Mumbai: Life is a long and an unpredicted journey! Apart from everything good it has in store, it can anytime even take sharp and fatal turns which may leave you physically and financially bruised.
Moreover, the challenging lifestyle attributed by extremes such as junk food, stress, lack of physical activity and sleep, has made healthcare one of the major concerns. And if you are not well prepared for any medical emergency, the cost of treatment and skyrocketing medicine prices can wreak havoc with the budget of your family.
Considering the rising cost of medical treatment in India, health insurance has become a basic need. Health insurance is your most secured safety net that protects you against financial crises in case you or your family members get hospitalised.
Following the great awareness being spread around health insurance, though the health insurance market in India is growing at a significant fast pace, there is still a lot of confusion amongst the buyers.
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While many buy health insurance without adequate sum insured, many even think that the employer provided health insurance is sufficient enough to cover unforeseen medical expenses. As per a recent report, most of the Indians are least prepared for any medical emergency.
While many have medical cover, the amounts are significantly insufficient. The report states that over 95% of the middle-class Indians do not have adequate health insurance to cover even the most common procedures and ailments.
While the extent of under-insurance is around 60 to 62% in the middle-aged individuals, the number is relatively higher i.e. around 69% in the 45-plus age group. On an average, the Indian policyholders cover themselves for a maximum of Rs 5 - 6 lakh and considering the current medical inflation, a sudden hospitalisation can easily spell trouble for anyone.
In order to help consumers, there are multiple options available in the market for increasing the cover without paying a lot of money - Super Top-up Plan being one of them.
What is Super Top-up Plan?
Super Top-up health insurance plan is an added protection in your regular health insurance policy that offers you coverage of Mediclaim above your chosen deductible limit. Under the plan, you can avail financial relaxation in the event when your hospitalisation claim bill crosses your total sum insured.
The plan acts as a cushion and comes in to play when you have exhausted the chosen limit. As a policyholder, you even have the option of choosing a specific limit/deductible amount that you will have to bear, before the insurance policy starts paying out at the time of claim.
The biggest feature of Super Top-up plans is that it covers the total of all the bills in a given year as it covers multiple hospitalizations.
Scenarios covered
Assuming, you have a health insurance policy of Rs 5 Lakh sum insured and a Super Top-up health cover of Rs 10 Lakh sum insured (Total Cover 15 Lakh), with the threshold limit of Rs 3 Lakh. Now, your insurer will cover you under the following scenarios.
- If there is a single claim of Rs 4 Lakh in a year, your regular health insurance policy will pay Rs 4 Lakh
- If there is a single claim of Rs 13 Lakh in a year, your regular policy will pay Rs 5 Lakh and the remaining claim amount of Rs 8 lakh will be paid by the Super Top-up plan
- If there are two claims in a year, one for Rs 5 Lakh (Claim 1) and another for Rs 7 Lakhs (claim 2), your regular policy will pay the claim 1 amount (Rs 5 Lakh) and the total coverage is exhausted, the 2 nd claim amount (Rs 7 Lakh) will be paid by the super top-up plan
Always buy a Bundled Policy
It is equally important to know that it is best to buy Super Top-up plan from the same insurer from whom you buy the base health insurance plan as buying Super Top-up plan from a different insurer will lead to a non-cashless claim.
Subsequently, at the time of an emergency, arranging for Rs 5-10 Lakh or more instantly can prove to be distressful. In order to avoid such a scenario, it is best to either take a higher sum insured health insurance, or take a bundle of base plan and Super Top-up plan.
Most importantly, buying a bundled plan can give significant monetary benefit to the customers. For instance, if you take Rs 10 Lakh of base health plan, it will be 20 -30% more expensive than taking a Rs 3 Lakh base plan and Rs 7 Lakh Super Top-up plan.
(Written by Amit Chhabra, Head- Health Insurance, Policybazaar.com)
