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Insurance Article

Your Guide to Super Top Up Plans

October 10 2016
Super Top Up Plans

Frequently asked questions about Super Top-up plans

Vani Sharma was chatting with her colleague; who has been a great support to her these recent weeks. The state of her father's health was causing a great deal of emotional and financial stress to her. Her colleague Ameya was bouncing off ideas for financing treatments when the topic of super health plans came up.

This is how the conversation goes:

Vani: What is a top up plan?

Ameya: A top-up plan is a deductible plan which enhances your base health policy. For instance, let's say your father has a base policy of ₹ 5 lakh and you purchase a top up plan of ₹ 10 lakh with ₹ 5 lakhs as the deductible. In case your father’s medical expenses from the first treatment is billed as ₹ 7 lakh, ₹ 5 lakhs will be taken from your base health insurance and the remaining will be from your top-up plan.

But, in order to receive the top-up plan coverage, you will need to surpass the deductible limit. If your expenses from first hospitalisation is only ₹ 3 lakhs, top-up plan won't come into effect.

Also, top up plans treat every hospitalisation as singular in a year. So, taking the same example I mentioned above, if your father is hospitalised for the second time and the expenses are ₹ 4 lakh, you will won't get any coverage as the top-up considers each hospitalisation as new and your deductible is reset. This is where Super top-up plans are value differentiators.

Vani: So, what is a “Super Top-Up”?

Ameya: Super top-up plan is a top-up plan on energy drinks. It takes into account the aggregate of hospitalisations in a policy year. So, if you would have chosen the super top-up plan instead of the top-up in the example above, you will be covered for ₹ 4 lakhs from the second hospitalisation.

Vani: Could you explain the difference between a super top up and a regular top up plan?

Ameya: Both these plans differ in how they are structured, health plans which are efficiently structured can help bring cost down. Top-up plans consider each hospitalisation as singular and a new one. So if you anticipate multiple hospitalisations, each of them will have to exceed the deductible. This is one of the major and most cost-effective differentiators of a super top-up plan.

Super top-up’s cost-benefit lies in its coverage of multiple treatments in a year. It considers the total treatment expenses in a year for claiming, hence you end up saving on huge medical bills in such a policy.

Vani: Why do I even need these top-ups?

Ameya: Most comprehensive insurance don’t cover every specific illness. They are designed to suit wide range of uses and demographics. Hence, if you need a very specific treatment, the cost can go much higher and some of it won’t be covered by your basic health insurance policy.

Whereas, a super top-up also offers specialised coverage such as Donor Expenses, and gives enhanced coverage over and above your normal policy. Instead of buying a new insurance policy entirely to meet you increased medical requirement, it is a much feasible option to attach a top-up to your regular health plan.

Vani: How important is choosing a right deductible in my health plan?

Ameya: Very important! Deductible can make or break the efficacy of your health insurance plan. It is the amount that you have to pay for – either out-of-pocket or from your basic health insurance policy – before your health insurance top-ups kick in.

Choosing a very high deductible means you will have to take care of the base amount yourself. Always calculate the amount of deductible by taking in your medical history and the kind of costs you anticipate in the next 5 years. If you are nearing 50, a super top-up will be more beneficial, since the risk of ailments is higher as you grow older.

Vani: Do I need to have a health insurance policy to opt for Super top up plan?

Ameya: No, you need not. If you don't have a health plan, you can still purchase a Super top-up plan. For instance, ICICI Lombard’s Health Booster Plan is a standalone policy that can be purchased independently, even if you don’t have a base plan.

However, in this case you will end up paying the expenses out-of-pocket until you exceed your deductible limit and the super top up kicks in. Hence, it is ideal to have a basic health insurance plan, however not necessary.

Vani: What kind of coverages are offered in ICICI Lombard’s Health Booster Plan?

Ameya: Health Booster, a super top-up plan comes with features like lifetime cover, day care treatment, pre and post hospitalization, critical illness coverage. Wellness Programs and emergency ambulance charges are also included in the plan. With the free-look in period of 15 days, you can get to know the policy closely before investing. The inclusions and exclusions in the policy wordings will offer you a better understanding of the scope of coverage.

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