Health insurance is an intrinsic part of our life now. You necessarily allocate a portion of your income to secure protection for unforeseen medical emergencies requiring hospitalization through medical insurance plans. The quantum of the sum insured is solely dependent on your profile, which includes your profession, liabilities and your dependents.
As a natural corollary, deciding upon the quantum of sum insured becomes crucial as modern health care is a costly affair with the profusion of super specialty hospitals that dish out the best that medical science can offer. Your normal health insurance cover can fall short of the requirements when it comes to the crux beyond the common medical expenses primarily and secondarily due to inflationary pressures.Top up health insurance is an ideal instrument in your hand, by which you augment your sum insured, at a cost marginal to the base medical insurance plan.
Health Insurance and its necessity:
Health insurance basically aims to protect you from emergency hospitalization expenses to the extent of the sum insured. Hospitalization expenses can be prohibitive and lead to financial ruin, if not provided for by adequate health insurance cover. The primary advantages of health insurance are:
- Providing financial stability: An adequate health insurance cover gives you peace of mind in the knowledge that you have a good financial back-up.
- Riders and add-ons: You can enhance the ambit of your cover by means of riders and add-ons to satisfy your specific requirements.
- Flexibility: The insurance providers have to offer many innovative plans that allow cover for critical illness, daycare treatment, lifelong renewability and tweaking of the sum insured matching your requirements. On top of this, there are plans which cover for maternity, senior citizens and the best of all, top-up plans to increase your cover substantially, at a marginal cost as compared to the base policy.
- Tax benefits: There is generous provision for tax rebate under Section 80D of the IT Act, 1961 acting as an incentive.
Types of Health insurance:
Basically health insurance plans cover for hospitalization treatments. There is a wide canvas describing in details of the inclusions and the exclusions within the overall limit of sum insured. Most plans offer pre and post hospitalization expenses for specific periods, ambulance charges and existing illnesses after a defined waiting period. Technological advances have resulted in some treatments that do not require overnight stay in a hospital but it suffices in a daycare facility. Most plans cater for such treatments. There are riders and add-ons or specific disease cover plans to cater to special situations. Keeping a wide canvas of cover on the horizon, there are two other types of plans which need special mention.
- Family Floater Plan: Unlike an individual plan, this type of plan covers multiple heads which is ideally suited to a family. The sum insured extends to self, spouse and the children and in most cases it covers four persons. Singly or severally all the members covered can enjoy medical insurance benefits to the extent of the sum insured.
- Top-up Plan: When you fear that your health insurance sum may not suffice your need, you may opt for a Top-up plan which indemnifies you for the additional sum insured. For example, if you have a base plan of Rs.4 lakhs and you buy a Top-up for Rs.5 lakhs, you are effectively covered for Rs.9 lakhs in total, subject to the rules inbuilt into your plan.
Top-up Insurance Plans:
Top-up is designed to augment your health insurance cover when you project a higher protection amount for medical emergencies. The sum insured in the Top-up plan kicks into play when the defined threshold or deductible limit is crossed. Though it is incumbent upon you to choose the deductible and the threshold as it impacts the premium, it is best fixed in harmony with your base health insurance plan.
To cite an example, if your base insurance provides a cover of Rs.4 lakhs and the Top-up is for Rs.5 lakhs, the best scenario for use of the entire cover of Rs.9 lakhs is to fix the threshold at Rs.4 lakhs. Only when the sum insured of Rs,4 lakhs gets exhausted, does your Top-up cover kick into play.
Advantages of Top-up health insurance:
There are certain inherent advantages of buying a Top-up plan. Some of the key ones are tabulated below:
- You are covered for a substantially higher sum at a marginal cost as compared to the cost you would have to bear for the total cover in a single health insurance.
- You have the flexibility to enhance the features at the time of renewal.
- You can purchase a Top-up plan even if you do not have a base health insurance.
- If you have a base health insurance, it is not necessary to purchase the Top-up plan from the same insurer.
- However, it is prudent to have the same insurance provider and ensure that the features are in sync in both to obviate future hassles.
An important point to be noted in Top-up Insurance plans:
Normally the plan caters to a single bill for the treatment and the total combined sum insured cannot be invoked for different illnesses. To illustrate the point further, suppose your base sum insured is Rs.4 lakhs and the Top-up is Rs,5 lakhs with threshold the former; and you run a bill of Rs.7 lakhs. The entire amount is paid by the insurer. But if the bill is for Rs.2.5 lakhs for the first and Rs. 3 lakhs for the second after six months, you get a cover of only Rs.1.5 lakhs remaining in your base policy. The solution here is that you opt for a Super Top-up plan and the second case scenario is catered for where your second bill is fully paid. It is a superior plan as it considers bills in totality and does not segregate them as in Top-up plan.
When it comes to health insurance, no cover seems to be safe in the current scenario. The line separating the normal expenses for medical emergencies escalating into a family financial crisis is very thin. It is in this light that the option of Top-up insurance has come as a boon. For reasons already enunciated, the most sensible thing to do is to buy a Super Top-up plan that will not only look after your emergencies but also absorb the inflationary trends.