Top- Up your Health Insurance Policy!
You realize the importance of having health insurance in times of rising medical
bills and expensive new forms of treatments and get yourself and your family covered in a health insurance policy - only to realize that the insured amount is insufficient. This is what Mr. Sharma realized, here is how it happened.
Mr. Sharma bought a health insurance policy in year 2000 worth Rs. 3 lakh for his family of four, his wife, his son and his mother thinking that it was an adequate cover. Then this year (2010) his mother had to undergo a knee replacement surgery for her persistent knee problem and since 4 year waiting period had already passed, the treatment was covered. The cost of treatment was Rs. 1. 5 lakhs and Mr. Sharma was thankful that his claim could besettled by his insurance company.
However the same year, he suffered a heart attack and had to undergo a bypass surgery for Rs. 3 lakhs. Now, Mr. Sharma was in a fix since the insurance company paid only half the amount of charges (being the balance amount in his policy), he had to strain his finances to shell out the other half. He realized then that just having health insurance is not enough, having adequate health insurance cover is also essential.
Similarly you could also face a tricky situation in case the expenses for a hospitalization go beyond your cover amount or if you have multiple hospitalizations in one year. In such a case, in spite of having a cover, you will have to shell out money from your pocket.
You need additional cover if:
There is no way to know if you have an inadequate cover but you certainly need additional cover if one or more of the following is true:
You have covered your parents in your family floater policy.
You and your spouse are over 50 and are covered in one policy.
If you are over 45 and have a cover amount less than 3 lakh for individual policy and Rs. 6 lakh for family floater.
Top-up and Super top-up to your Rescue
Traditionally the answer to finding yourself an additional cover wasbuying another health insurance policy
that will add up to a sufficient amount or increasing the Sum Insured under your existing policy. However the problem was paying for another policy or increasing the Sum Insured would prove to be too expensive. Thus grew the need for a top-up plan.
What is a Top-up Plan?
Top-up is a policy that provides an additional cover to add to your existing cover in a very economical way. For example Mr. Sharma can take a Star Super surplus top up of Rs. 10 lakh for just Rs. 5700 for his entire family on a floater basis. This amount is almost equal to his premium for his original cover of Rs. 3 Lacs while now, he is getting a cover that is triple the amount. This situation holds good for most of the age brackets.
But the thing to note here is an amount called as threshold level' also known as compulsory deductible' amount. This amount is the level above which the top up can be utilized for paying the expenses. For example, for a 10 lakh top up amount, the compulsory deductible amount is Rs. 3 lakh, the top up amount will only pay for expenses that go above Rs. 3 lakh. Once the expenses exceed Rs. 3 Lacs, the total expenses upto an additional Rs. 10 Lacs will be paid. What this means is that, the Company providing the Top up cover will not require proof of your having a basic cover of Rs. 3 Lacs. It is simply that, their cover will pay from the Rs. 3 Lacs and first rupee irrespective of the first Rs. 3 Lacs is covered under insurance or not.
What is Super top up?
Super top up is also like a top up policy the only difference is that for a top up policy, the expenses for a single treatment should be over the threshold while in a Super top up, the total amount of expenses in a year needs to go above the threshold level for the policy to be effective.
For example: In case of Mr. Sharma, a top up of Rs. 10 lakh will be ineffective as the cost of both his bypass and his mother's knee replacement is under Rs. 3 lakh. But if Mr. Sharma opts for a super top up, since the cost of treatment in the year comes to Rs. 4.5 lakh, the additional Rs. 1.5 lakh will be paid by the company providing the Super top up.
Thus between Top-up and Super top up, Super top up is more beneficial for the customer.
Now for the details of the policy: There are currently three companies that provide a top up policy- United India insurance, Bajaj Allianz and Star health.Out of these only United India insurance has a super top up plan.
General conditions of the policy are as follows-
You can take a Top up plan or a Super top up for an individual or as a family floater.
There is a waiting period of 4 years for pre-existing ailments cover with all the companies.
No expense will be covered till 30 days of buyinghealth insurancepolicy.
All expenses should be above the threshold limit for it to be payable.
You can buy a top up policy even if you don't have a health insurance policy covering the first level expenses.
Pre and post hospitalization charges will be payable if the claim amount is above the threshold limit for Top up policies.
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Top- Up your Health Insurance Policy!
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