What is a top up plan? How does it work? Read ahead to find out.
If you are young and salaried, one of the best investments you can make is by purchasing a health insurance policy. A health insurance plan is your best friend in case you meet with an accident in the near future. Additionally, a health insurance provides cover against the financial expenses arising out of hospitalization.
But what if the cover provided by your health plan is insufficient? For example, you purchase a health plan which provides a cover of ₹1 lakh and in the same year, you meet with an accident which costs you a hospital bill of ₹1.5 lakhs. Under such a scenario, the health insurance planwill provide cover of upto ₹1 lakh (as per the chosen sum insured amount). But the additional ₹50,000, you will have to pay from your own pocket.
Accidents can occur anytime and you may never know how serious the consequences can get. If you have already exhausted your cover amount for a particular financial year, life will become difficult in case you meet with another accident.
The best way to counter such a situation is to purchase a Super Top Up Plan. A Super Top Up Plan provides cover over and above your base health insurance plan. Another advantage is that you can avail all the benefits of a Super Top Up Plan at an affordable premium. With a Super Top Up Plan, you can make multiple claims in a single financial year, even if you have exhausted the base sum insured. Now that you know the basics of a Super Top Up Insurance Plan, let us look at the features and benefits for the same.
Additional Cover - This is the primary purpose of a Super Top Up Plan. It provides additional cover. The top up cover supplements your basic health plan by covering medical expenses over the deductible.
Less Premium - You can easily purchase a super top up plan at a lower premium. The premium amount depends on the deductible. A higher deductible comes at a lower premium.
Multiple Claims - With a super top up plan, you can make multiple claims till your sum insured gets exhausted.
Claim Settlement - Your claims are settled when the medical bills cross the deductible limit.
Tax Benefit - You are eligible for a tax deduction of up to ₹ 1,00,000 on health insurance premiums (including super top up plans) under Section 80D of the Income Tax Act, 1961.
In the above article, you must have come across the word ‘deductible’. This is an important component of a Super Top Up plan.
What is Deductible?
A deductible is a fixed amount paid from the policyholder’s pocket for the medical expenses before the insurance company pays the remaining balance cost.
What is Aggregate Deductible?
Aggregate deductible is the sum total of all the claims made by the policyholder during the given period of time.
How does Aggregate Deductible Function?
The following example will help you understand how aggregate deductible works:
Super Top Up Plan - ₹3 lakh aggregate deductible
Super Top Up Plan Sum Insured - ₹7.5 lakhs
| Claim 1 | ₹75,000 |
| Claim 2 | ₹50,000 |
| Claim 3 | 1 lakh |
| Claim 4 | 1 lakh |
| Total Claims | 3.25 lakhs |
| Aggregate Deductible as per policy | 3 lakhs |
| Total Sum Insured | 7 lakhs |
| Balance Claim Payable | ₹25,000 |
| Balance Sum Insured | 7.25 lakhs |
From the above table we can learn that, in case of multiple claims (more than ₹3 lakhs), the super top up plan will pay you the balance claim amount (up to maximum 7 lakhs).
Group Insurance Cover
When you join a new company, you must have noticed that the HR automatically enrols you in the company’s group insurance cover. This is applicable to all employees. group health insurance cover of ₹2 lakhs If your company puts you under a group health insurance cover of ₹2 lakhs and you feel that it is not enough, you can purchase a top up or a super top up plan. You can easily purchase a super top up plan with ₹2 lakhs as deductible.
Let us look at some of the best super top up health insurance plans in the market.
HDFC ERGO - my: Health Suraksha Plan - This plan supplements your primary health insurance cover at lower premiums along with a wide range of sum insured and no room rent sub limits.
Apollo Munich Optima Plus - Under this plan, you are covered for higher hospitalization expenditure at nominal premium rates. You will be entitled to wide in-patient cover post deductible and the policy can be renewed for life. You also have the option of converting it into a full-fledged nil deductible plan. The sum insured per insured person per policy year is ₹5,00,000 and the deductible amount can be selected in the options of 1|2|3|4|5 lakhs.
Super Surplus Insurance Policy - This is a top up policy which comes with a higher sum insured at affordable premium rates. There is no pre-acceptance medical screening required and the policy can be taken on both individual and floater basis. Any person aged between 18 years and 65 years is eligible for this plan, including children aged between 91 days to 25 years. This plan comes with lifelong renewal.
Care Health Insurance (formerly Religare) Enhance - This is a high deductible health insurance plan for you and your family. This plan comes with a flexible choice of deductible with wide range of sum insured options (max upto ₹55 lakhs). There is no pre-policy medical check-up required for coverage.
Given the rising cost of modern medicine, expenditure on healthcare will always be a part of life. You simply cannot increase the sum insured of your health insurance plan. Even if you do, it will be as expensive as buying a new health insurance plan. The best solution for this problem is to purchase a top up or a super top up plan which will enhance the cover of your base health insurance policy at the cost of minimum rise in premium.
