Each health insurance policy has a set amount insured, and if it is used up during the middle of a hospitalisation, things can get demanding, at least financially. Top-up plans have been developed by insurance companies to deal with such circumstances. When the policyholder has used up all of the insurance coverage under the standard insurance plan, this plan becomes effective. Such plans are beneficial, particularly for expensive surgeries where the amount covered would not be sufficient to cover all costs. In India, various health insurance policies offer top-up and super top-up policy options for you to consider. But many of you may not be able to understand these options properly given the technicalities involved and could thus make a wrong decision only to regret later. Let’s not commit such mistakes by going through this simple guide on top-up and super top-up health insurance plans.
What is Top-up Health Insurance?
Health insurance that is added on top of your primary insurance is referred to as top-up insurance. If the claim amount exceeds the existing sum insured limit, these policies provide an additional cushion and safeguards you financially. Therefore, a top-up health plan can help you if you feel that your current sum insured or coverage quantity is insufficient.
What is a Super Top-up Health Plan?
Super top-up health insurance plans are those that apply the threshold limit to all costs incurred throughout the course of the policy period. For instance, if a policyholder is hospitalised twice throughout the course of the insurance (the term of the policy, e.g. 1 year or 2 years). Super top-up policies expire only after the total amount protected has been used, not after one claim. That is how it differs from a standard top-up plan.
Get Acquainted with the Terminology
Basic Coverage
Basic coverage refers to the insurance coverage offered by an individual health plan. The top-up and super top-up plan enters the picture once the basic coverage is gone.
Deductible Limit
The term "deductible" refers to the sum that the policyholder must pay when filing a health insurance claim. It is regarded to be the threshold beyond which top-up and super top-up health insurance plans become active.
How Does a Top-up Health Insurance Plan Function?
Let’s understand its function by considering an example below. So, the sum assured limit for your current policy is INR 7.5 lakh and you avail a top-up plan of INR 5 lakh. The top-up plan would help you if you get sick and your medical bills total more than INR 10 lakh. That's when you can use your top-up plan when your current sum insured has run out. Your top-up plan will cover the additional INR 2.5 lakh. If you believe your current medical insurance is insufficient, you can purchase a top-up plan. In the event of unanticipated emergencies, it will provide additional safety.
Principal Advantages of Health Insurance Top-up and Super Top-up Plans
Protection Against Rising Medical Costs
In India, the expense of healthcare is rising at twice the rate of inflation. Consequently, a super top-up plan is now required rather than just a luxury.
- Greater Insurance Coverage for a Lesser Premium - You can receive additional coverage over and above your employer-provided plan at a very modest additional fee with the aid of a health insurance top-up plan.
- Better Protection - Hospitalization costs, including rent, doctor fees, and other fees levied by the hospital, are typically not subject to restrictions or sub-limits. You receive the full advantages of a health insurance plan.
- Family Discount - In some situations, health insurance top-ups also include a family discount.
- Single Sum Insured- All family members are covered under the same sum insured under top-up health insurance plans with a single premium.
- Up to a two-year policy term.
- There won't be a need for a pre-medical exam if you enroll in the top-up plan while you're young.
- Using section 80/D of the Income Tax Act, you can receive tax benefits on the paid insurance premium (up to Rs 50,000).
What Do Top-up and Super Top-up Health Insurance Plans Cover?
The coverage of a top-up health insurance will fluctuate for various providers, just like with health insurance. But typically, additional health insurance will offer the following:
- Coverage for in-patient hospitalisation includes, among other things, room rental costs, nursing costs, doctor's costs, operating room costs, prosthetic devices or other equipment implanted during surgery, blood, and diagnostic procedures.
- Expenses for pre-hospitalization up to 60 days before admission
- Hospitalization-related costs will be paid for up to 90 days after discharge.
- Cost of an emergency ambulance (up to a limit).
- Additionally, some insurers offer a cumulative bonus when renewing a policy.
Things to Remember
The following are a few crucial guidelines for top-up and super top-up plans:
- The premium for your top-up/super top-up plan will be lower if the deductible limit is higher, and vice versa.
- But ensure the deductible limit is not that high. It will help avoid excessive payments from you.
- Tax advantages are available for top-up or super top-up plans.
- Top-up/super top-up plans are typically less expensive when compared to a comprehensive Individual Health Plan.
- A top-up/super top-up plan can be purchased separately from various health insurance companies.
Conclusion
If any big claims occur and the basic coverage is insufficient, the top-up and super top-up plans both serve as a financial safety net. Therefore, it's crucial to choose your plan prudently after carefully reading all of the terms and conditions. Prior to purchasing the top-up and super top-up plans, it is crucial to thoroughly study the policy document since different insurance providers may have different terms and conditions for top-up and super top-up plans.
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