Friday, 25 December 2015

5 Best Super Top up Health Plans That Should be Considered

Posted by MyInvestmentsPub
Many of us not aware of the importance of having Health Insurance Policy. We may think that the Health Insurance policy is not at this stage but at the later stage like after 60 + years and having Health Insurance policy at younger stage is just waste of money in paying the premiums. However nobody knows when the life turns into fatal moments. Because  any unpredictable situation may occur at any of point of time in our life. Medical emergency is one such situation. If you are not prepared well in advance to face such Medical emergency situation, it would lead to a huge loss to you and your family. But what about the premium cost? Is it affordable to meet the sky-rocketing medical costs? What are the options to get higher Health Insurance at affordable price?



Top up Health Insurance Plans:


Considering Top up Health Insurance plans is one option to get higher Health Insurance coverage at affordable prices. These Top up health insurance plans are a unique type of health cover policies that offer you (insured) an additional coverage, which is beyond the “threshold limit” (or) the maximum limit of the existing health insurance policies.

For example – You are a working professional and your Employer providing Group Health Insurance for 5 Lakhs and you also have a Top up Health Insurance plan for Rs 5 Lakhs with the threshold limit or deductible of Rs 5 Lakhs.

Suppose, assume that you have a medical claim of 7 lakhs this year. Then, your Group Health Insurance Policy will pay Rs 5 Lakhs and the remaining 2 Lakhs will be covered from your Top up Policy. In the absence of Top up Health policy, the remaining 2 lakhs should be paid from your pocket. Hope, you now got some idea on how these Top up Health Insurance Policies will work.

What is Threshold limit?

A top up cover means the additional cost on top of the insurance threshold limit will be covered by the base plan. For example, if you have a health insurance for a sum insured of Rs. 5 lakh, and the cost of hospitalization is Rs. 10 lakh, you will have to dish out an additional Rs. 5 lakh towards your medical expenditure. However, if you have a top up cover plan, the initial Rs. 5 lakh can be claimed from the basic health insurance plan and the balance of Rs. 5 lakh can be borne by the top up plan. Here the Threshold limit for the Top up plan is 5 Lakhs. The Top up plan will come into action when your Medical expenses crosses this Threshold limit in a single instance.

What are the Disadvantages with Top up Health Plans:

Before going to discuss about the disadvantages of Top up Health plans, let us take the following scenarios:

Scenario - 1: Ram has a regular Health Insurance for Rs 5 Lakhs and Top up Health plan for Rs 5 Lakhs. Assume that he has a Medical claim for amount of 10 Lakhs in year 2014.

Settlement: Rs 5 Lakhs will be settled by regular Health Insurer and the remaining Rs 5 Lakhs will be settled by Top up Health Insurance provider.

Scenario - 2: Next year i.e. in 2015, Ram has undergone Medical treatment for 2 times and he has Two claims in 2015 of one for Rs 7 Lakhs and second one for Rs 3 Lakhs.

Settlement: For 1st claim of 7 lakhs, the Regular Health Insurer will settle Rs 5 Lakhs and the remaining Rs 2 Lakhs will be settled by Top up Health Insurance provider. Then, what about the second claim of Rs 3 Lakhs? Ram has to settle this 3 Lakhs from his own pocket. Yes, because the Top up Health Insurance facility is applicable to only one single claim in a year. Hence, the Top up Health Insurance will not settle the second claim. A Top up plan will pay you, if your claim amount for a single hospitalization and that is above the threshold limit.

Then what are the solutions available to encounter these kind of situations. The only solution is Super Top up Health Plans.

What are Super Top up Health Insurance Plans?


Super Top Up Health Insurance Plan works exactly like Top Up Health Insurance but with only one difference. In Top Up Health Insurance Plan, there is a limit for a claim in a year i.e. single claim in a year. However, in case of Super Top Up Health Insurance Plan, there is no such limit.

Scenario: Shyam has a regular Health Insurance plan for Rs 5 Lakhs and having a Super Top up Health Plan for Rs 5 Lakhs. Shyam has undergone a Medical Treatment and is having 2 Medical claims for Rs 7 Lakhs and 3 Lakhs respectively. The first claim of Rs 7 Lakhs, Regular Health Insurance plan will cover 5 Lakhs, and the remaining 2 Lakhs will be covered by Super Top up Health Plan. for the second claim, the Super Top up Helath plan will cover Rs 3 Lakhs.

