July 22, 2021

Rishabh, an employee of a multinational company in Bangalore was recently detected with cancer. As is the case with cancer treatment these days, the bills ran into several lakhs of Rupees.  This created an immense problem with his family who had difficulty in coping with the expenses since the bill was much more than the Rs. 5 lakhs of health insurance cover that Rishabh had taken for himself. The remaining amount had to be arranged by them from other sources.

This same problem can happen to anyone who has inadequate health cover. If you too have a health cover which you deem to be inadequate, then you will need Health Top Up Plan. This will provide you with additional coverage over and above the basic health insurance cover that you already have. It is an easy and cost effective way of enhancing your health protection.

How a Health Top-up Plan works:

Consider two different health protection levels:

  • Scenario1: You only have a basic health cover of Rs. 5 lakhs
  • Scenario2: You only have a basic health cover of Rs. 5lakhs and a top-up cover of Rs 5 lakhs.

Let us now see how you can meet the medical expenses of various amounts under these scenarios:

Cost of Treatment Scenario 1 (Basic Cover = Rs 5 Lakhs) Scenario 2 (Basic Cover of 5 Lakhs + Additional Cover of Rs 5 Lakhs.)
Rs 2 lakhs Fully paid from basic cover Fully paid from basic cover
Rs 5 lakhs Fully paid from basic cover Fully paid from basic cover
Rs 8 lakhs
  • Rs. 5 lakhs paid from basic cover
  • Rs 3 lakhs from own money
  • Rs. 5 lakhs paid from basic cover
  • Rs. 3 lakhs paid from top up cover
Rs 10 lakhs
  • Rs. 5 lakhs paid from basic cover
  • Rs 5 lakhs from own money
  • Rs. 5 lakhs paid from basic cover
  • Rs. 5 lakhs paid from top up cover
Rs 12 lakhs
  • Rs. 5 lakhs paid from basic cover
  • Rs 7 lakhs from own money
  • Rs. 5 lakhs paid from basic cover
  • Rs. 5 lakhs paid from top up cover
  • Rs 2 lakhs from own money

This is how a Health Top Up Plan works.  Its cover sets in when the basic health insurance coverage ends.

The Difference between Regular Health Insurance and a Top Up Plan

The only difference between the two lies in the deductible. This is the minimum amount beyond which an insurance plan wiell provide you the protection. In the previous example we had taken, the deductible was Rs. 5 lakhs. The benefit of the Top Up Plan was derived only when they it will run to more than Rs. 5 lakhs.

Thus, if you have a Health Top Up Plan of Rs. 10 lakhs, and your medical expenses amount to Rs. 6.5 lakhs, then the insurance policy will provide you coverage for the amount over and above Rs. 5 lakhs, i.e. Rs. (6.5 L – 5.0 L) = Rs 1.5 lakhs.

Why are the Top Up Plans Cost Effective?

In the world of insurance, the higher the deductible is, the lower is the premium that the insurance companies will charge you. The Health Top Up Plans have a very high deductible and cover you only when your expenses go beyond this deductible levels. This is why their premiums are quite affordable. It is a very cost-effective and hassle free way of enhancing your protection.

The regular health insurance policies generally have nil or negligible deductibles, and hence their premiums tend to be higher than that of the Top Up Plans.

Super Top Up Plans

Super Top Up Plans are very similar to Top Up Plans but they have one major difference. The top-up policies specify that the entire claim has to be made for one single bill has to be for one single hospitalization.  This restriction is not there in case of Super Top Up Plans. Multiple bills or expenses for multiple hospitalization expenses can be clubbed together, and claims can be made for the entire amount under Super Top Up Plans.

In India,  not many Super Top Up Plans are available at present. Some of the common Super Top Up Plans that are available are  ICICI Lombard Health Booster and Super Top Up Plan by New India Assurance.

Why You need a Health Top-up Plan

You will need a Top Up Plan in case you feel that your current coverage is not reasonable, or is not going to be enough going forward. Some of the main reasons why  you will need a Health Top Up Plan are:

  • Rising medical costs: These days the medical costs have become exorbitant in many cases and you cannot predict accurately how much you will have to spend. Since the levels of medical expenses are going up every year, you will need to be adequately prepared to meet the ever rising costs. A Health Top Up Plan is the best way to deal with this.
  • To get adequate protection: Sometimes many of us realize that the basic health insurance plan that we have might not be adequate to cover us anymore. Take the example of Rishabh. Rs. 5 lakhs of cover at today’s  price levels is simply not enough.  The cost of treatment for any major disease easily run into several lakhs of Rupees, and the level of coverage provided by the health insurance policies that you have taken years back is simply not adequate. In such a situation, you should look at a Health Top Up Plan for proper coverage.
  • Rising inflation: Even if you have a large coverage by today’s standards, it might not remain so large in the future years. With the inflation levels going up frequently, the purchasing power of money is diminishing every day. So even if you have a coverage Rs. 10 lakhs, which might be adequate now, as time passes by the value of Rs. 10 lakhs will get diminished due to the effect of inflation. In such a situation a top up or super top up health plan will come in extremely handy for you.
  • Enhanced protection: Even if you have a cover which is just enough to meet your needs, it never hurts to get additional protection. A heads up or plan will give you the necessary cushion to deal with any unforeseen expenses that may arise out of a major illness. This is a great way to get complete mental peace.

Even if you are a corporate employee leaving covered by group insurance by your employer, you can choose to go for a Top Up Plan on a Super Top Up Plan in order to get enhanced protection. These plans are suitable for anyone who is looking for adequate health protection in India.

Like in the case of a regular health plan, top up and super top up plans also have their inclusions and exclusions. So check the list of diseases covered carefully before you buy these plans.

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