the insurer's Non-Medical Expenses Add-On covers the IRDAI List I consumables and non-payable items that standard health insurance policies don't pay for — gloves, masks, syringes, cotton, diapers, crepe bandages, attendant charges, and 60+ more. These items silently add 5–20% to your hospital bill. One add-on. Filed January 2025. Covers every hospitalisation under your eligible the insurer Mediclaim policy.
the insurer Health Insurance· Non-Medical Expenses Add-On· IRDAI Standardised· Policy Wording Filed Jan 2025
The the insurer Non-Medical Expenses Add-On is a health insurance add-on that covers the IRDAI List I consumables and non-payable items that your standard the insurer Mediclaim policy excludes. These are the gloves, syringes, masks, cotton, bandages, diapers, attendant charges, and 60+ other items that appear on every hospital bill — but are typically rejected during claim settlement. The the insurer policy wording was filed with IRDAI in January 2025.
The IRDAI has standardised the list of non-payable consumables across all health insurers. The the insurer Non-Medical Expenses Add-On covers these List I items during inpatient hospitalisation — gloves, masks, syringes, cotton, diapers, crepe bandages, and 60+ more.
IRDAI Standardised"Non-medical expenses can account for 5% to 12% of the total bill. A ₹1,00,000 hospital bill may have ₹5,000–₹12,000 in non-payable items." For critical illness with high consumable use: up to 20%. This add-on eliminates that out-of-pocket burden.
5–20% of BillNon-medical expenses coverage applies during inpatient hospitalisation — when you are admitted to a hospital in India. Each hospitalization claim under your base policy can also include List I non-payable items under this add-on.
Inpatient· Indiathe insurer's Non-Medical Expenses Add-On policy wording was filed with IRDAI in January 2025. This is a recently introduced product — reflecting the growing market demand for consumables cover following COVID-19, which made PPE kit costs (₹5,000–₹15,000 per admission) a major out-of-pocket expense.
Jan 2025· New ProductMarket benchmark: the insurer charges ₹1,500 for ₹15,000 cover. The premium is typically small relative to the potential claim value. A single hospitalisation can generate ₹5,000–₹45,000 in non-payable items — easily exceeding several years of add-on premium.
Low Premium· High ValueLike the Home Care Treatment Add-On, this product requires an eligible the insurer base Mediclaim policy. It cannot be purchased independently. The add-on's policy period matches the base policy period. Confirm eligible base policies with Probitas at 022 4302 0000.
Base Policy RequiredIRDAI Guidelines· Why Non-Medical Items Are Excluded· The Hidden Bill Shock
Most people assume their health insurance pays 100% of the hospital bill. It doesn't. The IRDAI has standardised a list of items called "non-payables" that insurers are not required to cover. These appear on every hospital bill — and are rejected during claim settlement. The shock comes at discharge, when you realise a significant portion of the bill must be paid out-of-pocket.
ACL Surgery (₹2.4L bill)
₹45,000
consumables not covered without add-onconfirmed
COVID-19 Admission
₹15,000–₹25,000
PPE kit costs per admission· made consumables cover essential post-2020
Childbirth (₹2.4L bill)
₹35,000
diapers, cotton, tissue, gowns example
IRDAI Standardised List I· 68 Non-Payable Items· from IRDAI
The IRDAI has standardised List I across all indemnity health insurance policies. These are the items that standard policies don't cover — and that the the insurer Non-Medical Expenses Add-On is specifically designed to cover. Confirmed from the insurer's identical rider and the insurer's standard list.
IRDAI List I confirmed from the insurer Non-Medical Expenses Rider and the insurer standard non-payable list. the insurer's specific list may have minor variations — confirm with Probitas at 022 4302 0000.
Beyond List I, the IRDAI also specifies List II items that are considered subsumed into room charges — hand wash, shoe covers, caps, gown, slippers, tissue paper, toothpaste, toothbrush, bed pan, face mask, disinfectant lotions, luxury tax, HVAC charges, air conditioner charges, IV injection charges, clean sheets, blankets, admission kit, diabetic chart charges, and more. While these aren't separately claimable, the Non-Medical Expenses Add-On focuses on the major List I items that patients are billed separately for and that cause significant out-of-pocket costs.
IRDAI Classification· Four Non-Payable Expense Categories
IRDAI categorises non-medical expenses into four broad types during hospitalisation. Understanding each category helps you identify which costs on your hospital bill should be covered by the add-on — and which to question.
Real Claims Examples· Data
These examples are based on confirmed real-world claim data fromand. They illustrate exactly how non-payable items add significant out-of-pocket costs without the add-on — and how the add-on eliminates them.
₹26,000 paid out-of-pocket at discharge. Insurance pays ₹1,95,000 of ₹2,21,000 bill. — Confirmed data pattern fromACL example
NME Add-On covers List I items up to the add-on sum insured. Full ₹2,21,000 bill covered between base policy + add-on. Zero surprise at discharge.
