Here’s the Best Way to Increase Your Health Insurance Cover
Published On Sep 26, 2019 5:30 AM By Yamini Sharma
Buying health insurance in India comprises multiple steps. At first, people analyse whether or not there is a need of investing in health insurance. Next, they weigh their health insurance options according to their medical requirements. Checking the plan premium amount is the next crucial step in the entire process that can also be considered as one of the various key deciding factors, which later follow. Once the plan meets every set standard, including the prime aspect of affordable premium, it is opted for. However, even after purchasing the selected plan, people wish they could have got more cover at the same premium price. While one may not get more cover at the same premium amount, they can secure more by paying a minimal amount that doesn’t burn a hole in their pocket.
Top Up Plan & Super Top Up Plan - The Concept
A top up plan is a regular health insurance plan that covers costs of a hospitalisation, but only when the threshold limit or deductible is crossed. Those new to the concept of deductible, it is a portion of the claim amount uncovered by the insurance company, only to be paid by the policyholder before the implementation of top up plan. Beneficial after the exhaustion of sum insured limit of the primary health insurance cover, top up plans work for a SINGLE HOSPITALISATION. Under top up plans, all claims are treated individually and multiple claims are not aggregated.
A super top up plan is similar to a top up plan, however, there’s a major difference. A super top up plan provides claim for the TOTAL OF ALL HOSPITALISATION BILLS within a policy year, once deductible and sum insured of the basic plan gets exceeded. It can be said that it covers you for expenses that are not payable by a top up plan or the basic health insurance plan.
Assume that you have a basic health insurance plan of Rs. 5 Lakh. The top up plan/super top up plan opted for is of Rs. 10 Lakh with a deductible or threshold limit of Rs. 5 Lakh.
When a single hospitalisation bill of Rs. 8 Lakh is generated -
- Basic health insurance plan - Covers Rs. 5 Lakh (For both, top up and super top up)
- Top up plan - Covers the remaining Rs. 3 Lakh
- Super top up - Covers the remaining balance of Rs. 3 Lakh
When 2 different bills with Rs. 4 Lakh amount for each are generated -
- Basic health insurance plan - Covers Rs. 4 Lakh (first claim) and Rs. 1 Lakh (second claim) (For both, top up and super top up)
- Top up plan - Doesn’t cover as the claim amount is not more than Rs. 5 Lakh (threshold limit/deductible)
- Super top up - Provides cover for remaining Rs. 3 Lakh (second claim) after considering the total of all bills
When 2 different bills with Rs. 7 Lakh and Rs. 2 Lakh amount are generated -
- Basic health insurance plan - Covers Rs. 5 Lakh (first claim), (For both, top up and super top up)
- Top up plan - Covers remaining Rs. 2 Lakh for first claim as the bill crosses the deductible or threshold limit of Rs. 5 Lakh. The bill of Rs. 2 Lakh (second claim) will not be covered as top up plans only cover single hospitalisation bill.
- Super top up - Provides cover for remaining Rs. 2 Lakh (first claim) and Rs. 2 Lakh (second claim) as the total claim in the year crosses Rs. 5 Lakh limit.
If, until now, higher coverage meant higher health insurance premium to you, it’s time to change your thought process. Top up plan and super top up plan definitely allow one to enhance their basic health insurance cover without having to burn a hole in their pocket. Nothing less than a stepney to the primary insurance, top up and super top up plans are a major hit in the insurance market. Owing to their beneficial features, both are highly sought after by policyholders looking forward to covering more, but without paying a significant health insurance premium amount.
Making ‘The Choice’
While choosing between top up and super top up plan may be difficult at first, but you can easily decide once you get clarity on their differences. In general, policyholders opt for super top up plans as they are great in the long run. What’s prime about super top up plans is that they are extremely pocket-friendly and provide coverage for a vast array of illnesses. So, those with a high risk of being hospitalised more than once a year, due to chronic illnesses find themselves satisfied with super top up plans. Nonetheless, it doesn’t mean that top up plans don’t hold value at all. Top up plans become preference of those who do not suffer from chronic diseases or don’t possess the risk of being hospitalised more than once a year.
Covering OPD Cover in Health Insurance
Health Insurance with OPD Cover or Health Card?
Enhancement of health insurance cover may be important to you, but an increase in health cover with ‘The Ideal Plan’ is what would matter the most to you at the time of need. Making the perfect decision would be only possible if you emphasise considering factors such as premium outgo, budget, and your medical history.
It is advisable to read the policy wordings of the health insurance plans as well as the top up & super top plans offered by the insurer extremely carefully. Make sure you are well aware of the coverage, inclusions, exclusions, and other key features before investing in your perfect basic health insurance and top up/super top up plan.