Choosing Policy Cover With Top-Up Health Insurance

Wanda Rice

Planning for medical expenses can be difficult since predicting the kind of medical emergency is impossible. Therefore, when we buy a health insurance policy, we try to ensure that we cover different types of diseases and ailments and look for a sum insured that can manage most medical costs with ease.

However, there can be times when you suspect that your sum insured might be able to cover the medical bills. This is when you start looking for a top-up cover. This additional cover kicks in when you exhaust the sum insured on your health insurance plan.

This article will talk about how you can choose a policy cover with top-up health insurance.

What is a Top-up Cover?

In the simplest terms, a top-up cover is like a backup cover. For example, if you have a health insurance plan with a sum insured of ₹5 lakh. There is a medical emergency in the family, and your costs might cross the insured amount. If you have a top-up cover, it can cover the costs over and above those covered by your primary medical insurance policy.

Many people confuse top-up covers with add-on covers or riders. Health insurance companies offer a range of add-ons and riders like personal accident cover, critical illness add-on cover, etc.

However, it is important to remember that while add-ons can be purchased with a base health insurance policy, top-up plans can be purchased independently. Also, add-on covers are for specific costs. On the other hand, health insurance top-up plans cover all hospitalisation expenses.

Example to Understand Top-Up Cover

You have a medical insurance plan that covers you, your spouse, and your daughter. The sum insured is ₹5 lakh. You want to increase the sum insured and consider talking to your insurer about the same. You also consider buying a top-up cover.

How top-up health insurance plans give you more coverage at a lesser premium? Find out - The Financial Express

If you want to increase the sum insured by, say, ₹10 lakh, then increasing the sum insured of your policy will cost you more in premium compared to a top-up cover. However, the top-up cover will have a deductible of ₹5 lakh. This means that it will kick in only after you have spent ₹5 lakh in hospital expenses.

So, if there is a medical emergency in your family and the hospital bill is ₹7 lakh, then ₹5 lakh will be borne by your medical insurance policy and ₹2 lakh by the top-up cover.

How to Choose a Top-Up Cover?

Here are some factors that you must keep in mind while choosing a top-up cover:

  • If you are opting for a top-up cover, then it is likely that you are expecting your medical costs to increase. Hence, ensure that you choose a top-up plan that can cover the medical costs that you can foresee. While predicting medical emergencies is not possible, take stock of the health of the people covered under the policy and make an informed decision.
  • Top-up plans in medical insurance have a deductible clause. They kick in only when your hospital expenses cross the agreed deductible limit. While a higher deductible would mean a lower premium, ensure that you choose a reasonable limit so that the top-up cover can cover your costs when needed.
  • Consider the medical history of all people that will be covered under the health insurance top-up plans.
  • Remember, top-up plans can have certain restrictions and limitations where the plan will not offer coverage. Make sure that you read the policy documents and are aware of these restrictions before making the decision of buying the policy.

Summing Up

Health insurance plans are an important purchase since it comes in handy during medical exigencies when you are already going through a lot of stress. The right medical cover can ensure that you don’t worry about finances during such times. Also, the rate at which medical treatment costs are increasing, not having a health plan can squeeze out your savings and investments in no time.

Hence, buy medical insurance plans that offer maximum coverage and benefits. Over time, if you feel that the medical expenses might increase, you can start looking at top-up plans that complement your existing plan. Research the market, look for options, compare plans, and ensure that you choose the best health insurance plan in India for your needs. Good Luck!



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