Health Prime Rider: Benefits, Eligibility, and Exclusions – A Quick Overview

Health insurance is an extremely important component of financial planning. It not only provides financial assistance in case of a medical emergency but also helps individuals to stay prepared for any future contingencies. While buying health insurance, it is essential to choose the right plan with adequate coverage. However, the rising medical costs have made it challenging for individuals to afford comprehensive health insurance plans. This is where riders or add-ons come into play. Health Prime Rider is one such add-on that can be added to a health insurance plan to enhance its coverage.

What is Health Prime Rider?

It is an add-on cover attached to an existing health insurance policy. It provides additional coverage for medical expenses not covered under the base policy. The rider covers expenses such as OPD expenses, diagnostic tests, and wellness benefits.

Benefits of Health Prime Rider

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

Tele-Consultation Cover

If the insured individual becomes ill or injured, they can easily consult a registered doctor listed on the digital platform via video, audio, or chat channels.

Doctor Consultation Cover

The policyholder who suffers from an illness or injury can easily consult a licensed doctor/physician in-person from the designated network centre. If necessary, it is also possible to consult persons outside the prescribed network centre within the limits indicated in the terms and conditions.

Investigations Cover – Pathology & Radiology Expenses

If the insured is ill or injured, they can travel to the designated network centre or other locations and use this medical insurance add-on for pathological or radiological examination. This will be within the limits specified in the terms and conditions.

Annual Preventive Health Check-up Cover

The insured can benefit from a free 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
• Test liver function
• Serum creatinine
• T3/T4/TSH
• Urinalysis Health

You can easily avail of the health check-up through cashless claims at any of the prescribed hospitals or diagnostic centres. It should only be used during the term of the health prime rider. After the rider expires, you cannot extend its term.

Eligibility for Health Prime Rider

Here is the criteria you need to fulfil to be eligible for the Health Prime Rider:

Age

The Health Prime Rider is available for individuals between the ages of 18 and 65 years.

Policy Type

The Health Prime Rider can be attached to an individual health insurance policy or a family floater policy.

Pre-existing Conditions

Policyholders with pre-existing conditions may have to undergo medical underwriting before availing of the Health Prime Rider.

Waiting Period

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

Exclusions of Health Prime Rider

Here are the benefits that are not included in the health prime rider:

Cosmetic Treatments

The Health Prime Rider does not cover cosmetic treatments, such as plastic surgery, unless it is required due to an accident.

Non-allopathic Treatment

The Health Prime Rider does not cover non-allopathic treatments such as Ayurveda, Homeopathy, or Unani.

Maternity Benefits

The Health Prime Rider does not cover maternity expenses, such as prenatal and postnatal care, delivery charges, and newborn baby care.

Pre-existing Conditions

The Health Prime Rider does not cover pre-existing conditions for the first 48 months from the date of attachment of the rider. When buying the Health Prime Rider, individuals should consider their healthcare needs and budget. The premium for the rider varies depending on the age, health condition, and coverage amount. Therefore, individuals should compare the premium rates of different insurance providers before deciding on the Mediclaim provider. The Health Prime Rider is an add-on cover providing additional coverage to an existing health insurance policy. The rider covers expenses such as OPD expenses, wellness benefits, and cashless hospitalization. It is eligible for tax benefits under Section 80D of the Income Tax Act. However, the rider has certain exclusions such as cosmetic treatments, non-allopathic treatments, and pre-existing conditions. Individuals should carefully read the terms and conditions of the rider before opting for it. The Health Prime Rider is an excellent option for individuals wanting to enhance their health insurance coverage. It provides comprehensive coverage at an affordable cost. Moreover, it is easy to attach the rider to an existing health insurance policy. Individuals can buy the Health Prime Rider when they purchase a new policy or at the time of policy renewal. ** In conclusion, Health Prime Rider is an excellent option for individuals wanting to enhance their health insurance coverage. It can also be a great option when buying health insurance plans for family. It provides coverage for expenses that are not covered under the base policy. However, it is essential to understand the terms and conditions of the rider before buying it. Policyholders should also disclose their medical history truthfully to avoid claim rejection in the future. With the rising medical costs, it is essential to have adequate health insurance coverage. Health Prime Rider is a step towards ensuring financial security and peace of mind during medical emergencies.   * Standard T&C Apply ** Tax benefits are subject to change in prevalent tax laws. 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.