Examples based on confirmed real-world data patterns. childbirth example confirmed (₹35,000 consumables on ₹2.4L bill).ACL example confirmed (₹45,000 consumables on ₹2.4L bill). Actual claim amounts subject to the insurer's add-on sum insured limit and List I items as specified in the insurer's policy wording.
Base Policy Requirement· Inpatient Hospitalisation· IRDAI Regulation
The Non-Medical Expenses Add-On requires an existing eligible the insurer base Mediclaim policy. It cannot be purchased as a standalone product. Key eligibility conditions based on IRDAI standards and the insurer's January 2025 product filing.
IRDAI Standard· Policy Terms· What the Add-On Does Not Cover
The add-on specifically covers IRDAI List I items during inpatient hospitalisation. Items outside List I, outpatient expenses, and all standard base policy exclusions apply.
The Non-Medical Expenses Add-On covers consumables during inpatient hospitalisation only. Non-payable items incurred during outpatient consultations, diagnostic centre visits, or non-hospitalisation medical encounters are not covered under this add-on.
Only items specifically listed on the IRDAI List I (as incorporated in the insurer's policy wording) are covered. Items not on List I — even if they appear on the hospital bill — remain outside this add-on's scope. Always check the exact List I in the insurer's January 2025 policy wording.
The add-on covers the cost of consumable use during hospitalisation. Purchasing durable medical equipment for home use (wheelchairs, hospital beds, oxygen concentrators, nebuliser machines as home devices) is typically excluded — consistent with the Home Care Treatment Add-On's same exclusion.
"All exclusions as mentioned in the Base Plan unless otherwise stated" — confirmed from the insurer's identical rider structure, consistent with IRDAI add-on guidelines. All base policy exclusions (pre-existing diseases waiting period, self-injury, war, etc.) apply equally to this add-on.
Day care procedures (typically <24 hours) that don't meet the inpatient threshold may not trigger the non-medical expenses add-on. Coverage is linked to inpatient hospitalisation claims under the base policy.
Non-medical expenses incurred during hospitalisation outside India are excluded. The add-on, like the base policy, applies to treatment in Indian hospitals only. International health insurance or travel insurance would apply for overseas treatment.
the insurer Claims Process· Reimbursement Based· Itemised Bill Essential
Non-medical expenses add-on claims are filed alongside your base policy hospitalisation claim. The key to a successful claim is an itemised hospital bill that separately identifies each non-payable item. the insurer Toll-Free: 022 4302 0000.
When admitted, immediately request that the hospital provide an itemised bill — each charge listed separately, not as a lump sum. The itemised bill is essential for identifying which charges fall under IRDAI List I (non-payable items covered by add-on) vs. treatment charges (covered by base policy). Ask the billing department to separate consumable charges from medical treatment charges.
Inform the insurer (022 4302 0000) or your TPA of the hospitalisation — as required under your base policy. Mention that you also hold the Non-Medical Expenses Add-On policy and intend to claim non-payable items. This ensures both claims are processed together.
Before signing off at discharge, obtain the complete itemised bill. Identify each item against IRDAI List I. Ask the hospital to segregate: (a) treatment charges → base policy claim, and (b) List I non-payable items → add-on claim. If the hospital provides a consolidated bill, request a detailed breakup. Retain all original bills, receipts, and the the insurer Non-Medical Expenses Add-On claim form.
Submit the claim form for both the base policy hospitalisation claim and the non-medical expenses add-on claim together. Key documents: the insurer Non-Medical Expenses Add-On policy schedule, Itemised hospital bill (original), Base policy hospitalisation claim form, Discharge summary, Doctor prescriptions where relevant for consumable use. Submit within the time limit specified in the policy.
the insurer / TPA reviews the itemised bill and identifies List I items. Non-payable items confirmed on List I are paid under the add-on (up to the add-on sum insured). Treatment costs are paid under the base policy. Combined settlement settles the entire bill. For cashless: inform the hospital's TPA desk at admission to coordinate cashless settlement for both claims simultaneously.
the insurer Non-Medical Expenses Add-On — FAQs
Add Non-Medical Expenses Cover to Your the insurer Mediclaim
Tell us about your existing the insurer Mediclaim policy. Our health insurance specialist will confirm your eligibility, explain the insurer's exact sum insured and premium from the January 2025 policy wording, and add this cover at your next renewal.
By submitting you agree to our Privacy Policy and Terms & Conditions. Non-Medical Expenses Add-On per the insurer policy wording filed IRDAI January 2025. Covers IRDAI List I non-payable items during inpatient hospitalisation in India. Requires eligible the insurer base Mediclaim policy. Add-on cannot be purchased standalone. Exact sum insured, premium, and eligible base policies per the insurer's Jan 2025 filing. Probitas Insurance Brokers Pvt. Ltd.· IRDAI Lic. No. 528.