Life is an unpredictable journey. It can take sharp, fatal turn at moments, which are capable of leaving one physically, mentally, emotionally and financially bruised.
Many of us ignore buying a personal Health Insurance plan (Mediclaim). Many of us also think that the mediclaim coverage provided by the employer is sufficient enough to cover any unforeseen medical expenses.
In my experience, the average medical cover opted (personal health insurance) or provided by an employer (group mediclaim) is generally in the range of Rs 3 Lakh to Rs 5 Lakh. Do you really think that this coverage is sufficient? What if the claim amount is more than the coverage amount? Can you afford to pay for the medical expenses out of your pocket? Do you agree that medical expenses are increasing at a very fast rate every year?
But, we are also aware of the fact that the premiums of health insurance plans are increasing every year. For some of us, the premiums are unaffordable. Also, it is not practically possible for everyone to increase the premium of their existing plan, or buy another mediclaim policy.
So, what are the available options? How to get higher coverage at affordable premium rates? How to deal with the inflating costs of medical treatment?
Have you heard of Top up Health Insurance plans / Super Top up Medical Insurance plans?
In this post, let us understand – What are Top up Health Insurance plans? What are Super Top up Health Insurance Plans? How does Top Up medical insurance work? How does Super Top up plan work? Which one should you buy, a Top up plan (or) a Super top up plan? Frequently Asked Questions (FAQs) on Top up Health Insurance Plans / Super Top up Health Insurance Plans.
What are Top up Health Insurance Plans?
Top up health insurance plans are a unique type of health cover policies that offer you (insured) an additional coverage, which is beyond the “threshold limit” (or) the maximum limit of the existing health insurance policies.
For example – Let’s say you have an Employer’s Mediclaim policy for Rs 3 Lakh and also a Top up Health cover for Rs 10 Lakh with the threshold limit (deductible) of Rs 3 Lakh.
If there is a claim for Rs 5 Lakh, your mediclaim policy (employer’s) will pay Rs 3 Lakh and the remaining claim amount of Rs 2 Lakh will be covered by your Top up policy.
So, such Top up health insurance policies come handy when the threshold of the existing health cover is already used or exhausted and there are some medical costs left to deal with, which would otherwise exert pressure on your financial savings. (To buy a Top up plan, it is not mandatory to have an existing health insurance policy. The threshold limit is the mandatory deductible, which can be borne by you or by your existing health insurance policy i.e., your company’s or personal regular health insurance policy)
How does Top Up Health insurance plan work?
Top up plans work on ‘per hospitalization’ basis. A Top up plan will pay you, if your claim amount for a single hospitalization is above the threshold limit.
Example – Mr Kejriwal has a personal Health Insurance policy of Rs 3 Lakh and also has a Top up health cover of Rs 10 Lakh sum assured, with the threshold limit of Rs 3 Lakh.
Scenario 1 – If there is a single claim of Rs 2 Lakh in a year, his regular policy will pay Rs 2 Lakh.
Scenario 2 – If there is a single claim of Rs 5 Lakh in a year, his regular policy will pay RS 3 Lakh and top up plan will pay the remaining Rs 2 Lakh.
Scenario 3 – If there is a single claim of Rs 10 Lakh in a year, his regular policy will pay Rs 3 Lakh and the remaining claim amount of Rs 7 lakh will be paid by the Top up plan.
Scenario 4 – If there are two claims in a year, one for Rs 3 Lakh (Claim 1) & another for Rs 2.5 Lakhs (claim 2), regular policy will pay the claim 1 amount (Rs 3 Lakh) and the total coverage is exhausted, the claim 2 amount (Rs 2.5 Lakh) is not covered by regular as well as the top up plan. (Though he has Rs 10 lakh as a top up cover, it is not applicable for 2nd claim as the threshold limit is Rs 3 Lakh. Top up cover will pay only if the bill amount is more than Rs 3 Lakh)
What are Super Top up Health Insurance Plans?
We are now clear that the Top up plans work on ‘per claim’ or ‘per single hospitalization’ basis, they are beneficial as long as the single claim amount is above the threshold limit.
