Worried About The High Cost Of Treatment For Covid ?
If you want to increase the Health Insurance coverage for COVID policy, you may like to consider Super Top up Health Insurance. This policy triggers when your existing Sum Insured is exhausted and the claim is over and above the sum insured.
The average medical cover provided by an employer is generally in the range of Rs 3 Lakh to Rs 5 Lakh, however considering the medical expenses in current medical settings, do you think that the coverage by the employer is enough?
Yes and No.
Yes because:
No because:
Around 3-5 lacs expenses on health care may not impact my lifestyle. We can always depend on my friends and relatives or on my savings.
But imagine if the treatment cost goes beyond 20 lacs or 40 lacs.
It happens in accidents, cancer, joint replacements, heart attacks, kidney transplantation etc..
Many of us will go back 2-5 years financially. Many will have to sell their houses to cover the cost.
This is when we actually need health insurance.
This is when Super Top up Health Insurance helps.
It covers higher value of claims and surprisingly very low cost of premiums. It does not cover the lower value of claims and that can be covered from your pocket or from your employer group health insurance or from any other regular health insurance policy.
In-fact it is a wise idea to first cover ourselves with a higher amount of claims through Super top up Insurance and then if our budget permits, we can cover for a lower amount of claims too
Mr. Raju had a major Surgery for which the medical expenses were Rs 9 lakhs. His insurance policy provided by his company had a threshold limit of Rs 3 lakhs. When his boss asked how he would manage the rest of the expenses, Mr. Raju said that he has a Super top-up plan.
A regular health insurance policy has a sum insured limit, beyond which it does not cover any expenses. This is when a Super top-up policy is useful, it becomes effective soon as the sum assured from a health plan is exhausted. Therefore, Ms.Raju can claim the balance amount of Rs 6 lakhs from his super top-up health cover. So essentially, he has a super top up plan with a deductible of Rs 3 lakhs.
1. A Normal Health policy of 3 lacs and (it could be your corporate policy or you may choose to cover up to 3 lacs from your pocket.)
2. Super top up policy of 10 lacs with 3 lacs deductible.
Case 1: If the claim is of 9 lacs
Policy 1: will pay 3 lacs which is equal to its sum insured. If you don’t have a base policy or corporate policy, then this amount will be paid from your pocket.
Policy 2: This policy will pay above 3 lacs (which is deductible). That means 6 lacs (9-3=6) will be paid from this policy.
You will be still having a balance sum insured of 4 lacs (10 lacs – 6 lacs = 4 lacs) in the super top up policy which can be utilised in any future claims.
A super top up comes to the rescue when a single claim does not cross the deductible limit of top up policy, but multiple claims do. Thus, if Mr.Raju submitted three different claims of Rs 3 lakhs, Rs 3 lakhs and Rs.3 lacs respectively, the top up plan would be useless since none of them exceed Rs 3 lakhs individually.
But in Super top up, all the three claims will be added up the total claim beyond 3 lacs deductible, which in this case will be 6 lacs is payable.
Thus one should always choose Super top up instead of Top up.
