Medical costs are reaching alarming levels in India, and often one hears of high costs even for the treatment of minor infections. The costs incurred for major treatments can thus run into huge amounts.
There are many people who do have group medical insurance cover from their employers. Some who may or may not be covered under the employer’s scheme have probably researched for the best health insurance policy in India in order to purchase an adequate insurance policy for themselves and their families.
If you fall into any of the above two categories, have you estimated if your health cover is enough in case you do incur medical costs? The chances are that you may find it inadequate. What can you do in such circumstances?
You can obviously increase the medical cover of your existing family health plan policy, but you would end up paying heavy premiums. Is there a middle and smarter way that could increase your health cover, yet keep you free from the burden of heavy premiums? The solution lies in the super top-up health insurance.
What is super top-up?
Most of the health insurance companies offer a super top-up plan. This is a plan that provides coverage against additional medical liability in case the regular medical insurance falls short. The best part is that the premiumsof super top-up plans are much lesser as compared to regular health insurance plans. In this way, the super top-up becomes another layer of medical cover to be paid by the insurer, in case your expenses exceed the amount covered by the medical insurance.
There is a threshold limit called the deductible that is linked to the super top-up plan. When the expenses exceed the deductible amount, the plan covers those expenses. This is the prime reason why these plans are cheaper. The higher the threshold, lower the premium.
Let’s understand how super top-up policies work
Rajiv has a family floater health insurance plan covering him and his wife Anjali, for an amount of Rs5 lakhs. Considering the rising medical cost, he buys a super top-up policy for an amount of Rs 10 lakhs with the deductible of Rs 5 lakhs. Now he has a total health insurance cover of Rs15 lakhs.
- Scenario 1: Anjali is hospitalised and the total medical expenses are Rs 4 lakhs. Rajiv can get the full claim amount from his main family floater health cover. There will be no claim payable from the super top-up policy as the medical expenses have not crossed the deductible limit.
- Scenario 2: Rajiv is hospitalised and the total medical expenses are Rs 4 lakhs. In the same year, Anjali also hospitalised and the bill amount is Rs 4 lakhs. In the case of Rajiv, the entire medical expenses will be covered under the family floater. Now, Anjali will be left with only Rs 1 lakh from the main health insurance. But Rajiv had also purchased a super top cover which pays when the total amount crosses the threshold. In this case, the deductible limit has crossed the threshold limit, i.e.; Rs 5 lakhs (4+4); the remaining Rs 3 lakhs will be paid by the super top-up policy.
- Valid over multiple claims: Super top-up plan is very helpful as it covers medical expenses as a sum, irrespective of each expense incurred in a year. Thus, it is practical to reach the minimum threshold expense limit. The super top-up does not limit the expenses to a single hospitalisation for instance. If multiple expenditures as a total cross the threshold, the insured settles the claim under the super top-up plan.
- Reimbursement only: Super top-up is a reimbursement policy like the normal health insurance plan. This is because the insurer would like to ensure that the insured has spent the money in the medical bills, and that too above the threshold.
- Tax Benefits: The premium of super top-up gets tax benefits under Section 80D of the Income Tax Act.
- Options of policies: Super top-up plans can be bought both with individual and family health plans. You can buy this policy, even if you don’t have any health insurance policy.
- Different insurers: It is not necessary to buy the super top-up and a regular plan from the same insurance company.
Who should buy it?
If you do not have adequate medical coverage via your regular health insurance plan, you can opt for a super top-up plan to boost your medical cover. If you have been contemplating increasing your cover without having to dole out bigger premium amounts, super top-up is the perfect family health plan for you. In addition, it can be bought by those who are covered under a corporate health policy.
Things to remember
It is advisable to go over the wordings of the policy document very carefully. Also, you should compare the plans from various insurance companies, study their inclusions, exclusions, waiting periods, pre-existing disease conditions and other details and then choose the one that best meets your requirements.