In the above scenario 4, though Mr Kejriwal has Rs 10 Lakh Top up cover, his claim amount (claim 2) will not be paid. Super Top plans will be useful in these types of scenarios (multiple claims).
Example – Mr Kejriwal has a personal Health Insurance policy of Rs 3 Lakh and also has a Super Top up health cover of Rs 10 Lakh sum assured (total coverage Rs 13 Lakh), with the threshold limit of Rs 3 Lakh.
Scenario 5 – If there is a single claim of Rs 2 Lakh in a year, his regular policy will pay Rs 2 Lakh.
Scenario 6 – If there is a single claim of Rs 5 Lakh in a year, his regular policy will pay RS 3 Lakh and super top up plan will pay the remaining Rs 2 Lakh.
Scenario 7 – If there is a single claim of Rs 10 Lakh in a year, his regular policy will pay Rs 3 Lakh and the remaining claim amount of Rs 7 lakh will be paid by the Super Top up medical insurance plan.
Scenario 8 – If there are two claims in a year, one for Rs 3 Lakh (Claim 1) & another for Rs 2.5 Lakhs (claim 2), regular policy will pay the claim 1 amount (Rs 3 Lakh) and the total coverage is exhausted, the claim 2 amount (Rs 2.5 Lakh) will be paid by his super top up plan (though the claim 2 amount is less than the threshold limit)
Scenario 9 – If there are two claims in a year, one for Rs 5 Lakh (claim 1) & another for Rs 6 Lakh (claim 2), regular policy will pay upto Rs 3 Lakh (claim 1) & super top up plain will pay the remaining Rs 2 Lakh amount (a portion of claim 1). The entire claim 2 amount (Rs 6 Lakh) will be paid by Super top up plan, as the regular policy coverage is exhausted.
So, it is now clear that Super Top up plans consider ‘the total of all the bills’ in a given year. Super Top up plans cover ‘multiple’ hospitalizations and they look at the aggregate claim. This means they put together several cases of hospitalization to calculate the deductible limit (threshold limit).
FAQs & Important points about Top up / Super Top up Health Insurance plans ;
- Is it necessary to have a regular health insurance plan? – It is not mandatory to have an existing regular or group mediclaim to buy a top up or a super top up plan.
- Is it necessary to buy a top up plan from the same company? No, if you have a health insurance policy let’s say with ICICI Lombard, you may buy a top up or super top up plan with United India Insurance.
- Why are top up or super top up plans cheap? The deductible limit makes these plans cheaper when compared to regular plans. Higher the deductible (threshold limit), lower the premiums of top up plans. Generally, Top up plans are cheaper than super top up plans.
- Can I Top up a family floater policy? Yes, Top-up policies come as individual and floater plans.
- No Claim Bonus (NCB) & Top up plans – If you have accumulated no claim bonus (for claim free years), top up / super top up plans will pay the claim amounts over and above the regular plan’s sum assured + No claim bonus amount.
- Top up plans generally do not offer No-Claim Bonuses.
- Another important point is that most of the Top-up / Super Top plans work on reimbursement basis. They will pay the claim amount after the insurer gets the details of all the medical bills, to assess whether the policyholder has paid the deductible limit by himself or through any existing health insurance policy.
- Are there any Top up plans for Parents / Senior Citizens? – Yes, some companies do offer top up plans for senior citizens. Example : United India Super Top up Plan.
- Are there any income tax benefits on Top up plans? – Yes, the premiums paid on top up or super top up plans are eligible for Income Tax deductions under Section 80 D.
- What are the important things that I should watch out for, before buying a Top up plan? – It is advisable to go through the policy wordings of any health insurance plan. Understand the important points like the duration for pre-existing diseases, scope of cover, if day-care procedures are covered, cover for pre & post-hospitalization expenses etc., (If you have an existing health insurance policy with a continuous cover for last say 4/5 years, some health insurance companies waive off pre-existing diseases condition)
Below are some of the popular & best Top up Health Insurance Plans
- Bajaj Allianz’s Top up Plan – Bajaj Allianz Extra Care plan
- Star Health’s Top up Plan – Star Health Super Surplus Insurance Policy
- United India’s Top up Plan – Top up Medicare
- Apollo Munich Optima Plus Top up Plan
- ICICI Lombard Top up Plan – Health Care Plus Insurance Plan
- New India Assurance’s – Top Up Mediclaim Policy
Latest Update : Kindly note that Apollo Munich Health Insurance is now HDFC ERGO. The holders of Apollo Munich Health Insurance policies now become part of HDFC ERGO Health Insurance.
