Vishal Mehra, aged 32, has Rs 5 lakhs family floater health cover for himself, his wife and two kids. However, high medical costs have made him realize that a serious ailment may require costly medical treatment and that could also exhaust his coverage. While he was thinking to buy additional health insurance, his friend suggested him to go for a super top-up plan.
Let’s first understand what super top-ups are?
A super top-up offers additional coverage beyond the ‘aggregate threshold limit’. Thus, it acts as a cushion and helps when you have exhausted the coverage available under health insurance. Let’s say you have an individual health insurance policy of Rs 5 lakhs and a super top-up policy of Rs 10 lakhs with Rs 5 lakhs threshold limit. In case there is a claim for Rs 6 lakhs, your individual health policy will pay Rs 5 lakhs and the remaining claim amount of Rs 1 lakh will be paid by your super top-up policy. However, if there is another claim of Rs 5 lakhs in the same policy year, then the entire amount will be paid by your super top-up plans.
While buying super top-up plans, consider the following points:
- You don’t need to have a health insurance to buy this policy because it can be bought as a separate policy also
- The threshold limit is applicable for each policy tenure
- An aggregate threshold limit is the total of all hospitalization expenses incurred in a year
- As the threshold limit is mandatory, it needs to be taken care by the customer either through a corporate policy or an individual policy
If you have a car, you know the risk of driving it without a stepney. Super top-up plans act as the stepney to your health insurance policy after you cross the sum insured limit. Super top up plans offer a better and affordable solution for people who are already covered under the corporate health cover or hold an individual health insurance policy but want to enhance their coverage.
Reasons to opt for super top up plans:
- It covers medical expenses when the threshold limit of the existing health policy is over
- In the last few years, the cost of medical treatment has increased to a great extent. As a result, the current health cover may not be sufficient. With the help of super top-up plans, you can deal with the rising medical costs
- It is available with both individual and family floater health insurance options
- You can buy the policy from any company as there is no compulsion to get it from the same insurer from whom you bought your health policy. In fact, you don’t need to have a health insurance policy to buy the super top up plan because you can buy it as a separate policy also
- Super top-up health policies get tax benefits under Section 80D
How super top-up enjoys an edge over top-up plans? A top-up cover helps only when your claim amount is above the threshold. For instance, you have a regular health insurance cover of Rs 5 lakhs and a top-up health cover of Rs 10 lakhs with Rs 5 lakhs threshold. Your top-up will help you only if your bill is above Rs 5 lakhs. If your medical bill is Rs 6 lakhs, then Rs 5 lakhs will be paid by your regular health insurance and the remaining Rs 1 lakh will be paid by top-up. However, if you have two separate medical bills of Rs 3 lakhs each, top-up will not help you because no bill has crossed the threshold limit. Here super top-ups will help you. Super top-up plans consider the total of the bills in a year and not just the single case. If you have a super top-up plan of Rs 10 lakhs with a threshold limit of Rs 5 lakhs, your two medical bills of Rs 3 lakhs each will be covered. As the total bill exceeds the threshold limit of Rs 5 lakhs, it will be covered by super top-up plans.
Who are the beneficiaries?
People who want higher coverage without creating a hole in the pocket should go for a super top-up along with their basic health insurance policy. If you are covered under your group health insurance which has limits on the sum insured, then you can consider buying a super top-up plan to protect yourself from medical emergencies. However, if you think you can take care of health care costs up to a certain limit, but will need help if the costs go beyond a threshold limit then you should go for a super top-up plan.
Carefully check rules
Super top-up plans allow you to claim as many times as you want till the exhaustion of sum insured. However, it is important to check the coverage offered by these plans. You don’t want to end up buying a super top-up plan that won’t cover the treatment of ailments which might arise in the future.
The Bottom line Though relatively a new concept, super top-up plans are already in the demand. They prove to be a good option for those who wish to go for a comprehensive cover at affordable rates. However, do keep in mind the threshold limit as super top-up policies do not yield fruits until this level is crossed.