How Can You Customise Your Health Insurance with Top-Up Plans?
Critical illnesses, medical emergencies and advanced medical procedures can lead to financial distress even when you have a health policy. If the medical expenses exceed the sum insured, you may have to pay the expenses out of your pocket.
One of the easiest ways to customise and enhance your medical insurance plan is by adding health insurance add-on riders. However, since such riders can only be purchased with a medical insurance plan, it is not possible to add them in the middle of a policy year. You have to wait till the renewal of your plan to add any health insurance rider to it.
However, with flexible health insurance options like top-up plans, you can enhance your health insurance coverage at any time during the year. What’s more, such a plan is usually lighter on your wallet than buying another medical insurance plan would be.
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List of Content
Customise Health Insurance with Top-Up Plans- What is a Top-Up Health Insurance Policy?
- How does a Top-Up Health Insurance Policy Work?
- What is a Super Top-Up Health Insurance Policy?
- Top-Up vs Super Top-Up Health Insurance Plan
- How to Use Top-Up Plans for Better Coverage?
- Benefits of Customising Health Insurance with TATA AIG Super Top-Up Plans
- Explore TATA AIG MediCare Select - A Fully Customisable Health Insurance Plan
- Conclusion
Customise Health Insurance with Top-Up Plans
Top-up plans provide additional health insurance coverage once your medical expenses cross a certain threshold limit. This limit is referred to as a deductible. The coverage gets active only after the deductible amount is paid. You can pay the deductible amount from your pocket or with another health insurance policy.
Let us quickly understand the difference between a base health insurance and a top-up health insurance policy.
Top-Up vs Base Health Insurance
| Differentiating Factors | Base Health Insurance | Top-Up Health Insurance |
|---|---|---|
| Coverage | Provides comprehensive coverage for medical expenses up to the sum insured. | Covers medical expenses beyond the threshold limit or the deductible. |
| Deductible | May not have or have a lower deductible amount | Has a mandatory deductible that applies to every claim |
| Premium | Higher | Lower |
| Policy activation | Gets activated immediately after the purchase and is payable after the initial waiting period. | Gets activated only when the deductible amount is paid. |
Now that we know the differences, let us learn about top-up health insurance plans. There are basically two ways to enhance insurance coverage with top-up plans:
Standard top-up health insurance plans
Super top-up health insurance plans
What is a Top-Up Health Insurance Policy?
A standard top-up health insurance policy provides additional coverage when medical expenses exceed the deductible amount.
However, this deductible applies to every claim, meaning every claim should exceed the deductible amount to activate the top-up health policy.
How does a Top-Up Health Insurance Policy Work?
Let us consider a simple example to understand how the top-up health insurance policy works.
Example 1
Ms Lekha has a health insurance policy with a sum insured of ₹4 lakhs and a top-up health insurance policy of ₹7 lakhs with a deductible of ₹2 lakhs. She underwent surgery, and the hospitalisation bill was ₹8 lakhs. She can claim the base health insurance policy of ₹4 lakhs and activate the top-up health insurance policy.
The amount paid from the base health insurance policy can be considered for the deductible amount of ₹2 lakhs. Therefore, the remaining ₹4 lakhs will be paid by the top-up health policy.
So, if you customise your health insurance with a top-up health policy, you can ensure this enhanced coverage.
What is a Super Top-Up Health Insurance Policy?
A super top-up health policy offers additional coverage beyond the threshold limit or deductible, similar to a top-up health policy.
However, the policy gets activated for the entire policy term after the deductible limit is reached based on multiple claims as against single claims in top-up health insurance policies.
At TATA AIG, we offer the Medicare Plus (Super Top-Up) health policy that offers additional coverage to supplement your basic medical insurance or serve as a standalone plan for enhanced protection.
You can explore the key features and purchase this health insurance online.
How does a Super Top-Up Health Insurance Policy Work?
