With the advent and spread of the Coronavirus all over the world, the state of healthcare and our own attitudes towards personal care and health finance came into sharp focus. The virus made us all introspect about our health, how we deal with medical emergencies, and if we are adequately prepared to meet future health shocks. Those who had not purchased health insurance till the time COVID struck, decided to do so to protect themselves and their families.
But if you purchased a health plan, did you ensure that it provided adequate coverage for every eventuality? Maybe you need a good primary health plan supported by a super top up health insurance policy. In any case, read on for more information.
On second thoughts, do I need health insurance?
The simple answer to this question, whatever their age or economic background, is ‘Yes’. It’s akin to asking if you need a security net for future eventualities – will you ever refuse one? In the same vein, you cannot take chances with your own future health and that of your loved ones. You might all be young and relatively healthy today. But the future might bring injuries, chronic illnesses, or even serious disorders that require long term treatment and hospitalisation.
Health insurance is not just about protecting yourself and your loved ones against future unknowns. If there have never been major illnesses in the home, you may not be fully aware of the prohibitive costs of treating yourself or a family member in India. The costs are high to begin with – even a single night of hospitalisation, medicines, doctors’ visits, treatment and surgery, etc. can set you back by thousands, if not lakhs of Rupees when treated in a private facility. Quality health care comes at a high premium in India, and not everybody is adequately prepared to meet these costs when a medical emergency arises.
Health insurance plans are designed to bear the financial pressure of a medical emergency, by paying for treatment, hospitalisation, diagnostic tests, etc. Some of the best health plans in India even cover ambulance costs, post-operative care, critical illness riders, etc.
Thus, if you want yourself and your loved ones to be protected against future health scares and the resulting financial setback to your income, you must invest in a good health insurance plan right away.
The kinds of health insurance to consider…
Individual health insurance plans cover only one person. You may buy it for yourself or a dependent immediate family member, provided you pay their annual premiums
Family floater plans cover the costs of the entire family, comprising yourself, your aged parents, spouse, children and dependent siblings. The sum assured of the plan can be used by any of the insured members, or it can be split between one or more in a year
Group health insurance policies are offered by one’s place of employment. These are generic policies that offer a certain sum assured amount to the insured in case of illness, treatment or their unfortunate demise
What’s a super top up health insurance policy? And why should I get one?
The super top up health plan is where the health insurance arena becomes interesting. For the uninitiated, there is a factor known as a ‘deductible’ ingrained in every health plan. This is a threshold over which the plan does not pay the sum assured.
For example, suppose that you or a family member are hospitalised for treatment and the bill racks up to Rs 10 lakh. Your primary health insurance policy has a sum assured of Rs 8 lakh. The remaining Rs 2 lakh would not be covered by the same health plan in that year, since the entire threshold is exhausted. You must pay the balance sum from your own pocket
However, if you have a super top up health policy, it pays the remainder of the bill. It is designed to provide reimbursement over and above the deductible of your primary health plan. Do note that its benefit comes into play only after all the sum assured money on the primary health insurance is consumed, or you have paid the costs up to the deductible, and not before.
The top advantages of taking the super top up health insurance plan are:
– You can choose the deductible. As the policy buyer, you have the freedom to select the deductible option depending on the sum insured of your primary plan
– You get a cumulative higher sum assured with both the base health plan and the super top up plan. This is an advantage when the hospitalisation and treatment costs are high. You don’t need to defer treatment or take the same from an inferior facility to save costs, if you have a high sum assured to pay the expenses.
– It covers eventualities that a group health plan or generic basic health policy may not, such as critical diseases and AYUSH treatment.
– It offers tax benefits under Sec 80D of the Income Tax Act, 1961
I already have a family floater plan with a high sum assured. Do I need super top up health insurance?
A super top health plan coverage is recommended for those with family floater plans, though those with individual coverage may also take it. In the case of a family floater, suppose one individual is hospitalised and consumes the entire sum assured, another family member may not be able to avail of the plan’s benefits. This happens commonly with families that have senior citizens, and who have a higher propensity for illness and treatment than others in the family.
In this case, the super top plan’s benefits can help pay for another family member’s treatment. The same benefit can be derived on individual plans if the insured person has consumed the entire sum assured in a single course of treatment and hospitalisation.