The importance of health insurance cannot be stressed enough. Most of us who are employed in big firms are quite happy with the mediclaim insurance provided by the company. Sometimes, the coverage may be generous but it would be better to check exactly what you are covered for.
Generally the cover provided by an employer is to the tune of Rs.3-5 lakh. With the present inflation, this cover may not prove to be sufficient. For individual covers, the premiums are increasing by the year making it difficult to buy a 2nd health insurance policy.
This is where the Top Up/Super Top Up health insurance plans can be a real boon. Top Up health insurance plans are a unique type of cover that offer you an additional coverage on your existing plan. They give you an additional cover beyond your threshold limit — that of your existing plan. When you are covered for Rs. 3 lakh by the employer or individually, and you have a Rs. 5 lakh claim, your existing policy will pay Rs.3 lakh and the remaining amount will be paid by your Top up health cover. A Top up plan comes handy when the existing cover is used up — it pays the balance.
Top Up plans work only when you're hospitalized. These plans have Rs.10 lakh sum assured. Once a consumer uses Rs.3 lakh from his sum assured and tops up the difference of say Rs.2 lakh with his Top up plan, he cannot use it for a second hospitalization which may be for Rs.2 lakh, and even though the sum assured is Rs. 10 lakh. He can even top up with Rs.7 lakh on the existing policy but then it cannot be used solely for a second hospitalization.
The super Top Up plan will pay the total amount spent in a year. The existing policy has a Rs.3 lakh cover with an added Rs.10 lakh cover for super top up — the total amount covered will be Rs.13 lakh. If there are two claims in a year, one for Rs.5 lakh and another for Rs.6 lakh, a regular policy will pay up to Rs.3 lakh and super top up plan will pay the remaining Rs.2 lakh amount. The entire claim 2nd claim amount of Rs.6 lakh will be paid by Super top up plan, as the regular policy coverage is exhausted.
- You need not have a regular or group mediclaim policy to buy a Top up or Super Top up plan.
- The Top up plan which you buy need not be from the same company as your existing plan. You can have a regular policy from ICICI Lombard and the Top up can be taken from United India Insurance.
- Top up plans are cheaper than regular policy premiums.
- You can buy Top up policies for individual as well as Family Floater Plans.
- Usually Top up and Super Top up plans don't have a no-claim bonus.
- Top up and Super Top up plans will reimburse the amount after they get all the medical bills and having assessed that the policy holder has paid the deductible limit himself or through his existing policy.
- There are Top and Super Top up plans for senior citizens — for instance, United India Super Top up Plan.
- Premiums paid for Top up and Super top up plans are eligible for Income Tax deductions under 80-D.
As health expenses increase, you may find that your base health insurance is no longer sufficient for your needs. A serious illness or accident can require long term care and complicated treatment that can quickly become expensive and exhaust your health cover.
At times, you feel that the sum assured of your existing health insurance plan does not suffice for expenses due to illness or accidents, you may definitely consider buying a top up or super top up health insurance plan.
In case your basic policy and the top-up policy are from two different companies, informing two insurers and getting the claim settled may be troublesome. So, you may consider taking a top up or super top up plan from the same company.
Source: Sreekanth Reddy