Overview
Your health insurance is designed to pay hospital bills, but what happens once you're discharged and the doctor says you still need a wheelchair or an oxygen concentrator at home? Most base policies do not cover these, and the rental or purchase cost falls on you.
This is exactly the gap durable equipment cover add-ons try to fill. But here's the catch: not every plan defines this coverage the same way. Limits range from ₹1 lakh a year to a one-time ₹5 lakh cover, and the fine print differs by insurer.
This guide breaks down what these add-ons cover, compares the major plans, and helps you decide whether you need one.
What Are Durable Equipment Cover Add-Ons in Health Insurance?
Durable equipment cover add-ons cover the cost of expensive, reusable medical devices prescribed for home use or long-term recovery after hospitalization. Standard base policies typically exclude these devices, which makes this rider worth a look if you're managing a chronic illness or recovering from surgery.
Common Covered Equipment
These add-ons generally cover items built for repeated use to manage a condition or support daily living:
- Oxygen concentrators and ventilators
- CPAP (Continuous Positive Airway Pressure) machines
- Wheelchairs and walkers
- Infusion pumps and suction machines
- Medical beds, including airbeds or waterbeds used to prevent bedsores
How Does the Coverage Work?
- Capping and Sub-Limits: Insurers usually cap the payout as a percentage of your base sum insured.
- Medical Necessity: The device must be medically necessary and prescribed by a licensed physician.
- Exclusions: Comfort items, such as air conditioners, and disposables, like syringes or gloves, are typically excluded.
This is a fairly new feature, mostly available with recently launched plans. You can select it and pay an extra premium at purchase or renewal.
ManipalCigna Sarvah: Durable Medical Equipment Add-On
All three ManipalCigna Sarvah variants, Pratham, Uttam, and Param, offer this as an optional cover. It pays up to ₹1 lakh in a policy year for buying or renting ten listed items: CPAP, Bilevel Positive Airway Pressure (BPAP), ventilator, wheelchair, prosthetic device, suction machine, commode chair, infusion pump, continuous passive motion device after knee replacement, and oxygen concentrator.
The hospitalization claim must be admissible, and the device must be prescribed during hospitalization or within 30 days of discharge, and purchased or rented within 30 days of that.
Ditto's Take: The annual reset is helpful, but remember this ₹1 lakh comes out of your base sum insured, not on top of it.
Star Health Super Star: Durable Medical Equipment Cover
Super Star offers up to ₹5 lakh, payable once in the policy's lifetime, for nine listed devices: CPAP, ventilator, wheelchair, prosthetic device, suction machine, commode chair, infusion pump, Continuous Passive Motion (CPM) device, and oxygen concentrator. This is applicable for renting or purchase of the equipment.
The device must be prescribed after an admissible hospitalization for the same condition. The cover remains available until the ₹5 lakh lifetime limit is exhausted. Once the limit is fully exhausted, the cover cannot be selected again at renewal.
Ditto's Take: ₹5 lakh sounds generous, but it's a one-time benefit, not an annual reset. Use it wisely.
Here’s an illustrative premium including the add-on cost for some common profiles.
Note: A stands for adult and C stands for child. The premiums are calculated for a ₹15 lakh Sum Insured (SI) for healthy individuals residing in Delhi (110010). These are indicative values and may vary by age, location, underwriting, and medical conditions.
Premium Analysis: The DME rider is priced flat at ₹118 per adult, regardless of age. It doubles to ₹236 for two adults but doesn't change with a child added or with age. For senior citizens, this makes it a very cost-effective add-on, since it's just 0.38% of their much higher total premium, versus 1.2 to 1.5% for younger buyers.
ICICI Lombard Elevate: Medical Equipment Add-On
Elevate covers the purchase or rental of up to 9 listed devices, including CPAP, ventilator, wheelchair, prosthetic device, and oxygen concentrator, for up to ₹5 lakh or your available annual sum insured, whichever is lower.
Your hospitalization claim must be accepted first, and the purchase must occur within 30 days of the prescription.
Ditto's Take: This isn't an extra ₹5 lakh. The payout comes out of your base coverage.
