Health insurance: Things to keep in mind before opting for super top-up plans
We are always worrying about the rising medical costs, irrespective of having a basic health insurance cover or being covered by the company’s group health insurance scheme.
We are always worrying about the rising medical costs, irrespective of having a basic health insurance cover or being covered by the company’s group health insurance scheme. Think about it! Haven’t you been disturbed by the thought of your medical cover being insufficient and you running from pillar to post for paying the bills? With diseases like dengue and swine flu adding up to the list and the looming fear of critical illnesses like cancer, it is quite natural to self-doubt your preparedness to meet such medical emergency situation.
With rising costs of hospitalisation, diagnostic check-ups and treatment, having a health insurance anywhere below R5 lakh is quite average and often meagre. On the other hand, purchasing a health insurance of R5 lakh to R15 lakh will have a high premium thus putting immense pressure on the family budget. Ideally, you need a higher coverage but practically you can’t afford the high premium. Tricky, isn’t it?
Well, it is here that a super-top plan comes to your rescue.
How super-top cover works?
Super top-up resolves this precarious situation and makes health insurance affordable. It comes into force as soon as you exhaust your base cover. It works over and above a deductible amount. Let’s assume that you have a group health insurance of R5 lakh. You are hospitalized and your medical bills costs R8 lakh then the first R5 lakh will be paid by the group insurance while the remaining R3 lakh will be borne by your super top-up plan (if you have it, otherwise you have to pay the amount from your pocket).
What sets super top-up plans apart from top-up plans is that while the latter takes overall bill amount into consideration, the former would pay only if your claim amount crosses the threshold limit.
Money saver
Super-top plans are money saver as the premium on these is quite low. Let me explain this to you with an example. Let’s assume you have a base health plan with Rs lakh sum insured and you intend to enhance it by R10 lakh. You have three viable options — take another health plan, increase current sum insured to R15 lakh or opt for a super top-up plan instead.
Base cover
If you enhance your base health plan with a second health insurance plan, you will have to pay an additional premium of R9,900 and should you choose to increase your current sum insured to R15 lakh, you will have to pay around R9,400 as premium. In comparison, premium for super top-up plan will be as low as R1,900. Stark difference! Needless to say, the latter is a much more cost-effective while keeping all the benefits intact.
Who are the beneficiaries?
People who want higher health insurance coverage without creating a big dent in their pockets should consider buying a top-up plan along with the basic indemnity plan. If you are covered by group health insurance which has limits on sum assured then you should consider buying a super top-up plan to secure yourself from health emergencies. If you think you can manage medical costs up to certain limit but will require help if the costs go beyond a threshold then just buy a super top-up plan.
Check the rules
With super top-up plans you can claim as many as times as you want till you exhaust the sum assured. However, it is imperative for you to check the disease and treatment coverage of these plans. You don’t want to end up buying a super top-up plan that won’t cover the treatment you might undergo in future (as in case of pre-existing diseases). Thus, it is important to carefully scrutinise what an individual plan offers and what are its exclusions. This will help you align the right plan to meet your needs.
Make the most of super top-up plans to secure your health at an affordable cost.
n The writer is CEO & co-founder, Policybazaar.com