Below are some of the popular & best Super Top up Health Insurance Plans
Super Top up plans are offered by a few very health insurance companies;
- Apollo Munich Optima Super Top Up
- United India Super Top up plan
- L & T Super Top up Plan – Medisure Super Top Plan
- Max Bupa Super Top up plan – Heartbeat High Deductible Plan (under Silver Plan)
- HDFC Ergo Health Suraksha Top up Plus
- Cigna TTK Super Top Plan – ProHealth Plus Plan (Under ‘Protect’ & ‘Plus’ Plans)
My Opinion :
Should you top up your health cover?
As health expenses increase, you may find that your base health insurance is no longer sufficient for your needs. A serious illness or accident can require long term care and complicated treatment, that can quickly become expensive and exhaust your health cover.
If you think that the sum assured of your existing health insurance plan (personal or employer’s group mediclaim) does not suffice for expenses due to illness or accidents, you may definitely consider buying a top up or super top up health insurance plan.
Before choosing an additional cover, compare the premiums of additional regular policies, top up plans and super top up plans. Do not buy Top up health insurance plans just because they are cheap, they may not serve the purpose (as mentioned above). Super Top up Plans can be the best way to enhance your total Sum Assured. Always, keep in mind about the medical inflation before finalizing the required sum assured.
In case your basic policy and the top-up policy are from two different companies, informing two insurers and getting the claim settled may be cumbersome. So, you may consider taking a top up or super top up plan from the same company (not mandatory).
To summarize;
- Top up / Super top up health insurance plans are cheaper than regular mediclaim policies.
- You can buy them to enhance the basic sum assured.
- Top up plans are beneficial when the claim amounts are over and above the threshold limit.
- If you have an employer’s mediclaim policy, consider buying a top up or super top up plan.
Secure yourself with Super top up cover and never worry about your medical expenses again.
Did you like this post? Kindly share your views & comments. Cheers!
Continue reading :
- HDFC Ergo my:health Medisure Super Top Up Health Insurance Plan : Features, Benefits & Review
- 11 vital factors to consider when choosing the Best Health Insurance Plan!
- Difference Between Individual (Personal) & Employer based Health Insurance Plans – Pros & Cons
(Image courtesy of Mister GC at FreeDigitalPhotos.net)
Deat Sreekanth,
If I have 2 base health policies from different insurance companies ( say 5 lacs each) in case of a claim for 8 lacs, can I claim from both polcies? till how much max sum insured and how many claims I can use from both base policies? Will this be useful instead of taking a super top up plan. Please clar this doubt. or better to have one more super top up?
Thanks,
Venkat.
Dear Venkat,
You may go through this wonderful article – Claiming from Multiple Health Insurance Plans
Dear SR
Is Star Health’s Super Surplus health Insurance Plan a Super Top Up Health Plan ???
Dear
I believe its is Top up plan and not Super top up one. Do check with them!
Star Health’s Top up Plan – Star Health Super Surplus Insurance Policy
Sreekanth,
Also please confirm if we have base policy and super top up from different companies , supertop claim cannot be cashless?
Thanks
Venkat.
Dear Venkat,
Yes, can be from two different insurers.
But, it makes sense to have both the plans from the same company but not mandatory though.
Most of the super top up plans work on ‘reimbursement’ basis.
“Another important point is that most of the Top-up / Super Top plans work on reimbursement basis. They will pay the claim amount after the insurer gets the details of all the medical bills, to assess whether the policyholder has paid the deductible limit by himself or through any existing health insurance policy.”
Hi Sreekanth,
I Have base mediclaim health policy of 7 Lacs from Oriental. I am planning to take super top up with 10 lac deductible and 10 lac sum insured. please let me know if it is a wsie choise. Thanks
Dear Venkat,
Any specific reason for not taking deductible as 10 Lakh and not Rs 7 lakh ??..