Note: In this table, A denotes adult and C stands for child. These premiums are illustrative, based on a ₹15 lakh cover for healthy individuals residing in Delhi (110010). Your final premium may vary based on your age, city, and medical history.
Premium Analysis: Elevate’s DME cover is priced at a straight 9.3% of the base premium across all profiles. So the premium increases with age and family size, rather than staying fixed.
Aditya Birla Activ One MAX: Durable Equipment Cover
Activ One MAX covers eight items: ventilator, wheelchair, prosthetic device, suction machine, commode chairs, infusion pump, CPM devices, and oxygen concentrator, up to ₹5 lakh or your SI, whichever is lower.
It should follow an admissible hospitalization, domiciliary hospitalization, or home healthcare claim, with the same 30-day rules, and the payout reduces your sum insured.
Ditto's Take: Extending this to home healthcare claims is useful, but it's still reimbursement-based, so you pay first and claim later.
Note: A stands for adult and C stands for child. The premiums are calculated for a ₹15 lakh Sum Insured (SI) for healthy individuals residing in Delhi (110010). These are indicative values and may vary by age, location, underwriting, and medical conditions.
Premium Analysis: Activ One MAX prices its DME cover at a flat 7.5% of the base premium for the individual, young family floater, and family-with-child profiles. But for senior citizens, it jumps to about 11% of the base premium, so this rider becomes significantly more expensive as the insured ages.
New India Assurance: Durable Medical Devices Rider
New India Assurance offers this rider only with select base policies, such as New India Mediclaim, Floater Mediclaim, Yuva Bharat, and Arogya Sanjeevani, and only if your base sum insured is at least ₹5 lakh.
It covers a different device list than the private insurers above: stockings or leggings for varicose veins or Coronary Artery Bypass Grafting (CABG), oxygen concentrator, suction machine, ventilator, CPAP, infusion pump, airbed or waterbed, spirometer, and pneumatic compression device. Notably, it excludes wheelchairs and prosthetic devices.
The benefit is capped at 10% of your sum insured, subject to a maximum of ₹1 lakh per policy year. The device must be prescribed during hospitalization or within 30 days of discharge and purchased within 30 days of that.
One Key Restriction: Applicants already diagnosed with a critical, chronic, or recurring illness cannot opt for this rider, except those with hypertension or diabetes.
Should You Add a Durable Equipment Cover Add-On?
In Ditto's opinion, a durable equipment cover add-on is not a must-have, unlike a consumables or non-medical expense add-on. Coverage and cost vary a lot between insurers, it's a fairly new type of rider, underwriting tends to be stricter, and the payout structure (reimbursement, tied tightly to an admissible hospitalization) makes it less straightforward than other essentials.
That said, it's worth considering in a few specific cases:
- An older family member is likely to need mobility or breathing support equipment after a hospital stay.
- Someone is undergoing major orthopedic surgery, where a wheelchair or CPM device could be prescribed.
- You'd genuinely struggle to pay out of pocket for a listed device after hospitalization.
Even in these cases, an add-on should never be your only priority. Look at these features first for a well-rounded plan:
- No room rent capping
- No copayment clause
- No disease-wise sub-limits
- Unlimited or high restoration of the sum insured
- Higher cumulative bonus, building coverage over the years
- Adequate consumables or non-medical expense cover
If your shortlisted plan already offers this add-on, then it can be considered since the rider does not cost much. If you don't fall into one of the cases above, we'd lean toward skipping it and prioritizing the fundamentals instead.
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Conclusion
A durable equipment cover add-on may look small on your premium, but it can spare you a genuinely painful expense the day you're wheeled out of the hospital. The real question is whether the rest of your plan is strong enough to back you up when that day comes.
Before you add this rider and move on, check the insurer's claim settlement record, room rent limits, co-payment clauses, and restoration benefits. A plan with generous DME cover but a shaky claims process, or a thin base sum insured, won't hold up when a real emergency hits.
Bottom Line: If you already have a policy, take five minutes to check whether it lists this cover, and if the device you might need is actually on that list. If you're still comparing options, check out our guide to the best health insurance plans in India to compare insurers on all fronts, not just this one add-on.
Frequently Asked Questions
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