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Get a top-up health insurance plan

Get a top-up health insurance plan

If you’re considering an increase in the sum assured of your health insurance plan, consider a top-up plan. They’re a cheap, practical solution to all your insurance problems.

A top-up health insurance plan is useful for a number of reasons. If you’re nearing retirement and your health insurance company doesn’t want to raise the sum assured of your policy. If you believe your company health plan offers inadequate coverage. If you think it’s the cheaper, if roundabout way, to insuring yourself. If you need coverage of over Rs5 lakh, it’s your only option. Perhaps you’re not sure what a top-up plan, so let’s discuss what it is. The short version is that it is a regular health insurance plan with a high deductible, of anywhere from Rs50,000 going way up to Rs5 lakh. An interesting option, isn’t it? Let’s find out how it works:

How they work
A top-up plan is simply a health insurance plan with a high deductible. In every other way, it’s a regular health insurance policy, which may, aside from other restrictions, not cover pre-existing illnesses over the first four years. So let’s take an example of how it works. Let’s say you’re insured for Rs2 lakh under one plan and have a top-up plan with a deductible of exactly that amount. If your hospital bill crosses Rs2 lakh, your base plan is surely not going to reimburse you. However, this is exactly when the top-up plan would kick in. Now, why wouldn’t you simply raise the sum assured on your base plan? Because it’s much cheaper to get a top-up plan.

Two types

Basic: With the basic plan, the cover kicks in only if you exhaust the deductible within a single hospital visit. So let’s say you have a Rs10 lakh top-up cover with a deductible of Rs3 lakh. If you are hospitalized with a bill of Rs2.5 lakh in one month and Rs1 lakh later in the year, the top-up plan would not be activated a single time. However, if your bill is for Rs5 lakh, it would cover Rs2 lakh of the bill.

Premium: As the name indicates, this is the superior plan, which also costs more. If you’ve understood the concept behind the basic plan, you’ve probably figured what makes this plan different. With the premium plans, the sum assured under the top-up policy is triggered even if no individual bill is as high as the deductible, so long as the combined bill in any given policy year is higher than the agreed limit. So if you have a deductible of Rs3 lakh and are hospitalised thrice with bills of Rs2.5 lakh, Rs4.5 lakh would be eligible for reimbursement in a single year under this plan. Only United India and Max Bupa so far offer this plan.

Plan Type Coverage Deductible
Health Care Plus Basic Rs5 lakh to Rs10 lakh Rs2 lakh to Rs4 lakh
Chola MS Healthline Basic Rs50,000 to Rs15 lakh Rs30,000 to Rs5 lakh
United India Super Top Up Premium Rs3 lakh to Rs15 lakh Rs2 lakh to Rs5 lakh
Apollo Optima Plus Basic Rs5 lakh Rs1 lakh to Rs5 lakh
Bajaj Allianz Extra Care Basic Rs10 lakh to Rs15 lakh Rs3 lakh to Rs5 lakh
Max Bupa Heartbeat Premium Rs2 lakh to Rs50 lakh Rs2 lakh to Rs3 lakh

Low costs
While the cost of regular health insurance depends largely upon your age, the cost of a top-up health plan is based mainly on the deductible. If the deductible is Rs50,000, you’re not going to say it’s cheap. The higher you go, though, the lower the cost of the insurance will be. Age matters less; in fact, with most plans, the cost remains exactly the same for all those under the age of 45. With Bajaj Allianz’s Extra Care plan, for example, you can get a top-up of Rs10 lakh (with a Rs3 lakh deductible) for anyone under the age of 40 at just Rs2,500. Super top-up plans, the second type described above, are more expensive, but they also offer greater risk cover as compared to the basic top-up plans.

Here are the costs of some top-up plans, as compared to regular health plans:

Insurer Type Coverage Deductible Premium (at 40) Premium (at 60)
ICICI Health Care Plus Basic Rs10 lakh Rs4 lakh Rs2247 Rs2247
Bajaj Allianz Extra Care Basic Rs10 lakh Rs3 lakh Rs2500 Rs3750
United India Super Top Up Super Rs10 lakh Rs5 lakh Rs3700 Rs4600
Chola MS Topup Healthline Basic Rs10 lakh Rs5 lakh Rs4002 Rs6220

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