Health insurance top-up plans offer the financial backup that you would require once the cover available under your base health insurance plan is exhausted. For instance, if your medical expenses are Rs 10 lakh and your mediclaim policy covers only Rs 5 lakh. The remaining Rs 5 lakh would cover by your health insurance top-up plans.
Considering the alarming medical inflation rate, it makes complete sense to go with health insurance top-up plans which offer coverage once you cross the threshold limit.
Here are some of the factors which you should consider before opting for a health insurance top-up plan:
1. Benefits Available
Check whether the benefits offered by the health insurance top-up plan are sufficient for various kinds of treatments that you foresee or not. You want to buy a top-up plan to expand your cover and get additional coverage, however, there is no point in paying high premiums if the policy doesn’t offer you coverage when you require it most. Reset benefit is one such important feature that will offer you enhanced cover. As per this feature, the insurer would refill your health insurance coverage if you exhaust it in the middle of the year.
2. Deductible Limit
In the insurance field, the deductible is the amount that a policyholder would require paying at the time of claim before the insurer settles the remaining claim amount. Health insurance top-up plans come with a deductible clause. These plans come into effect only when medical expenses cross the deductible limit. Most of the insurers follow the rule of ‘higher the deductible, the lower would be the premium’.
However, it doesn’t make sense to go with a high deductible limit that will never kick in. Moreover, what is the use of having a top-up plan, if you would have to bear the substantial claim amount? The deductible of your health insurance top-up plan should be close to the sum insured of your primary Mediclaim policy.
The other factor that should be considered is the structure of your top-up plan. For instance, your single medical claim is Rs 6 lakh with Rs 4 lakh deductible, it means, you would have to pay the deductible amount, while the difference would be covered under top-up insurance cover.
Read More: Super Top-Up Vs Top-Up Health Insurance
However, if you have two claims of Rs 2 lakh and Rs 3 lakh in a year, they won’t be covered under the top-up plan as none of the claims has crossed the deductible limit. This is where super top-up plans come to your rescue as it considers the aggregate claims in a policy year.
In the above case, you would need to pay Rs 2 lakh from your pocket since the claim amount is less than the deductible. However, for the second claim, the insurer would consider the total claim amount, i.e., Rs 2 lakh + Rs 3 lakh= 5 lakh which is more than the deductible limit, i.e., Rs 4 lakh Here, the second claim would be covered under the super top-up policy.
As per your needs, you would need to decide whether you should go with a single incidence plan (top-up) or a cumulative deductible plan (super top-up).
3. Coverage
It is essential to carefully review the medical history of your family members before buying top-up plans. That you can purchase for your parents and other family members. Further, the city where you live would also help in deciding the coverages for these plans. Moreover, you can also add top-up covers to your current individual and family floater health insurance policies, if any.
4. Pre-existing Ailment Cover
In most cases, health insurance policies do not cover pre-existing ailments. Therefore, you should go with a top-up plan which covers pre-existing ailments as well. This cover becomes useful if you are susceptible to various diseases due to your family history. Usually, it comes with a waiting period.
Read More: How Does Top-Up Insurance Work in Health Insurance Policies?
5. Restrictions
There are various restrictions, imposed on your health insurance top-up plan like sub-limits, which can restrict the coverage available in the policy. Your policy can have sub-limits on some specific surgeries, treatment, and room rent. Make sure your health insurance top-up policy doesn’t have any sub-limits. Even if there is a sub-limit, it should be a minimum.
Then there is a co-payment clause which is another type of sub-limit. It is a fixed percentage of the bill which you will have to pay at the time of claim.
It is essential to have a comprehensive understanding of all the aspects before buying a health insurance top-up plan. To purchase the best health insurance top-up plan, you can also take the help of SecureNow, a leading insurance advisor. That would offer you multiple policy quotes on the basis of information provided by you. Further, you can compare these quotes to find the best policy. With SecureNow, you can choose the right policy from the comfort of your home.
It is not only at the time of buying a health insurance top-up plan, but SecureNow is also there to assist you at the time of the claim as well.
Written By-
Gunjan Saxena
MBA Insurance Management
With a robust background in the insurance industry, Gunjan is a seasoned professional who brings 10 years of expertise to group personal accident insurance. Throughout her career, she has demonstrated a deep understanding of the intricacies and nuances of insurance products, particularly in personal accident coverage. Having worked closely with both individuals and businesses, she has gained valuable insights into the diverse needs and challenges faced by clients seeking insurance protection. Her experience encompasses designing tailored insurance solutions, providing expert advice, and guiding clients through the insurance process with confidence and clarity.
Through her articles, Gunjan aims to educate and inform readers about the importance of group personal accident insurance and the benefits it offers in safeguarding against unforeseen events.