Sreekanth,
I am planning to increase the base cover from 7 to 10 soon that’s why pls suggest.
Dear Venkat.. You may kindly go ahead!
Advisable to have high SA under a mediclaim plan..
Assume I take 1 lacs critical illness policy at the age 45, the premium is 2500 per year. By the age of 85 the premium is around 35000. If you calculate the premium from age ot 45 to 85, I would have paid more than 1 lacs as premium for 1 lac critical illness policy. Can you pls explain me how come is it worth to pay more then the sum insured for critical illness policy Or could you pls explain with example for critical illness policy understanding.
Dear JP,
What if there is a scenario where-in the policyholder claims the insurance amount in the first year itself??
Insurance is not an investment.
[…] can purchase a super top-up plan from a different insurer than your current one. The claims process is easier though, with a single […]
Star health wordings : Super topup plan. What does “waiver of Deductible” mean and what is “option is exercised”
Waiver of Deductible : The Proposer can opt at the beginning of 6th year before renewal of
this policy or later during any successive renewal, for an Indemnity Health Insurance policy
without defined limit offered by the Company with continuity of benefits for the average sum
insured of immediately preceding 5 years period subject to the following :-
ü All Insured Persons are insured with the Company for the first time before the age of 50
years and have been continuously renewed without any break
ü No claim has been made during the immediately preceding 5 years
ü This policy shall not be further renewed if the option is exercised
Dear JP,
The mandatory ‘deductible’ limit gets waived off (optional) after 5 policy years. If this waiver is opted, the current policy may cease to exist and a new indemnity policy will be issued.
Deductible is applied under each and every claim for ‘Silver’ plan. The above option is available for ‘Gold’ plan.
whether it is possible to claim medical bill both by insurance company and CGHS
Dear jyoti .. Yes, it is possible (assuming you are referring to different claim amounts..)
What does this mean, can you explain with example, this is in super topup plan in united india insurance. your expert explanation will help me to understand pre-existing clause
4. EXCLUSIONS:
The company shall not be liable to make any payment under this policy in respect of any expenses whatsoever incurred by
any Insured Person in connection with or in respect of:
4.1 Any pre-existing condition(s) as defined in the policy, until 48 months of continuous coverage of such insured person
have elapsed, since inception of his/her SUPER TOP UP MEDICARE Policy with the Company.
Pre-Existing Condition/Disease definition – Any condition, ailment or injury or related condition(s) for which insured
person had signs or symptoms, and/or were diagnosed, and/or received medical advice/treatment, within 48 months
prior to his/her SUPER TOP UP MEDICARE policy with the Company.
N.B.: In case of persons having any other Health Insurance Policy from any Company with a Sum Insured above
Threshold Level at the time of taking this policy, the exclusion period of 48 months for Pre-existing Disease/Condition
will be reckoned from the date of inception of the policy for such portion of Sum Insured, including Cumulative Bonus
earned if any, above the Threshold Level. If expiring policy sum insured has increased over the years, the 48 months
of continuous coverage has to be completed for the incremental sum insured.
Dear JP,
1 – The pre-existing Diseases are covered after 4 years of policy inception. Looks like, this is applicable for stand-alone Super top up policies.
2 – If one has an existing Mediclaim policy for say Rs 5 lakh and Rs 2 lakh is the Threshold limit, then the SA above the threshold limit (Rs 3 lakh) will have 4 year pre-existing disease clause applicable to it..
Any increase in the SA over the policy duration, that incremental hike SA has to meet the 4 year pre-existing diseases clause..
You may kindly cross-check this with the Insurer as well..
Sir,
I have INDIVIDUAL MEDICLAIM policy of my mother since year 2005 and its being renewed continuously with out any gap. The policy in the year 2018 has been increased from 200000 to 500000. my question is will the policy can be claimed 500000 in case of any hospitalization or we have to wait for 4 years wait time for pre-existing issues for upgraded 300000 lacs amount. In the year 2019 can I increase the policy amount to 8 lacs. again the same question, when I increase from 5 lacs to 8 lacs, should i have to wait 4 years for pre-existing issue. the policy name is INDIVIDUAL MEDICLAIM which is not available for new takers, its available only for renewal.
