s an example of why consumables cover is essential. Imagine that, for some medical treatment, an entire roll of cotton was called for. However, only half of it was used for any treatment. The remaining half, although unused, would be forfeited to the hospital. Since you are not billed on an actual usage basis, consumable coverage in your health insurance helps you save for these costs where you, as a patient, lack any decision-making power. * Standard T&C Apply

When deciding which insurance policy to choose, make sure to understand what is health insurance, the policy’s coverage, and the exclusions of the plan. This will help you make an informed choice in regard to the policy. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.