Let us consider a simple example to understand how the super top-up health insurance policy works.
Example 2
Ms Ramya had a basic health insurance cover of ₹3 lakhs with TATA AIG. She also invested in a TATA AIG Super Top Up Health Insurance Plan of ₹10 lakhs with a deductible of ₹3 lakhs.
During the first policy year, she was involved in a severe car accident that left her with a serious leg injury. She was hospitalised twice, with each stay costing ₹1.5 lakhs. Later, doctors recommended surgery for her condition.
The cost of the surgery and the hospitalisation that preceded and succeeded it, along with the expenses associated with medicines and the long rehabilitation process, amounted to a total bill of around ₹2.5 lakhs.
In this case, Ramya covered the initial two hospitalisations of ₹1.5 lakhs each with the basic health policy. Further, as the total claims reached the deductible limit of ₹3 lakhs, she can cover all future expenses with the super top-up health policy. So, it could cover the cost of surgery and hospitalisation of ₹2.5 lakhs.
However, she wouldn’t have been able to cover the surgery expenses with a standard top-up health policy because the single claim of ₹2.5 lakhs is less than the deductible limit.
A super top-up health insurance plan helped Ramya wade through the murky and tempestuous waters of an accident, the subsequent surgery, and a difficult recovery without having to worry about how she was going to be able to settle her medical bills.
Not only does our MediCare Plus Plan allow you to customise and enhance your health insurance coverage, but it also ensures that if any coverage is missing in your basic medical insurance plan or a group mediclaim policy, you can have those benefits in your top-up health insurance plan.
Example 3
Mr Amish was enrolled in a group health insurance plan courtesy of his employment at a multinational corporation. Initially, he thought that this plan was enough to cover any future health issues.
However, when his close friend Gia had a cardiac arrest and underwent a stent insertion, Amish realised that the health insurance coverage would be inadequate.
Therefore, Amish went ahead and purchased our super top-up health insurance policy online in a few simple steps to enhance coverage.
With the TATA AIG MediCare Plus Plan, he got several benefits he did not have in his previous policy, including AYUSH benefits and an optional global cover.
Also Read: Cardiac Cover Health Insurance Policy
Super Top-Up Health Insurance as a Standalone Health Policy
A super top-up health insurance policy can also be used in isolation. For instance, consider that you purchase a super top-up health policy of ₹10 lakhs with a deductible of ₹2 lakhs.
Suppose you incur hospitalisation expenses of ₹2 lakhs, ₹1.5 lakhs and ₹3 lakhs during the policy year. In that case, if you pay the deductible of ₹2 lakhs, all further expenses for the policy year will be covered under the super top-up health insurance policy.
The premium for a super top-up health insurance plan will be slightly lower as it includes a higher deductible.
Top-Up vs Super Top-Up Health Insurance Plan
| Differentiating Factors | Top-Up Health Insurance Plan | Super Top-Up Health Insurance Plan |
|---|---|---|
| Coverage | Offers additional health insurance coverage beyond the deductible limit. And the deductible applies to each individual claim. | Offers additional health insurance coverage beyond the deductible limit. And the deductible applies to total medical expenses for the policy year. |
| Claim | Each claim must exceed the deductible amount to be eligible for the coverage. | Once the total medical expenses in a year exceed the deductible, all future claims are covered. |
| Usage | Generally used in addition to a base health insurance policy | Can be used with a base health insurance policy or as a standalone policy. |
| Suitable When | There is a large one-time hospitalisation, such as treatment for a critical illness. | There are multiple medical treatments or hospitalisations in a year. |
How to Use Top-Up Plans for Better Coverage?
Enhancing health insurance coverage with top-up health insurance and customisation requires careful consideration of key details. Before you purchase a top-up health insurance policy, you can consider the following aspects to make a well-informed decision.
Determine the Additional Coverage Required
While it is difficult to calculate the exact additional coverage, you can determine the approximate coverage by considering certain key factors.
