A top-up health policy is an additional coverage only for people who have an existing health insuance or a mediclaim from the employer.
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What is Extra Care Plus?
Ever been in a situation where you’ve been hospitalized and your basic health insurance plan falls short of covering expenses? With medical costs on the rise, why wait for the exhaustion of your sum insured amount that prevents you from getting the required medical help? Here’s presenting Extra Care Plus, a health insurance top-up plan that is designed to take care of medical expenses, should you deplete your basic health insurance policy amount. A plan that acts as an extension of your base health insurance plan by offering a high sum insured with a low deductible at a nominal premium. Moreover, individual Extra Care Plus top-up plans for individual health insurance come for as little as Rs. 2500 per annum.
About Health Insurance Top-Up
Health insurance is a valuable product that allows one to financially protect yourself and your family against sudden medical contingencies. However, have you ever wondered what you would do if your regular health insurance coverage falls short in times of need? Well, considering that the medical costs in India are rising by the day, it is wise to invest in a top-up plan that comes in handy when the existing sum insured is exhausted.
At Finserv MARKETS, you can buy health insurance top-up to take care of the additional medical expenses that exceed your existing coverage. The top-up health insurance plan is an extension to your primary health insurance policy, which offers a high sum insured with low deductibles at a nominal rate.
Let us understand how health insurance top-up plans work, with the help of an illustration.
Illustration
Miss Rekha has a basic health insurance coverage of Rs. 5 Lakhs and a top-up health insurance plan of Rs. 5 Lakhs. Below are a few scenarios that will help you understand the need for top-up health insurance.
- Situation 1:
Rekha claims Rs. 4 Lakhs on her health insurance plan. The primary coverage will inevitably take care of the expenses as the health insurance coverage is of Rs. 5 Lakhs.
- Situation 2:
Rekha claims Rs. 8 Lakhs. In this case, the primary health insurance will cover Rs. 5 Lakhs of the total amount, and the top-up plan will cover the remaining Rs. 3 Lakhs.
- Situation 3:
Rekha claims Rs. 12 Lakhs. In such a case, her basic health plan will cover Rs. 5 Lakh and the top-up plan will cover another Rs. 5 Lakh (that is a total of Rs. 10 Lakh). The remaining Rs.2 Lakh has to be paid by her from her pocket.
Benefits of Health Insurance Top-Up
By now, we believe that you must have gained a good understanding of health insurance top-ups. Let us proceed to understand the difference between regular health insurance and top-up health insurance.
Regular Health Insurance vs Top-Up Health Insurance
The following table will help you understand the difference between the two policies –
|
Regular Health Insurance |
Top-Up Health Insurance |
Type of Policy |
Independent health insurance plan that covers the medical expenses of an individual or a family. |
Add-on health plan that acts as an additional benefit over and above your basic health insurance coverage. |
Premiums |
If you choose a high sum insured, the premiums of the health plan will be comparatively high. |
Top-up health insurance plan is cost-effective as the policy provides extended coverage at a nominal rate. |
Waiting Period |
The insured needs to complete the waiting period before the health plan covers pre-existing health conditions. |
There is no waiting period on the top-up health plan to cover the pre-existing health conditions. |
Now that we have covered the basics of top-up health insurance plans let us take a look at the top-up health insurance plans available on Finserv MARKETS.
Health Insurance Top-Up at Finserv MARKETS
Here’s a glimpse of what the top-up plan at Finserv MARKETS consists of-
|
Bajaj Allianz Extra Care Plus |
Type of Plan |
Extra Care Plus is a top-up health insurance plan designed to take care of the additional medical expenses in case you exhaust your base health insurance plan. |
Premiums |
Extra Care Plus top-up plans on individual health policies will cost as little as Rs. 116 per month. |
Key Benefits |
|
Eligibility Criteria |
● Entry Age ● Policy availability ● Policy Period ● Medical Test Requirement ● Minimum Entry Age for Proposer/ Spouse/ Dependent Parents – 18 Years ● Maximum Entry Age for Proposer/ Spouse/ Dependent Parents – 80 Years ● Minimum Entry Age for Dependent Children – 91 Days/3 Months ● Maximum Entry Age for Dependent Children – 25 Years |
Inclusions |
● Sum Insured of up to Rs. 50 Lakh: Our partner, Bajaj Allianz, offers Extra Care Plus top-up plan with the sum insured amounts that range from Rs. 3 Lakhs – Rs. 50 Lakhs. This proves to be especially helpful when your base family health insurance plan falls short. ● Organ Donor Cost: This plan covers certain costs that are part of organ transplantation. These include one week of hospital stay and one month of medicines. Charges related to organ procurement and expenses incurred by the donor are not covered. ● Maternity Benefit Cover: Extra Care Plus covers all maternity-related charges. It also takes any expenses that may arise from delivery complications into consideration. However, there is a waiting period of 12 months to avail this benefit. ● Day Care Facilities: Costs incurred on availing daycare/hospital facilities are covered. This includes daycare facilities like surgical procedures requiring hospital/daycare, upon admission as an in-patient for less than 24 hrs. ● Pre and Post hospitalisation Expenses: All expenses incurred 60 days before and 90 days after hospitalisation are covered under this health insurance top-up plan. This usually includes fees for doctor and nurse’s services, use of ICU and OT, rent for room and charges for purchasing blood, medicine and oxygen. ● Ambulance Charges: In the event of an accident, a maximum amount of Rs. 3000 is provided for the use of transportation per valid hospitalisation. |
Exclusions |
● Diseases/sickness that is diagnosed during or before purchasing of this insurance top-up. ● Any condition that is contracted within 30 days of purchasing/starting the top-up plan. ● Any expenses related to pre & post hospitalisation of an organ donor. ● Costs incurred for the treatment of HIV AIDs and other such diseases. ● Fees associated with the purchase of non-allopathic medicines. ● Illnesses/diseases that are caused by the consumption of alcohol and intoxicating drugs. ● Any surgery that requires joint replacement (except accidents) and has a waiting period of 4 years. ● Expenses incurred for cosmetic and aesthetic treatment. ● Any expense incurred during dental surgery and doesn’t require hospitalisation. ● Medical treatment costs for a new-born baby. ● Any procedure related to fertility, impotence, subfertility, assisted conception, and sterilisation. Note: For the complete list of exclusions, refer to the PDF in the 'Download' section. |
What is a deductible?