Dear JP,
Normally, the pre-existing diseases (if any) will be covered within the new coverage amount.
However, advisable to get this checked and confirmed with your Insurer.
Many thanks, let me check with Insurer. I have a different question. Can a senior citizen star health can be ported with normal PUS insurance. The PUS insurance company are interested in accepting our application. The new plan does not have co-pay. Will the new insurance company will treat the senior citizen claims as with other claims which does not have co-pay.
Dear JP,
Yes, can..
But, did you check with other features and T&Cs (of the new Insurer)?
Excellent article again. Thanks !
I have a basic 3 lakhs policy from United India covering me (father) and my 4 year old which is expiring in Nov 2019.
My wife is moved back to India now and I am thinking of increasing the cover to say about 20 lakhs. My wife is also planning to start work soon and may get a cover of upto 5 lakhs from her employer.
I am confused about how to structure the policy in this scenario. Please could you give me specific tips in this regard? Please note I have read most of the articles on this blog and I think I did not see this info in them.
Other doubts I have are:
1. Say we don’t have a company insurance policy and we have to take personal health insurance policy. When super top up policy is so beneficial, why would we not just have only super top up policy?
2. Any guidelines on how to structure the basic policy and super top up policy? For example: 30% of total SA for basic and 70% of total SA for super top up.
3. If I am doctor working in a private hospital, do I have to consider any other things?
Hi,
You can check with your Insurer (United India) to add your spouse name in the existing Family floater policy.
1 – You can have. But, you need to bear the expenses till the threshold limit.
2 – No one can ever come to a conclusion as to what is the expected ideal sum assured that one should have under Health insurance plan. It is a factor of many things, can vary from individual/family to family.
Ideal way is to have a medical cover of up to say Rs 10 lakh and then Super top up it + accumulate a corpus (emergency fund) for unforeseen contingency.
3 – Do have sufficient ‘Professional indemnity insurance cover’.
Dear Sreekanth,
My father age is 75 completed. but he is having some health issues like:- normal prostate surgery done(That was not malignant), Engiograpy done before 6 yrs..and the same time BP is also detected. His 1 basic policy running from Aditya birla health insurance.
So kindly suggest me any best Super top up plan so i can make insure my father.
Dear Mohar,
You need to check with any Insurer of your choice if he is eligible to get a (regular) Super Top up policy. (They may load the premium..)
Else, you may consider taking an additional stand-alone policy for Senior citizens..
Topup is not good and Super top is good.
Reason 1: If you go for topup then every time you have to pay basic amount from basic policy or from your pocket to use top up.
Reason2: If you go for supertop up then no need to worry about every time payment from basic policy or from your pocket always you need to utilize your super top-up amount for a year.
I have employer provided Medicare policy from united India of 12L for self (age 31). And for my mom (age 52) 6L from same insurer., She has hypothyroid and anemia as existing disease.
I have one younger brother for whom I want to take health insurance and selected Religare care with 5L SI and 6300/- premium. Existing disease depression.
Now I have questions
1. Shall I take indivual policy separately for my brother and myself or any policy which can cover both of us under one family cover ?
2. Or shall I go for super top for me and individual policy for my brother?
3. Which super top up plan can be an option for my mom considering her age.
Dear Sadhli,
1 – Advisable to take separate mediclaim policies, and do disclose the existing diseases / medical treatments in proposal form(s).
2 – Have base policy (independent to your employment) and then can Super top up it. In your brother case also, same suggestion.
3 – May be from the same insurer. (Is your mother’s base policy provided through your employer?)
Thanks sreekanth.
And yes mother’s current policy is on united india through employer.
Regarding no claim bonus if I have accumulated bonus for 5 years (10l base sum and plus bonus it’s 15l) and I claim the policy 6th years how sum insurer will be calculated 7th year.
Dear Sadhli,
Kindly do not depend entirely on Employer provided group cover. Risky!
Earlier, the IRDA guidelines on NCB for Health Insurance policies stipulated that once an individual files for a claim, he/she loses the entire No Claim Bonus accrued over the years. However, this norm has now been changed.
