The need for health insurance is more relevant than ever before. There’s a huge increase in the prevalence of lifestyle diseases and not to underestimate the associated medical costs. Rising medical costs can burn a hole in anyone’s pocket if not for health insurance.
In spite of having a health insurance plan, there may arise situations where you may need more funds to cover a medical bill. That is when Top-up health insurance plans come in handy. Consider, top up plans as your health insurance back up. Top-up plans give you that breathing space in case of any additional and unexpected medical expenses, that go beyond what’s offered by your base health plan.
How do top-up health insurance plans work?
Top-up plans are additional plans you buy over and above your basic health insurance policy to cover any extra sum that you may incur on top of the basic sum assured. These are individual insurance policies that you buy separately. They are not linked to your basic plan.
A standard insurance shall pay hospital bills up to the limit covered, while a top-up package shall cover expenses over and above the basic sum insured or once a certain level has been met.
Let’s say, you have a health plan that offers a maximum sum assured of Rs. 5 lakhs. You then take a top-up plan for Rs. 3 lakhs. In case of hospitalisation, your base health plan will bear the costs of medical bills up to Rs. 5 lakhs. The top-up plan will kick in after the maximum sum assured by your base plan has been crossed.
Assume the hospital bill is Rs. 7.5 lakhs. In this case, Rs. 5 lakhs will be covered by your basic health plan and the remaining Rs. 2.5 lakhs will be paid by your top-up plan.
Types of Top-up Plans
Top-up plans can be classified into:
Regular Top-up Plan: A regular top-up policy is applicable on a per claim basis and is payable only if the cost of the claim exceeds the scope of your basic health insurance. For example, if you have a top-up package, then in the event of a hospitalisation, if the cost exceeds the benefits of the health care plan, you will claim the difference sum from the top-up plan for that particular payment.
In case your medical insurance claim crosses the threshold limit, the top-up plan will come to your rescue, also known as a deductible. It means that the top-up plan can only become available if the claim amount is greater than the top-up deductible.
In a top-up package, the premium is the cap at which the health care premiums are met by the patient or the policyholder, based on the type of insurance policy.
Super Top-Up Plan: A super top-up health care plan is like an expansion of the health insurance that you can use after you have either used the full amount of insurance in the span of the policy year of your basic insurance plan, or are usually okay to spend more money out of your pocket, so need a private insurer to protect you as things get easier.
What's nice with a super top-up package is that it pays payments for total medical costs during the insurance year until you have surpassed the deductible similar to a normal top-up that only covers claim when a single payment hits the deductible.
Super top-up covers the sum once you have exceeded the annual benefits offered by the standard health insurance due to multiple claims. It operates at the cumulative stage and kicks in as once you have exhausted your basic health insurance package.
You can choose a top-up plan that best suits your needs and requirements.
Understanding Top-up Health Insurance Plans Better
Here are some pros and cons of buying a Top-up Health Insurance Plan
- It’s a cost-effective plan to get higher sum insured: Top-up plans give you additional sum insured at low price. Top-up plans are based on your existing health insurance plans and hence come at a lower price.
- Increased Cover: Basic health insurance can have a cap on the maximum limit allowed based on your age and any pre-existing conditions. If you want more than what is covered in your basic health cover, a top-up plan is the best option.
- You might not need a separate health check-up: Most top-up plans don’t require you to get a separate health check-up done as it is based on your basic health insurance plan. However, there might be a cap on the amount till which no health check is needed.
- Stand-alone plans: Top-up plans cover all treatment costs arising due to an illness. Moreover, they can be taken separately irrespective of the nature of the basic health insurance plan you have. You can have the basic plan from one insurer and the top-up plan from another insurer. In fact, you can get top-up insurance without basic health insurance.
- Convertible: Top-up plans can be easily converted into basic health plans at a later date.
- Tax Benefits: Insurance Premium paid towards top-up insurance plans can be claimed for tax rebate under Section 80D.
- Can only be used as a top-up: As the name itself suggests, top-up plans can be used only after the basic plan has been exhausted. These plans are mostly handy only with single incidence hospitalizations where you have exhausted the basic plan after the applicable deductibles.
- No Claim Bonus is not applicable on Top-up Plans: Your health care provider credits you for a claim-free year by increasing your coverage number or lowering your overall premium amount. This gain is considered a no-claim bonus. But the top-up options don't come with the no-claim incentive benefit. If you want to raise the sum of your cover for top-up plans, you're going to have to buy more cover.
- Top-up plans have a waiting period: Since the top-up plans are paid as a separate package, they have a waiting period when no claims are allowed.
- Top-up plans are not riders: Riders in health insurance policies cover special risks like critical illnesses, accidental death or disability, room rent waiver, daily cash, etc. Riders give you additional benefits on risks that are not usually covered in the base policy. However, a top-up plan will cover only the basic conditions in the base plan. It does not work like a rider that covers special conditions.
Top-Up Health Plans Protect You from Skyrocketing Medical Costs
A Top-up Insurance Plan allows you to get the much needed medical attention without worrying about the surplus you may have to spend. This allows patients to get good quality healthcare or any expensive procedures that may help them lead a better life. With sky-rocketing medical costs, having a Top-up Health Insurance Plan is a far-sighted decision that could prove to be very beneficial in the near future.