You've always heard the term Deductible under health insurance, but have never been able to understand it well, right? Here's making things a little easier for you. A deductible is an amount of money which you, as an insured, have to pay from your own pocket or your base health insurance/group health insurance (up to the limit specified in the policy). Once you have paid the deductible, your insurance provider will pay for your claims thereafter. Let's say for instance that the deductible limit mentioned in your health top-up plan is Rs. 3 Lakh. You got hospitalized for an illness and the bill came to a whopping Rs.20 Lakh. In this case, you'll have to pay Rs. 3 Lakh on your own or from your base health insurance policy & the remaining amount of Rs. 17 Lakh will be covered by your top-up plan.
Reasons To Buy Extra Care Plus
What is a health insurance top up?
Why choose Finserv MARKETS For Extra Care Plus
Extra Care Plus Eligibility Criteria
- Entry Age
- Policy availability
- Policy Period
- Medical Test Requirement
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Minimum Entry Age for Proposer/ Spouse/ Dependent Parents – 18 Years
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Maximum Entry Age for Proposer/ Spouse/ Dependent Parents – 80 Years
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Minimum Entry Age for Dependent Children – 91 Days/3 Months
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Maximum Entry Age for Dependent Children – 25 Years
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Residential Indians
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NRI’s (premiums to be paid in INR)
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Annual
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Age up to 55 Years – No Medical Test
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Age more than 55 Years – Medical Test Required
How to Buy Health Insurance Top at Finserv MARKETS
Just follow the steps below to buy a top-up health insurance plan at Finserv MARKETS online –
- Take a quick quote by entering the details of whom to insure
- Select the top-up coverage you need.
- Provide your personal details
- Review the policy and verify your details.
- Make a premium payment online.
- The insurer will issue the top-up plan on your existing health cover in no time.
Claim Process for Health Insurance Top at Finserv MARKETS
Filing claims was never so simple. Just follow these steps and you’re done!
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1
Register your claim online
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2
Upload documents online
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3
Claim Assessment
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4
Claim Decision
For information on your health insurance policy, refer to the 'Process' section below.
- Process
- Download
- Emergency Contact
- Cashless Claims
- Claim Intimation
- Claim Reimbursement
- Cancellation Process
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You need to approach the network hospital along with your policy details.
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The network hospital verifies the details provided by you and sends a pre-authorization form to the network hospital.
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The insurance provider verifies the pre-authorization request and informs the network hospital about your policy's coverage. If needed, the insurance provider may send a query letter to the network hospital requesting more details. The network hospital needs to respond to this query with the information requested for.
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Once the network hospital receives approval from the insurance provider, treatment begins. Upon discharge from the network hospital, the final bill along with the discharge papers are sent to the insurance provider. The insurance provider will settle the final amount with the network hospital after deducting co-payment (if applicable) and other consumable expenses.
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Should the pre-authorization request get rejected; you will have to bear all treatment expenses which can be reimbursed later.
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Claim Intimation
- Claims should intimated within 48 hours in case of emergency hospitalization*
- Claims should be intimated within 24 hours in case of planned hospitalization*
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Claims can be intimated on the following platforms:
- Contact the executes at the Call Center- 1800 209 5858 (Main Toll Free) and dedicated health toll free (1800 103 2529)
- Email on health.admin@bajajallianz.co.in
- Branch walk-in at the customer care desk
- Visit the website- https://general.bajajallianz.com/BagicHCM/cstprtl/getCustDtls.do
- Download the Caringly Yours App on App store/Play store
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Following details are required for claim intimation:
- Policy Number
- Name of the Patient
- Hospital Name
- Hospital Address
- Date of Admission
- Diagnosis
- Mobile Number
- Email Id
*Note: Relaxations in the timelines mentioned above may be considered in the extreme cases of hardship where it is proved to our satisfaction that under the circumstances in which you were placed, it was not possible for you or any someone else to inform or file a claim within the stated time limit.
