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Health Insurance Comes with Dual Benefit! Let’s Know about It

Having covered by an employer’s health insurance is a good thing, especially when you don’t own a separate health insurance plan. Nevertheless, considering the soaring healthcare expenses, the existing policy coverage being offered by your employer may not be fair enough for you. What if you get a better option at a much affordable rate? What if you come across a plan that comes with dual benefit of medical expense cover and tax saving?

Yes, it is possible.

Here Comes Top-up Plan into the Picture!

Here we’re going to talk about one of the types of health insurance cover-Top-up Plan.

Imagine... you are covered by ManipalCigna Health Insurance for sum insured Rs. 3 lakhs offered by your current employer. But in the age of medical inflation, you may end up paying more than Rs. 3 lakhs, if an emergency strikes.

Now let’s assume when an eventuality strikes you file a cashless claim against the expenditure incurred due to hospitalisation for a surgery that is covered by the employer’s policy. But you come to know that the expenses for hospitalisation, surgery, medical bills, pre and post hospitalisation expenses etc. incurred are estimated to be higher than the sum insured you are offered with.

In such a situation when medical expense exhaust the pre-decided sum insured, what would you do to meet the expenses? You may break your personal savings or borrow some money from family or friends. Even taking a loa would be hectic in such situation.

Wouldn’t a top-up plan comes to your rescue to supplement the additional expenses and to keep your savings protected? Certainly, it would!

Are you Aware of a Top-up plan?

Top-up policies are also considered as a back-up plan to support your finances in case of medical adversity. These plans keep the insured covered even if the basic policy sum insured is exhausted during a medical emergency. Had you opted for the top-up plan, you would have been able to cover the additional medical expenses, for which your basic corporate health insurance is not eligible. What’s more? You would also be covered for a higher sum insured, in case of need in the future.

And here comes cherry on the cake! The premiums paid toward to-up plans are eligible for tax exemption under Section 80D of Income Tax Act, 1961. Let’s take a detailed look

Alluring Features of Top-up Plans

Do these plans come with a higher premium? Do I need to pay more an for availing a higher premium? Not exactly!

  • Even top-up plans are come with a lesser premium but less risky. Because these plans are accompanied by a deductible clause, over and above which the policy can be triggered in case of an emergency.
  • These plans can be bought separately, along with your regular health insurance
  • The policy sum insured can be availed both as individual and floater basis
  • They can be bought from any insurance provider and not mandatorily from the one that the basic health insurance belongs to.

Let’s Consider the Concept in Detail-

There are  Super Top-up plan as well which proves to be a wise option when a single claim doesn’t exceed the agreed threshold limit applicable in your Top-up plan. But in case of multiple claims, the limit can be crossed. Let’s say, Mr Sharma owns Cigna Health Insurance along with top-up plan with a threshold limit of Rs. 3 lakhs. In case of a claim of Rs. 2 lakhs and 2.5 lakhs, he wouldn’t be able to use his Top-up plan either of these claims, as the deductible limit is not exceeded.

Considering the same example, if Mr Sharma had a Super Top-up plan with the same deductible of Rs. 3 lakhs. In case of his first claim of Rs. 2 lakhs, he can claim his corporate plan. Now in case of the second claim, the corporate policy will pay Rs. 1lakh and remain Rs. 1.5 lakhs will be claimed by using Super top-up plan.

Super-top-up plans are handy for one with a critical illness that requires regular medical visits or more than once hospitalisation is a year.

Top-up Plans and Tax Savings

Tax savings is one of the outstanding benefits of every health insurance plan, including top-up or super top-up plans. Premiums paid towards Top Up and Super top-up are eligible for tax exemption under Section 80D of Income Tax Act, 1961. The insured can claim a maximum of Rs. 25,000 as tax deduction annually.

An additional Rs. 25,000 can be claimed if the employee pays an additional premium to its employer for availing health insurance and top-up plan for covering its parents.

Rs. 50,000 can be claimed for paying the premiums of senior citizen health insurance and top-up plan. If all the premiums are considered, the combined benefit comes around Rs. 75,000/-.

The below table shows the amount of deductible to be claimed by an individual taxpayer under each category

Category

Premium Paid

Total Claimable Deduction

Individual and parents below age 60 years

Self/family/dependent children

Parents

50,000

25,000

25,000

Individual & family below 60 years but parents above 60 years

25,000

50,000

75,000

Individual, family and parents above 60 years

50,000

50,000

1,00,000

The Final Word!

Thus, health insurance serves you with the dual benefit of medical cover and tax saving. If you club your policy with a top-up policy, the benefit even doubles. It offers the much –needed boost to your regular policy by enhancing the coverage and further aids to tax deductions. Many tend to confuse them with riders such as hospital cash or critical illness. But they are not, they are just like an indemnity plan which provide the same benefit as a regular health insurance plan offers. However, the only difference is the higher deductible limit that makes the plan even cheaper. One of the most alluring features is insurers don’t ask for medical check-up up to the age 55, while in case of health insurance it is 45 years. So, next time when you’re up to buy health insurance don’t forget to consider Top-up Plan or Super Top-up plan to remain extensively covered.