Hospitalization is the most unavoidable expense in your life. If it happens, you do not have option to defer it anymore. With rising cost of treatment, immediate requirement of medical expenses can drag you few years behind if not planned well.
However, for most people the biggest question is how much insurance is enough? Is it under my budget? If not will I remain underinsured? All these questions are difficult to answer as which ailment you might be treated in future is no one guess. But a basic awareness on the cost of treatment in various hospitals across the city you live in will tell you how much insurance will be able to wither the expenses, if it arises. Your age too is a big factor for deciding on the probability of any sickness arising very soon.
To buy a normal mediclaim with a very high cover is not possible for every individual. The premium outgo exceeds the budget one can allocate for mediclaim. Hence, there is always a need of schemes which can give you high coverage on minimum cost. Some insurance companies have policies called Top up and super top which comes handy in enhancing your health insurance coverage.
What are Top up and Super Top Up Policies:
If you have bought a base policy and your medical cost goes above it, then you have to bear it from your own pocket. A top up health insurance scheme covers your medical cost above a certain limit call “Threshold Limit” or “Deductible Amount”. Whenever the claim arises the company will pay you the required cost over and above this limit. For.e.g if you take a top up policy of Rs 10 lakh with Rs 3 lakh deductible, the company will pay you claim only after Rs 3 lakh has been born by you. So if you have base policy of Rs 3 lakh and your claim comes to Rs 5 lakh, the first Rs 3 lakh will be covered by your base policy and the next Rs 2 lakh will be get paid through a top up policy.
A super top policy is similar to a top up policy. The only difference between the two is that in a top up policy the expenses for a single treatment should be over the threshold while in a Super top up, the total amount of expenses in a year needs to go above the threshold level for the policy to be effective. What this means is that in case of having a base policy, a top up policy will consider it as number of times as you are hospitalized where as in a super top policy the base policy is considered only once. For e.g if you have 3 lakh coverage from a base policy and you are hospitalized two times in a year with your claim coming to Rs 5 lakh and Rs 6 lakh. Then a top up policy will pay you Rs 2 lakh and Rs 3 lakh. However a super top up policy will pay Rs 2 lakh and Rs 6 lakh as the base policy is considered only once for deduction.
General Features of a Top Up policy
A top up policy is like a normal medicalim policy with exclusions and waiting periods. The pre-existing diseases are covered after 3-4 years and some specified illnesses have waiting periods like any other mediclaim policies. There is also the 30 day waiting period clause when your policy becomes effective. There are some companies who have increased benefits in their top up policy like pre-existing disease is covered after one year.
Benefits for the Consumer
One of the biggest benefit to an individual is the low premium rates offered by these schemes. They are as cheap as 28-30% lower than your base policy. If someone want to enhance his cover, instead of buying a new policy a top up policy will be more economical. This works very well for employees who have health insurance benefits from their employer. They can enhance their coverage through this policy and the employer one works like a base policy. Also one need not to have a base policy to take this scheme. If you can sustain initial expenses up to threshold limit from your pocket, you can buy this insurance.
Which one to buy?
Not many companies offer these policies. Star Health, United India Insurance and Bajaj Allianz has top up policies. Although super top up is more beneficial but only United Indi has such a policy.
Comparison of the Top up plans of the companies for Individual policy:
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Criteria
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Star’s Super Surplus
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Bajaj’s Extra Care
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United India’s Top Up
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Sum assured range (Rs.)
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7 lakhs and 10 lakhs
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10 lakhs, 12 lakhs and 15 lakhs
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3 lakhs, 5 lakhs, 7 lakhs, 10 lakhs and 15 lakhs
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Maximum entry age
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60 years
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70 years
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80 years
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Renewable age
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75 years
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80 years
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Lifetime
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Medical test mandatory after
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50 years
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55 years
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45 years
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Limitations
Although these policies work very well, you need to understand in details their coverage and exclusions to enjoy the benefit. All these policies have same feature what a base policy from these companies offer. For e.g Star Health Super Surplus has all sub limits and waiting period applicable to this policy. This means whenever you buy it, you will have to clear the waiting period to get the treatment reimbursed. These policies have no relation with your base policy except the deductible amount. Hence this policy works like a normal mediclaim and earlier you add it more beneficial it will be.
Top up and Super Top policies can help you immensely in increasing the coverage if bought at right time. Although, it’s difficult to identify whether you have an inadequate cover but some factors like covering your parents in a family floater, age above 50 etc. can tell you that you are certainly in need of an additional cover.