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Once discharged from hospital, you need to collect all original documents and bills and submit them to the insurance provider.
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The insurance provider initiates scrutiny of all claim-related documents. If additional documents are needed, you will be intimated about the additional documents required.
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Once all necessary documents are received, the insurance provider approves the claim.
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Payment will be released to you based on what is admissible under the insurance policy.
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Company Cancellation
The insurance provider may cancel your insurance policy providing a written notice 15 days prior to cancellation date. If no claim has been made, a refund of the premium for the unexpired policy period shall be provided on a pro-rata basis.
Your insurance policy will be cancelled for reasons such as non-disclosure of material facts, misrepresentation, fraud and non-cooperation.
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Customer Cancellation
As a customer, you may cancel your insurance policy by providing a written notice 15 days prior to cancellation date. If you've made no claims, the insurer will refund short-term rates for the unexpired policy period as per the rates detailed below.
Period of Risk Premium Refund - 1 Year Policy Period Exceeding 15 days but less than 3 months 65.00% Exceeding 3 months but less than 6 months 45.00% Exceeding 6 months but less than 12 months 00.00% Period of Risk Premium Refund - 2 Year Policy Period Exceeding 15 days but less than 3 months 75.00% Exceeding 3 months but less than 6 months 65.00% Exceeding 6 months but less than 12 months 45.00% Exceeding 12 months but less than 15 months 30.00% Exceeding 15 months but less than 18 months 20.00% Exceeding 18 months but less than 24 months 00.00%
- Cashless Claims
- Claim Reimbursement
- Other Health Insurance Related Claims
- Links for Claim Settlement Forms
- List of Network Hospitals
- Brochure
- Policy Wordings
Link to redirect customers to links category.
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Cashless Claims Request Form
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Reimbursement Form
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Self Declaration of KYC Document Submission - For Individual Partner
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Non-Medical Expenses List of Exclusions
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Personal Accident Claim Form
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Cashless Claims Request Form
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Reimbursement Form
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Self Declaration of KYC Document Submission - For Individual Partner
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Personal Accident Claim Form
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Non-Medical Expenses List of Exclusions
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List of Network Hospitals
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Extra Care Plus Brochure
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Policy Wordings - Extra Care Plus
Need further assistance? Reach out on the Toll-Free Number: 1800-209-5858 to connect with an insurance expert.
Best Health Insurance Plans Available at Finserv MARKETS
Manage all your queries here
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✔️I have health insurance in place. Why would I need a Health Insurance Top-up plan?
A basic health insurance plan offers protection for you and your family against financial contingencies that may arise due to medical emergencies. However, what does one do if the sum insured provided gets exhausted? Here’s where an individual Health Top-up plan helps. It acts as a supplement over and above your existing health insurance plan. If you are bound to change your job, a health insurance top-up is a must as it will supplement your savings especially when the costs incurred due to medical treatment are more than your savings. -
✔️What is a 'Deductible'?
The term ‘deductible’ refers to the cost/specific amount that a health insurance policy holder must bear as per the policy in question. For example, certain medical equipment used during hospitalization (syringes, gloves for doctors, bed charges) may be categorized as ‘deductibles’ and are not covered by the health insurance policy. These costs are then borne by the policyholder. However, do keep in mind that deductibles do not reduce the sum insured amount of the policy. To help understand this better, here is an example - Rahul opts for a basic plan with a sum insured of Rs. 10 Lakhs. In the same policy year, he makes a claim for Rs. 6 Lakhs. The amount is reimbursed by the insurer while Rahul still has Rs. 4 Lakhs of his sum insured remaining. On the other hand, Raveena opts for a base plan of Rs. 10 Lakh and a top-up plan of Rs. 15 Lakh and a deductible amount that is of Rs. 3 Lakh. She then makes a claim of Rs. 6 Lakh and has Rs. 4 Lakh of the sum insured amount left. This is reimbursed to Raveena. Going forward, she makes another claim of Rs. 7 Lakhs for which Rs. 4 Lakh is reimbursed from the base plan and Rs. 3 Lakh from the health insurance top-up plan. Raveena can still make a claim for Rs. 12 Lakh. -
✔️Please list the benefits offered by Extra Care Plus top-up plan available on Finserv MARKETS.
Extra Care Plus Top-up plan provides the following benefits: 1. Coverage of costs in the event of in-patient hospitalization, 2. Pre-& post hospitalization costs (60 days prior and 90 days post-hospitalization), 3. Certain costs related to organ donor procedures, 4. Day care treatment costs, and 5. Coverage of ambulance expenses in the event of road accidents. For a complete list of inclusions and benefits, please refer to the ‘What’s Covered’ section of this page. -
✔️Could you please tell me the eligibility criteria to avail this Extra Care Plus top-up plan with Finserv MARKETS?
The basic eligibility criteria would be your entry age. This should be between 91 days to 80 years. For more information on this, refer to the Eligibility Criteria section of this page. -
✔️Is it possible for me to save on taxes on the policy premium?
Yes, you can. Premiums paid for this top-up plan are tax-exempted under section 80D of the Income Tax Act.
