By Anuradha Sriram
The pandemic has severely impacted many people’s wellbeing and drained their finances. The life savings of many people have diminished due to job loss and pay cuts, as medical costs keep rising steadily higher. This has generated a need, as well as awareness for health insurance. Before the onset of the pandemic, a regular health insurance plan would have sufficed. But taking into account the costs incurred during hospitalisation, especially COVID therapy, this amount starts to seem insufficient. The insurance coverage you currently have may be unable to cover all the incurred costs of hospitalization. Opting for a higher level of health insurance coverage is easy but expensive.
A super top-up health insurance policy is a solution to safeguard against future healthcare needs. This plan covers healthcare expenses over an annual aggregate deductible amount that is a-pre-defined amount which the policyholder has to pay, as stated in your super top-up plan. After meeting your deductible, the super top-up policy is activated for future claims. As opposed to a regular top-up plan, it covers cumulative expenditures during the coverage period.
An aggregate deductible is a fixed amount paid toward medical expenses before your health insurance comes in. Once the insured has paid losses up to that amount (Added cumulatively), the insurer pays the remainder of losses for the annual period without seeking reimbursement from the insured.
Features and advantages of super top-up medical policy
Extended Coverage: Super top up policy helps you to extend your basic Sum Insured/coverage (personal or Group) with affordable premium
Pay Deductibles only once: Super top-up insurance requires the policyholder to pay the deductible once but make several claims each year. This is possible until the total sum guaranteed by the super top-up plan is exhausted. It is important to note that your base plan coverage should be equal to the deductible set in your super top-up plan.
Super top-up is customisable: In this policy, the policyholder chooses any deductible limit corresponding to their current policy and insured sum. Higher the deductible, Lower the Premium for the same Sum Insured.
Higher Sum Insured: The policy holders’ coverage limit can be increased above and beyond their business plan at a lesser premium. This ensures they never fall short of the total sum covered.
Coverage for senior citizens: The premium for health insurance plans for senior citizens can be very high. With a super top-up plan, you can enhance the coverage at a relatively lower premium.
Treatment at network hospitals: You can receive cashless treatment at any hospital in the network of your insurance. You could also be eligible for cost reimbursement.
Tax benefits: Under Section 80D of the Income Tax Act on the premium paid for the super top-up health insurance policy.
Other benefits: Most corporate policies do not provide broad coverage advantages and critical illness cover. But with a super top-up policy, you receive coverage that you might not be able to get via your employer’s health coverage policy. Besides other ailments, super top-up medical policies also cover the expense of COVID-19 treatment.
Important considerations while purchasing
When you buy super top-up coverage, make sure to select the appropriate deductible limit. This is the extent of your normal health insurance coverage. You should also verify the list of hospitals accessible in the super top-up insurance. These might differ from the list of hospitals available in your regular coverage. No matter how healthy you live, you or your family will experience a health emergency at some point. The first step to prepare for such crises is to have adequate health insurance coverage. Super top-ups are a cost-effective means of extending coverage provided by medical insurance. They are quite beneficial, particularly in situations of lengthy and/or expensive hospitalisation.
(The author is Chief Actuarial Officer, Aditya Birla Health Insurance)