Insurance Company | Star | Oriental | New India | Hdfc Ergo | United India | Liberty | Bajaj | Kotak | National | Universal Sompo | Future Generali | Cholamandalam |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Entry age | 18-65 | 18-70 years. 10% loading on premium if entry is | 18-65 years | 18-65 | 18-65 | 18-65 | 18-80 years | 91 days – 65 years. | 18-65 years | 18-80 years | Any age. | Adult: 18 years-70 Years |
Premium increase | Up to 80 years. | Up to 60 years | 2.5% every year beyond 65. | Up to 60 years for Medisure, upto 70 for HS | Up to 60 years. | Up to 65 years. | Up to 70 years | Up to 80 years. | Up to 75 years. | Up to 76 years. | Up to 70 Years | |
Pre acceptance health | Not Required | Above 55 years | Above 50 years | Above 55 years | Above 45 years | Not Required. | Above 55 years | Above 50 years | 50 years and above | Above 65 years of if Sum Insured is greater than 20 Lacs. | On case to case basis | Above 55 Years. |
Pre-Existing Diseases Waiting Period | 1 year | 4 years. | 4 years. | 3 years for Medisure, 4 years for HS | 4 years. | 3 years | 1 year | 4 years. | After 1 year – 50% Co-Pay. 2 years – 25% Copay. | 3 years for Gold, 2 years for Diamond and 1 year for Platinum plan. | 2 years. | Premiere: 4 Years Supreme : 3 years |
No Claim bonus | Not Applicable. | Not Applicable. | Not Applicable. | Not Applicable. | Not Applicable. | 10% every year, max 100% | Not Applicable | 10% every year, max 50% | 5% of Sum Insured every year, Maximum 50% | 20% every year, max 100% | 10% every year, max 50% | Not Applicable. |
Pre and Post Hospitalisation | 60/90 days respectively | 30/60 days respectively | Not Covered. | 30/60 days respectively | Not covered | 30/60 for option 1. 60/90 for option 2 | 60/90 Days respectively | 30/60 days respectively | 30/60 days respectively | 60/90 – gold, 90/120 – Diamond, | 60/90 days respectively | Not covered for Premiere and 60/90 days for Supreme |
Health Check up | Not covered | Not covered | Not covered | Not Applicable | Not covered | Once in 3 years. | Not Applicable | Not Applicable | Every Year. | Not Applicable. | Not covered | |
Room Rent limit | Single Standard Private Room | Single Standard Private Room | 1% and 2% of SI of Deductible for Normal and ICU respectively. | Single Standard Private Room | Single Standard Private Room | Single Standard Private Room | Single Standard Private Room | Single Standard Private Room | Single Standard Private Room | Single Standard Private Room | Single Standard Private Room | Single Standard Private Room |
Orgon Donor | Covered. | Covered. | Covered. | Covered. | Covered. | Covered. | Covered. | Covered. | Covered. | Not covered for Gold, Covered for Diamond and Platinum plan | Covered after 2 years. | Covered. |
Ayush Benefit | Not Covered | Covered. | Covered. | Not Covered. | Covered | Optional | Upto 50K | Covered. | Covered for Diamond and Platinum plans only. | Covered after 2 years | Covered | |
Special Benefits. | Maternity up to 50K with 1 year waiting period. Recharged benefit up to the limit specified. Air Ambulance up to 10% of Sum Insured for above 10 lacs Sum Insured only. | Maternity Benefit up to 10% of Sum Insured. New Born from day 1 up to 5% of Sum Insured. Treatment in SAARC countries | Cataract up to 50K max. | Not Applicable. | Not Applicable. | Maternity Covered with waiting period of 1 year. | Double Sum Insured for Accident Claims, max 40L. Restoration of Sum Insured | Maternity Covered after 36 Months. HIV/AIDS Waiting Period 3 Months (If pre-existing, not covered) Bariatric Surgery Covered – 36 Months | Bariatric Surgery Covered for 3 lacs for Diamond and 5 lacs for Platinum plans. Not covered for Gold plan. Global Cover for 180 days. Automatic Restore benefit – Not covered for Gold, Covered for Diamond and Platinum plan | HIV/AIDS Waiting Period 4years. Mental Illness or Psychiatric Illness covered after Waiting | ||
Co-payment | 10% Co-pay If entry is above 60 years. | Not Applicable. | Not Applicable. | 10% above 80 years. | Not Applicable | Not Applicable | Not Applicable | Not Applicable | Not Applicable | Not Applicable | Not Applicable | Not Applicable |
Optional benefits. | Not Applicable | Not Applicable | Not Applicable | Not Applicable | Not Applicable | World Wide Cover Ayush Benefit. Restore Benefit. | Air Ambulance Cover | Instalment Facility for payment of premiums | Not Applicable. | Wellness Benefit. | Instalment facility for payment of premium. | Not Applicable. |
Waiting Periods for specificAilments | 30 days One years waiting period. | 30 days One years waiting period.Two years waiting period | 30 days Two years waiting period1.Four years waiting period. | 30 days Two years waiting period | 30 days | 30 days Two years waiting period. | 30 days One years waiting period1. | 30 days. Two years waiting period | 30 days One years waiting periodTwo years waiting period | 30 days Two years waiting period | 30 days Two years waiting period | 30 days One years waiting period |