Healthcare costs in India are on the ascent at a double digit growth rate. The reliance on only a base health insurance policy can thus often prove costly. In case of expensive treatments, long stays in the hospital, or a medical crisis, the base sum insured might not be enough. That is when Top-up and Super Top-up plans prove crucial. These add-ons serve as financial shields that get activated after the core policy has been depleted, providing greater coverage at comparatively lower premiums. For all families and especially retirees, such add-ons fill in the gap andprovide peace of mind and real monetary security when medical bills soar above expectation.
Top-up Plans do not get activated until the insured’s hospitalization claim meets or exceeds the pre-set deductible threshold. Super Top-up Plans, on the other hand, combine all the medical claims made within a policy year and after the total claims exceed the deductible, the plan pays for the balance. This makes Super Top-ups more useful to those with multiple claims in the same calendar year, and more particularly, the elderly or the chronically ill in need of recurrent care.
Super Top-ups are particularly useful for the elderly, families with older members, or individuals with the need for frequent medical intervention because the cumulative benefit feature in super top-ups safeguard against repeated hospitalization within a year. Though they have benefits, there are also limitations. Deductibles in case of these policies are usually high which implies that policyholders need to spend a lot before the cover kicks in. For Super Top-up policies, cashless claims can sometimes get rejected if the base and top-up policies are not with the same insurer, making settlement difficult.
Customer experiences identify areas of concern like restricted pre-and post-hospitalization cover and admin delays when policies are split over insurers. Moreover, infrequent users of health services might find it easier to upgrade their base policy rather than keep several layers of cover. Therefore, although these policies appear impressive, a closer scrutiny of their terms and conditions and likely actual usage must be evaluated prior to purchase.
Financial planners usually suggest going in for a comprehensive base health policy accompanied by a Super Top-up from the same company, as it provides hassle-free claim settlement and cashless hospitalization without bureaucratic obstacles.
For low-risk healthy individuals with minimal medical history, a basic Top-up plan would suffice. However, those with long-term illnesses, old dependents and expecting more than one claim a year must seriously consider Super Top-ups for all-round financial security. Finally, budget constraints, family medical background, location and long-term healthcare aspirations should dictate whether a top-up, super top-up, or a bigger base policy should be purchased.
In modern times, where income is outpaced by inflation and rising costs are fueled by rapid advances in medicine and medical technology, Top-up and Super Top-up health insurance plans are critical in enhancing financial readiness. They help the insured to build layered protection that guarantees access to quality care without debilitating financial costs.
For those who do not yet have a Top-Up or Super Top-Up plan, it is worth looking into the feasibility of getting one.
(Ashok Kumar heads LKW India. The views expressed here are his own)
