TOP OF THE PILE | |||
|---|---|---|---|
Here is a comparison of the three top-up policies currently available in the market: | |||
| Top Up | Super Top Up | Super Surplus | |
| Minimum sum insured | Rs 3 lakh | Rs 3 lakh | Rs 7 lakh |
| Maximum sum insured | Rs 15 lakh | Rs 15 lakh | Rs 10 lakh |
| Eligiblity | 18-80 yrs | 18-80 yrs | 5 mths-60 yrs |
| Floater basis/Inclusion of parents | Yes/No | Yes/No | Yes/No |
| Pre- and post-hospitalisation expenses | Yes | No | Post-hospitalisation* |
* 7% of the hospitalisation expenses (excluding room rent) subject to a maximum of Rs 30,000 | |||
When Himanshu Gupta, an engineer, was hospitalised two years ago, he was sure the Rs 1-lakh health insurance provided by his employer would take care of the expenses. However, he suffered a setback when his bill exceeded the cover by Rs 50,000 and he had to chip in this amount.
Things have changed today. You can ramp up your existing medical cover by going in for top-up health policies, which are cheaper than the regular mediclaim policies.
At present, two insurers, United India Insurance, and Star Allied and Health, offer this policy. While the former has two varieties—Top Up and Super Top Up—the latter has the Super Surplus option. Says Rama, AVP, product development, Star Allied and Health: "Many insurance firms provide a limited health cover, which fails to cover the cost of high-end treatment and leaves individuals in the lurch."
Concurs Rahul Aggarwal, CEO, Optima Insurance Brokers: "These help increase the medical coverage, which may not be possible due to the non-availability of such covers in the market. The employees with limited health covers due to their hierarchy in the organisation can also go for this product."
Though these policies can be bought irrespective of a primary or basic health cover, they prove beneficial only when the basic cover is in force. How do they work? Unlike a mediclaim, which provides coverage from Re 1, the topup policies start coverage only when the cost of hospitalisation exceeds the threshold limit or the deductible provided in it. Suppose you have a mediclaim of Rs 2 lakh and purchase a top-up plan of Rs 3 lakh that comes with a threshold limit of Rs 2 lakh, then the total sum insured goes up to Rs 5 lakh. If your hospitalisation bill is Rs 4 lakh, the first Rs 2 lakh will be met by mediclaim, and the remaining will be taken care of by the topup plan as the total cost exceeds the threshold limit of Rs 2 lakh.
Does one need to cross the threshold limit each time one falls ill during the policy tenure? It depends on the type of plan. While it’s mandatory under the Top Up and Super Surplus plans, the Super Top Up plan also provides protection when the total of several hospitalisation expenses exceeds the threshold level even though the cost for each hospitalisation is less than this level. "The Super Top Up scores over others as it considers the total expenses during the policy year," says Veer Sardesai, a Punebased financial planner.
The top-up policies provide a wide cover and the premium too is not high. So a 26-year-old who takes Rs 3-lakh Top Up cover pays only Rs 1,875, while the same cover from United and ICICI Lombard, under a regular mediclaim plan, costs Rs 3,609 and Rs 3,043, respectively. The Super Top Up is costly at Rs 2,317, while the Super Surplus offers uniform premiums across all age groups.
Though top-up policies are a good back-up for those who fear exceeding the basic cover, financial planners warn about the threshold limit. "It should start from where the basic cover ends. A higher threshold means bearing the extra cost oneself," says Sardesai.
