
Basic health insurance policies often cover hospitalization but leave gaps in day-to-day medical expenses. That’s why insurers offer add-ons (also called riders)—optional covers you can add by paying an extra premium.
In 2025, Indian families are increasingly opting for add-ons like OPD, day-care, maternity, and critical illness riders to make their health coverage more practical. This guide highlights the most useful add-ons and how they work.
1. OPD Cover (Outpatient Department)
What It Covers
- Doctor consultations without hospitalization.
- Diagnostic tests like X-rays, blood tests.
- Pharmacy bills (in select policies).
Why It Matters
Most families spend ₹5,000–₹15,000 annually on OPD expenses, which often go uncovered. An OPD rider ensures these costs are reimbursed.
Best for: Families with kids, elderly members, and working professionals with frequent doctor visits.
2. Day-Care Procedure Cover
What It Covers
- Surgeries/procedures that don’t need 24-hour admission (e.g., cataract, dialysis, tonsillectomy).
- Coverage for more than 500+ day-care procedures.
Why It Matters
With medical technology advances, many surgeries are now same-day. Without this add-on, insurers may reject claims under “not hospitalized for 24 hours.”
Best for: All families, especially senior citizens.
3. Maternity & Newborn Cover
What It Covers
- Delivery expenses (normal & C-section).
- Pre- and post-natal care.
- Vaccination and newborn hospitalization cover.
Waiting Period
Usually 2–4 years before maternity benefits apply.
Why It Matters
Average delivery costs in private hospitals range from ₹80,000–₹2 lakh in urban India. A maternity rider protects young couples from this financial burden.
Best for: Couples planning a child in the next 3–5 years.
4. Critical Illness Rider
What It Covers
- Lump-sum payout on diagnosis of illnesses like cancer, heart attack, stroke.
Why It Matters
Standard policies cover hospitalization, but income loss during treatment can be devastating. A critical illness rider provides financial backup.
Best for: Middle-aged earners, high-risk individuals (family history).
5. Room Rent Waiver
What It Covers
- Removes sub-limits on room rent (e.g., ₹3,000/day).
- Lets you choose private/single rooms without paying extra.
Best for: Urban families who prefer private hospital rooms.
Quick Infobox: Cost of Popular Add-Ons (2025)
Add-On | Extra Premium (per year) | Who Should Buy |
---|---|---|
OPD Cover | ₹2,000–₹6,000 | Families with frequent doctor visits |
Day-Care Cover | Usually included, else ₹1,000–₹3,000 | Elderly & those with chronic issues |
Maternity Cover | ₹8,000–₹25,000 | Young couples |
Critical Illness Rider | ₹3,000–₹10,000 | Middle-aged earners |
Case Study: Anita & Rajiv’s Family
Anita (32) and Rajiv (35) bought a family floater policy of ₹10 lakh. Initially, they skipped add-ons. In 2025, they opted for maternity and OPD riders.
- Delivery cost of ₹1.4 lakh was mostly covered.
- Their child’s vaccinations were reimbursed.
- Annual doctor visits were now cashless.
Lesson: Add-ons may increase premiums, but they save far more in real-life scenarios.
Why This Matters
Health insurance is not one-size-fits-all. Add-ons like OPD, maternity, and critical illness riders help families customize coverage to match their needs.
Next, read: Why Indians Under-Insure Health: Behavioural and Financial Reasons
➕ Customize Your Health Policy
Use Insurance+ to compare add-on covers for OPD, maternity, and day-care, or join eBharat’s Agent Network to guide families in choosing the right riders.
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