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What do Health Insurance Top-Up Plans Cover?

By Finserv MARKETS - Jul 31,2019
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health insurance top-up plans

Having a back-up plan in place is very important because life is unpredictable. The same goes for health insurance. When you apply for an insurance policy you may think that the sum insured may be enough in case of illness in the family, but with rising medical costs, it can shoot up and leave you in a serious financial crisis.

A health insurance top-up is that backup plan for you when you have exhausted the sum insured from your existing health policy. So, don’t be complacent just because you have bought the best health plan, the coverage may not be enough.

Buying a health insurance top-up is not costly. You can buy a health top-up cover for as little as Rs.2500 per annum on our platform.

What is a health insurance top-up plan?

A top-up health policy provides additional coverage if your hospitalization expenses exceed the sum insured amount on your existing health insurance plan. You don’t need an existing health plan to buy a top up, however, it is recommended that you have a base plan. A health insurance top up is more cost-effective than buying an additional cover or upgrading your existing sum insured amount.

What is a deductible?

A deductible is an amount of money which you, as an insured, have to pay from your own pocket or from your base health insurance, up to the limit specified in the policy. Once you have paid the deductible up to the mentioned limit, your insurance provider starts to pay for your claims.

Let’s say for instance that the deductible limit mentioned in your health top-up plan is Rs. 5 Lakh. You got hospitalized for an illness and the bill came to a whopping Rs.15 Lakh. In this case, you’ll have to pay Rs. 5 Lakh on your own or from your base health insurance policy and the remaining amount of Rs. 15 Lakh will be borne by the top-up plan. Always check the deductible before you buy a top-up and ensure that the deductible amount is not more than the sum insured of your existing health insurance plan.

What does a health insurance top-up cover?

  • Firstly, as mentioned earlier, a top up only covers the amount over the threshold (deductible). Therefore, you have to ensure when you apply for health insurance top-up that the threshold or deductible is not higher than the sum insured on your existing policy.
  • A health insurance top, even with the best health plan, only covers a single incidence of hospitalization. If there is a relapse within 45 days, it is considered a single incidence and covered under the top up plan.
  • A health insurance top up also has a waiting period for some specific illnesses and pre-existing diseases.
  • Some insurers provide maternity benefit cover after a waiting period of 12 months. However, it also takes care of expenses arising out of delivery complications.
  • Daycare costs on services such as surgical procedures for less than 24 hours are also covered.
  • Our health insurance top-up plan also covers expenses arising out of organ transplantation, including 1 week of hospital stay and 1 month of medicines. However, it does not cover expenses incurred on procuring an organ.
  • All expenses incurred 60 days before and 90 days after hospitalization are covered under this health insurance top-up plan.
  • Some insurers also provide coverage for ambulance charges in case of an accident. For instance, our health insurance provides coverage of Rs.3000 for the use of transportation on hospitalization.

Benefits of health insurance top up

Buying a health insurance top up has its perks and it’s cheaper than buying a separate policy or increasing your sum insured amount. You can buy a health top up in a few minutes online as no medical tests are required if you are below 55 years of age.

Compared to riders and critical illness cover, which only offers protection against select few serious illnesses, a health top up plan has no limits and is good for all types of illnesses. You can also get deductions under Section 80D for the insurance premium amount paid on health insurance top-ups.

Just take care of a few things such as deductibles and buying top-ups from your existing insurer or a new insurer. Remember that you have to file claims with two different insurers for a single disease if you have the top-up from a separate insurer. In that case, you may not be eligible for cashless claims but only reimbursement claims. However, in this day and age, it’s important that you leverage the power of health top-up plans.

Read about the several health insurance benefits that you can avail if you purchase a policy or a top-up plan available on Finserv MARKETS.

Read our top blogs to know more about health insurance in India:

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Bajaj Finserv Direct Limited ("BFDL"), erstwhile Bajaj Financial Holdings Limited is a registered corporate agent of Bajaj Allianz Life Insurance Company Limited and Bajaj Allianz General Insurance Company Limited under the IRDAI composite registration number CA0551 valid till 10-Apr-2021. BFDL also renders services to Bajaj Finance Limited (‘BFL’) and Bajaj Housing Finance Limited (‘BHFL’) (referred hereinafter as ‘Lending Partner’) in sourcing of customers, providing preliminary credit support activities, fulfilment services and post-acquisition customer services related to lending business. Registered Office: Bajaj Auto Limited Complex, Mumbai – Pune Road, Akurdi, Pune – 411 035 CIN: U65923PN2014PLC150522