Just as Amit was busy planning for his annual holiday, his father suffered a major cardiac arrest and had to undergo a major bypass surgery. Since, he was admitted at a leading private hospital in the town, the expenses incurred towards this exigency were huge.
A single critical medical condition is capable of upsetting your finances. Typically, the opted sum insured range for basic mediclaim policies is Rs 3-5 lakh. Bearing medical expenses beyond this sum can take a toll on an individual’s hard earned savings.
Super Top Up
Super Top Up health insurance plans are an added protection in such scenarios, when the maximum payout from a basic health policy gets exhausted. Under Super Top Up policies, a customer can choose a specific limit/deductible amount that a policyholder will have to bear, before the insurance policy starts paying out at the time of claim. This limit is termed aggregate deductible in insurance parlance and a customer can opt for the figure depending on the maximum coverage of his or her basic medical policy or the expense one may extract from one’s own income.
In a Super Top Up plan, your insurer considers the sum total of all the eligible medical expenses in a given policy period and if this amount crosses the chosen deductible in the policy, you become eligible for a claim payout. Thus, Super Top Up plans are a comprehensive and economical shield against the unforeseen medical costs that may be incurred beyond the cap of a basic health policy.
For example, in Amit’s case, if he had a floater health insurance policy covering his father, with a coverage of `3 lakh, he should have opted for a Super Top Up plan, preferably with a Rs 10 lakh coverage and a deductible of Rs 3 lakh. Hence, any expenses that were incurred over `3 lakh, during the policy term, which otherwise he would have to bear out of his pocket, would now be covered by the Super Top Up health insurance.
This would have been a huge relief for him as earlier during the year, he had suffered a dengue attack and Rs 50,000 of the Rs 3 lakh mediclaim policy had already been consumed. His father’s ailment cost him Rs 5 lakh, half of which he had to bear himself since the policy limits got exhausted. Had he taken a Super Top Up, this extra cost would have been easily tackled, in fact, at a much lesser premium amount!
In order to offer maximum coverage, Super Top Up policies can be availed either as an individual or as a floater policy. With this type of policy one can cover self, spouse, dependent children and dependent parents under the same policy and total number of family members covered in one policy can go up to six members. The entry age criteria for dependent children and dependent parents may vary from insurer to insurer. There are a number of benefits that a Super Top Up plan offers besides the regular inpatient, pre and post hospitalisation expense covers such as aggregate deductibles, road and optional air ambulance covers, cover for organ donor expenses and free medical check-ups.
There are plans available in the market with sum insured ranging from Rs 3 lakh to Rs 50 lakh with the aggregate deductibles options from Rs 2 lakh to Rs 10 lakh. Waiting period for pre- existing diseases remains in Super Top Up plans. However, a few insurers have now started introducing a much shorter waiting period such as 12 months for pre-existing diseases.
Opting for affordable Super Top Up plans can be a good way of keeping your finances in good health, as they come at a lower premium and shield you during the critical medical needs and emergencies.
The writer is chief technical officer, Bajaj Allianz GIC