What Does Consumables Benefits Mean In Health Insurance Policy?

Here is a question for you. Have you read your health insurance policy document?

If you have, then do you know what consumables benefits are?

You might be quite confused now but don’t worry if you aren’t sure about it, here is what it means.

Consumables are usually, but not restricted to, medical aid/ equipment that have to be discarded after use. The cost incurred from the consumables is directly billed to the patient (if not covered in the health insurance policy. In 2016, the Insurance Regulatory and Development Authority of India (IRDAI) reviewed a list of 199 items (originally listed in 2012) that are ‘non-payable’ from the insurer’s perspective[1]. The list, however, just serves as a guideline and the insurers have the freedom of including or excluding any or all items from this list when it comes to policy coverage.

• Administrative charges
  Admission kit, birth/death certificate, documentation expense, entrance/visitor’s pass, daily chart charges, discharge procedure, medical records, etc.

• House-keeping items
  Mineral water, toothbrush, toothpaste, slippers, sanitary pads, tissue paper, combs, shampoo, powder, caps, belts, diapers, baby food, cradle, carry bags, etc.

• Room charges
  Telephone, television, DVD player, air conditioner, attendant charges, IV injection, luxury tax, etc.

• Surgical items
  Cotton, razors, needles, syringes, gloves, masks, gowns, sutures, surgical tape, tourniquet, thermometer, splint, slings, braces, collars, etc.

These are just 40-odd items from the list of 199 that are possibly excluded from your health insurance policy. Most of these seem like inexpensive everyday items but could make up a serious bill for you.

When it comes to consumables, you lack any decision-making power. Assuming some medical item is available in a price band of Rs 50 to Rs 500, the hospital or doctor decides the brand or quality of the consumable. There is also wastage; say for example a 250 gm cotton roll was opened for you, and possibly only a couple of swabs were used, you will be billed for the entire item, not on actual usage.

It is estimated that consumables could make up anything from 5% to 15% of your hospital bill, depending on the services availed. You can avoid this cost by considering a small add-on rider to your health insurance plan.

The add-on Consumables Benefits would come at a minuscule percentage of what the actual cost of consumables might be in case of a prolonged period of hospitalisation.

Tata AIG MediCare understands how important it is to cover such benefits, it provides Consumables Benefits as a feature rather than an add-on!

Not only does it cover all consumable expenses related to the patient’s medical and surgical needs, but it also covers over 540 different daycare procedures, high-end OPD tests and vaccination benefits.

So before opting for a comprehensive health insurance, look for a policy which covers all of these things and much more so you are not surprised by a hospital bill heftier than you were expecting.

Source: IRDAI, Guidelines on Standardization in Health Insurance, 2016