In a nutshell, the Top up Health plans work on ‘per claim’ or ‘per single hospitalization’ basis, they are beneficial as long as the single claim amount is above the threshold limit.

The Super Top up Health Plans work on  ‘multiple’ hospitalizations and they look at the aggregate claim. This means that they put together all of your claims of hospitalization to calculate the deductible limit (threshold limit) and settle accordingly.

Features of Super Top up Health Plans:

1. Cheaper than Regular Health Plan: 

The deductible or threshold limit makes Super Top up plans cheaper when compared to regular plans. Higher the deductible (threshold limit), lower the premiums of Super Top up plans. Generally, Top up plans are cheaper than Super Top up plans but when we consider the benefits of Super Top up Health plans over Top up Health Plans, the difference in the premiums can be justifiable.

2. No need of Buying Regular Health Insurance Plan:

It is not mandatory to have an existing regular or group mediclaim to buy a Super top up Health plan. However, the combination of Regular Health Insurance plan + Super Top up Health Plan would give you the maximum health benefits in all scenarios. If you have regular health insurance, then below the threshold amount will be settled by the regular plans and above threshold claim amount by Super Top up Health Plan.

3. Tax Benefit:

Exactly like regular health insurance products, you can claim the tax deduction under Sec.80D of IT Act for the premiums paid against Super Top up Health Plans.

4. No NCB (No Claim Bonus)

Super Top up Plans generally do not offer NCB, however, if you have accumulated no claim bonus (for claim free years), Super top up plans will pay the claim amounts over and above the regular plan’s sum assured + No claim bonus amount.

5. Work On Reimbursement Basis:

Another important point is that most of the Super Top plans work on reimbursement basis. They will pay the claim amount after the insurer gets the details of all the medical bills, to assess whether the policyholder has paid the deductible limit by himself or through any existing health insurance policy. They will not bother whether below threshold amount is from the policyholder’s own pocket or from his regular health insurance. Then only any dues of above threshold limit settled by Super Top up plans. Hence, getting cashless benefit from the Super Top up plans is difficult.

6. Both Individual and Family Floater Plans Available:

Similar to the Regular Health Insurance plans, these Super Top up Health Plans are also come up with Individual and Family Floater Plans. Some companies even offer Super Top up plans for senior citizens as well. Example : United India Super Top up Plan.

7. Guaranteed Renewal for Life: 

Most of the Insurers allow you to renew your Policy throughout your lifetime, provided your application for renewal and the renewal premium are received in full before the due date or within a maximum of 30 days from such date.

8. No medical tests up to the age of 55:

Because of the Threshold limit, many insurers offer the product with out any medical check up up to the age of 55.

Who Can Buy Super Top up Health Plans:

  1. The Super Top Up policy is ideal for people working with corporate sector who already have group health policy cover.
  2. Any Individuals who covered with Insufficient health coverage by the Regular Health Insurance Policy and looking higher coverage with lower premiums.
  3. If the claim history of you and your family from the last 3 - 5 years is above the coverage of Regular Health Insurance Policy.

Best Super Top up Health Plans That Should be Considered:

1. Star Super Surplus
2. Appollo Munich Optima Super Top up
3. L&T Medisure Super Top up
4. ICICI Lombard Health Care Plus
5. Cigna TTK Super Top Plan
6. United India Super Top up Plan


Things to Remember Before Purchasing Super Top up Plan:

  1. Read thoroughly about the Policy Terms and Conditions. 
  2. Check for duration for Pre-existing diseases and scope of cover.
  3. Check if any day-care procedure is available
  4. Check for Pre & Post hospitalization expenses are covering
  5. Check for premiums after 60 years
  6. Check for service history of the Insurer.

Conclusion:

For having higher health coverage at affordable prices, Super Top up Health plan is a very good option to consider. However, selection of Insurer and the suitability of plan varies from Individual to Individual.

Wishing You and Your Family a Happy & Healthy New Year 2016!

3 comments:

  1. Very use full post Sir,
    Could you please explain what is deductible amount?

    ReplyDelete
  2. Very use full post Sir,
    Could you please explain what is deductible amount?

    ReplyDelete
  3. Thanks Jagadeesh for following my website. Deductible amount is the amount you owe for covered health care services before your health insurance plan begins to pay. For example, if your deductible is 2 lakhs, your plan won't pay anything until you've paid 2 lakhs for covered services.

    ReplyDelete