Some of the key factors are your age, current health condition, potential health risks due to your occupation, family medical history, critical illnesses and pre-existing illnesses.
Consider the prevailing cost of medical treatments
Analyse the cost of medical treatments for some of the most prevalent diseases or illnesses in your locality. Consider the advancement in medical treatment procedures and the related costs.
The costs are expected to increase due to medical inflation. You can contact our customer support team to guide you in finding the coverage required.
Choose an affordable deductible
Determine the deductible that you can afford to pay before we cover the expenses. The higher the deductible, the lower the premium.
Consider your financial situation, emergency funds available or any other source that can help you pay the deductible to decide on the amount.
Determine how you want to include the top-up health insurance coverage
You can customise health insurance with top-up plans for individual requirements or family healthcare needs. For instance, you can get a family floater policy for your family or health insurance for parents and purchase a super top-up plan for additional coverage.
It can be particularly beneficial for expensive medical treatments, such as in the case of critical illnesses.
Consider the coverage offered
While you determine the coverage required and the deductible amount, consider the coverage offered under the super top-up health policy.
Understand the inclusions, exclusions, flexible health insurance options and the specific policy conditions.
Check the waiting period
Determine the waiting period applicable to certain health conditions. For example, waiting periods are applicable to pre-existing illnesses and certain specific illnesses.
Review the list of these specific illnesses and the applicable waiting period before purchasing the super top-up health policy.
Determine the policy conditions and claim process
Keep yourself well-informed of the policy conditions that apply to the top-up policy activation and the process for claim settlements.
TATA AIG offers hassle-free claim settlements online in a few steps. You can refer to the steps for the claim process.
Benefits of Customising Health Insurance with TATA AIG Super Top-Up Plans
A higher health insurance coverage at a lower additional premium;
Comprehensive coverage, including hospitalisation, pre-and post-hospitalisation, critical illnesses and AYUSH treatments;
Access to cashless insurance at a wide network of hospitals across the nation;
The security of a TATA promise;
A paperless application and policy delivery that ensured no harm was caused to the planet in the process;
The facility of a seamless claims process;
Round-the-clock assistance from the TATA AIG support team;
An association with an insurer that has a high claim settlement ratio;
A tax deduction benefit of up to ₹25,000 for individuals below 60 years of age and ₹50,000 for senior citizens.
Explore TATA AIG MediCare Select - A Fully Customisable Health Insurance Plan
Looking to personalise your health insurance? Explore TATA AIG MediCare Select for extensive, flexible and need-based coverage. Here are some of its key features:
Sum Insured- Choose between ₹5 lakhs and ₹300 lakhs.
Policy Term- Available for 1,2, or 3 years.
Plan Type- Offered as individuals and family floater plans
Restore Infinity Plus- Get unlimited restoration of your base sum insured whenever both the sum insured and cumulative bonus are fully utilised.
Optional Covers- Choose add-ons for consumables, maternity care and reduction of maternity care waiting period. You can also opt for unlimited coverage for one admissible claim during the lifetime of the policy, full access to the sum insured anytime for multi-year policies and more.
Available Riders- The supercharge bonus rider offers a 100% sum insured bonus every year, while the OPD rider covers consultations, dental, vision and teleconsultation. We also have the EmpowerHer rider for women-specific coverage, including consultations, PCOS treatment, cancer screenings and more.
Conclusion
By buying a health insurance top-up plan, Lekha, Ramya and Amish could enhance their medical insurance coverage as well as customise it. You can also do the same and be assured of adequate health insurance coverage.
Super top-up health insurance plans offer extensive coverage that helps you cover medical expenses beyond your existing health policy. It gets activated after the deductible is paid and offers comprehensive protection at a lower premium.
It is easy and safe to buy health insurance online at our TATA AIG official website. With just a few clicks, you can take considerable strides towards protecting yourself against any health-related mishaps.
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