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Top-Up Health Insurance: Here’s Why Having a Back-up Plan is Essential

Top-up health insurance plans play the role of Stepney (in a car). It supports the indemnity cover in case you exhaust the basic sum insured. When a regular health insurance policy indemnifies up to the chose sum insured, a top-up policy comes in handy when a certain threshold is reached.

Often, the cost of health insurance goes up over time but the policy cover remains the same. In such a case, instead of going for higher coverage, you can opt for any of the types of top-up policy.

Top-up policies offer the benefit of higher insurance coverage at a lesser premium, as compared to a new sum insured. Let’s know more about this.

Why Do You Need a Top-up Plan?

 You may be a part of an organised business sector where all your medical needs are taken care of through an employer’s own health insurance. This policy may extend the coverage to your family as well. But have you ever wondered what if after you resign the organisation or once you retire from the job? For your knowledge, employers health insurance offers coverage until you’re associated with the organisation. The day you resign, the coverage also ceases to exist. In such a case, if you’re not sufficiently insured, a hefty medical bill will be on you. Moreover, even if you are covered, is there any guarantee that the sum insured wouldn’t fall sort in case of a serious medical condition. So, top-up plan is the perfect way to prepare for your retirement days.

What’re the Types of Top-up Plans?

Top-up plans can be categorised into two covers:

  • Regular top-up Policy
  • Super Top-up Policy

Regular Top-up Policy

In case of regular top-up policy, the deductible limit is calculated on each hospitalisation. Let’s say, you own Apollo Munich health insurance of Rs. 3 lakhs with a top-up cover of Rs. 5lakhs. You can set a deductible up to Rs. 3 lakh, as the basic policy will pay up to this limit. In case of hospitalisation, if medical expenses come around Rs. 7 lakhs, the expenses up to Rs. 3 lakhs will be paid by the basic health insurance and above that, the remaining amount will be covered by your top-up policy. Moreover, in case you don’t have basic health insurance, the initial amount will be borne by you, up to the deductible of the top-up plan.

Super Top-up Policy

The second type of top-up policy is Super Top-up policy, where the threshold limit is applied to the total expenses spent during the policy tenure. Taking the above example with the same sum insured of Rs, 3 lakh for regular policy and Rs. 5 lakhs as top-up cover. Here, if you hospitalised twice with hospitalisation costs amounting to Rs. 2.5 lakhs for the first time and Rs. 2 lakhs for the second time, the super-top-up plan can be used for the second time. Because the total expenses (Rs. 4.5 lakhs) cross the threshold amount which is Rs. 2 lakhs. With this policy, you are indemnified for Rs. 1.5 lakhs which is the amount exceeding the deductible. Adding a super-top-up policy with your regular health insurance can be a wise decision. Just in case you own health insurance from Apollo Munich, you can add a super-top plan at the time of Apollo Munich health insurance renewal as well.

Top-up Policy- Some Facts to Know

Let’s know certain facts related to top-up plans:

  • Buying Top-up Policy: You can avail a top-up plan from your current insurer or if you want from a different one. Top-up plans are to be availed as an add-on with the basic health insurance policy. You can buy it online after entering the basic insurance details.
  • Eligibility Criteria: The minimum age to avail a top-up policy is 18 years. However, a dependent child can be insured for three months. The maximum age is usually 80 years. And for dependent children, it is 25 years. The age limit may vary from one insurance provider to another.
  • Deductible of Top-up Policy: You will have to select a deductible while buying the policy. in case of a claim, a certain amount will have to be borne by you as deductible and the rest of the amount is paid by the insurer as per the policy terms and conditions. As per the policy rule, the amount over and above the chosen deductible will be paid using the top-up policy. if the policy is availed as floater sum insured basis then the deductible may be applied in individual claims.
  • Premium and Sum Insured: The premium of a top-up plan depends on the sum insured, deductible and age of the insured. Higher the deductible, lower the premium or vice versa.
  • Pre-policy Medical Test: There is no medical test up to the age of 45 years. However, this may vary from insurers to insurers. Those who are above 45 years, will require a medical test to avail the plan.

Top-up Plan-Some Tips to Ensure the Right Policy

  • As you’re told higher the deductible, lower will be the premium to be paid towards the top-up plan. Nevertheless, you can’t just stick to a random figure as deductible. Your deductible amount should be the amount that you can pay effortlessly if an emergency arises.
  • Regular top-up has its drawbacks as well. In case of multiple hospitalisations, it will only pay up the amount over and above the deductible. So, in case of multiple hospitalisations and if you exhaust the threshold limit of the top-up plan, you may be left with no cover.
  • Super top-up plans are more useful. Possibilities are there that a single hospitalisation may not inflate the bills. But expenses could rise due to inflation in the healthcare sector. Here come super top-up plans to your rescue.
  • Though super top-up plan comes with an excessive premium, the added benefits always outweigh the premium cost.
  • Select a policy only after analysing if it covers day-care procedures, pre-existing illness, pre or post hospitalisation expenses as well.
  • You can avail tax benefit out of the premium paid towards the top-up policy as per the Section 80D of Income Tax Act.
  • Finally, consider the deductible amount and choose the one which is affordable.

To Conclude!

Top-up plans are considered as the most suitable supplementary option that comes with dual benefit of low premium and higher sum insured. It is a boon for those who fall under the category of senior citizens, the age when the chances of getting sick are quite higher or the medical expense are bound to rise. Even if you are covered by an employer’s health insurance, you can consider a separate top-up plan to support the basic cover. Hence, a top-up plan is a perfect match for anyone who is looking for a higher sum insured at an affordable rate.

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