An indemnity plan known as a health insurance top-up offers consumers an employer-sponsored mediclaim policy or an existing health insurance policy additional medical coverage. Even if a person has used up all of the insurance coverage under their standard health insurance policy, it still enables them to get their medical expenditures paid for. A top-up plan, on the other hand, has a mandatory deductible and only offers coverage when the insured has paid the deductible sum. *
Let us understand what is top-up in health insurance with an illustration. If your current policy has a 5 lakh rupee amount assured limit, and you purchase a 7 lakh rupee top-up plan. Use your top-up plan when your current sum insured has run out. In other words, if you have a claim for Rs. 8 lakh, Rs. 5 lakh will come from your basic sum assured and Rs. 3 lakh from your top-up plan. And the remaining sum must be paid out of your own pocket if the claim you submit is for more than 12 lakh. *
Features and advantages of top-up health insurance plan
- Easy to convert to a minimal health plan
- You can add your kids to the same plan if both parents have coverage.
- Hospitalisation costs, including physician fees, room rentals, doctor fees, and other costs, are not subject to restrictions or sub-limits. *
- Some plans additionally provide a family concession. This includes the policyholder, their spouse, any dependant parents, and up to a certain number of children. Parents are going to be covered under their own family floater plan.
- Get a cumulative bonus on the amount insured for each year without a claim (up to a specified percentage) *
- A 15-day free-look period is available following the date the insurance was purchased.
- Policies might be issued for one to two years (depending on the insurer)
- Pre-medical testing is not necessary until a certain age.
- There is a lifetime renewal option available.
- Using section 80/D of the Income Tax Act, you can receive tax benefits on the insurance premium you paid. **
What does a top-up health insurance plan cover?
The scope of coverage differs between insurance companies. But typically, you can gain from the following advantages:
- Compensation for in-patient hospitalisation costs, such as nursing and boarding fees, room rental fees, physician fees, OT fees, oxygen costs, prosthetic device or equipment insertion costs during surgery, blood costs, diagnostic tests, and other comparable costs.*
- Prior-hospitalisation costs 60 days before admission to the hospital
- Post-hospitalisation costs must be covered within 90 days of discharge.
- Daycare operations that don’t require more than a day in the hospital Organ donation charges may be covered by some health insurance plans
- Up to a certain amount, emergency ambulance costs will be paid.
- Additionally, some insurers offer a cumulative bonus when renewing a policy. *
- Domiciliary care costs, as recommended by the doctor
When is a top-up health insurance plan appropriate?
In top-up health insurance plans, a single hospitalisation cover is typically offered. When your hospital bill exceeds the deductible cap, your health insurance top-up plan comes into play (during the hospitalization).
The disease will be treated as a single illness if a relapse occurs within 45 days of discharge. Additionally, if a patient is readmitted to the hospital after 45 days following discharge, it will be considered a new sickness.
How do I choose a supplemental health insurance plan?
Higher deductibles are an option if you want to choose an economical plan. You must keep in mind that there is no overlap in the advantages when purchasing health insurance top-up plans. Don’t forget to verify the waiting period for pre-existing medical problems, pre- and post-hospitalisation expenses covered, single sickness deductible requirements, maternity coverage, etc.
* Standard T&C Apply
** Currently, there are 2 tax regimes in India – new and old. To get the tax benefit you desire, choose the correct one after consulting an expert. You can opt for a regime change during the next financial year.
Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.
Subscribe to Bajaj Allianz General Insurance YouTube Channel here!