For example, you have a 3 years and you have enjoyed 3 healthy no claim years. Now, if insurance provider increases your sum insured by 5% every claim free year, then in your 4th year, for an original sum insured of 5 lakhs, you will be eligible for Rs. 5,75,000.
If you file a claim in your 4th year, then your NCB on your sum insured will decrease proportionately by 5%. So now your sum insured for the 5th year will be Rs 5,50,000. Hence, the cycle of accumulating NCB starts again.
(This is just an example, suggest you to refer to policy wordings and T&Cs)
Understood.
I should first buy a base health insurance for my mom from same insurer and then Super top up from same insurer… am I right with the understanding ?
So NCB point is clear to me. And I think its not bad even if NCB gets reduced by 5% yearly after accumulating full bonus. Thanks again.
Is Religare a good company (in terms of how they handle grievance and queries) to buy Health insurance for my brother and me ? Reason I am asking is for 5L sum its recommended on both on coverfox and bankbazar, with super NPB till 150% and unlimited recharge once you exhaust yearly Sum insured.
Thanks lot for your suggestions.
Dear sadhli,
Same insurer or not – its purely your choice and based on your requirements.
If you are ok with its features and premium affordability, you may go ahead with Religare plan. Do disclose all the required info honestly and accurately in proposal form.
Hi Sree,
I am having an employer cover of 4 lakhs for my family of 3 (ages – 39,34,11).
1. Is it good idea to go for top up or a parallel base policy?
2. Considering retirement at 60, would it help taking a base cover now and top it up at 60? Would that save on premium as compared to taking a fresh policy at 60?
3. Should I go for a family floater or separate cover for myself and other family member? (I have some medical history)
Dear Pravin,
Suggest you to take family floater policy (regular / stand-alone) and then may consider taking Super top up plan.
Advisable to take health insurance (regular or top up) when your family is young.
In case, you had certain health challenges, you can take separate policy and your spouse+kid can take a family floater plan.
I have a health policy of Rs. 1 lakh and there is a room rent capping of 1% of SI i.e. Rs. 1000 per day. Suppose the total room rent incurred is Rs. 50000. This is for 20 days (Rs. 2500 per day). The total hospitalisation bill is Rs. 1,30,000.
Now if I have a super top up with 1 Lakh as deductible, so will the super top up policy reimburse Rs. 30,000 of room rent. Since this was capped by my base policy.
The super top up policy do not have a capping on the room rent, but they do not reimburse any deduction done due to the capping imposed by the base policy.
Dear Shyam,
So, it again depends on the terms & conditions applicable on Super Top-up policy.
I am 34 Yrs. old and covered under company group insurance with SA as 5 Lakhs. I also have a Religare Health Insurance of base SA of 7 Lakhs. Due to NCB and super NCB, SA has increased to 16 Lakhs now. If I continue not to claim anything for next 3-4 years, the SA would touch 21 Lakhs (maximum allowed). I don’t want to touch this and want to keep this amount for old age or major illness (god forbid). Also, if you claim even 1 Lakh rupees from the policy, it makes entire bonus to zero.
Now, I am looking for Super Top Up plan with deductible as 5 Lakhs (group insurance) and SA as 5 Lakhs. Idea is to have claims in this order (1) Company Group Insurance (2) Super Top Up (3) Either out of pocket in case of small outstanding or from Religare in case of Huge outstanding. Please help if this approach right. Also, what information I will have to share with different insurers. Will there be any challenges in case of claim. Can a super top up insurer reject the claim stating that I should have claimed from Religare first before raising it to them? Please help.
Dear Ankit,
As per new regulations have been put in place, you can decide to against which insurer you would like to claim. If the amount of claim is less than or equal to the amount insured then you can claim the entire insurance from a single agency.
If the claim amount meets above criteria, it is advisable to claim from Company group cover first.
Suggest you to kindly go through this detailed article on ‘how to claim Health insurance from multiple insurers?’ (ET article).
Dear Sir, I have one doubt. Some insurer provide super top up for which pre medical test is compulsory, while some don’t. Which insurer should we choose? I already have MaxBupa policy. Is super top up also available from MaxBupa? Thank you.
Dear Vivek ..Yes, super top up policy is available with Max bupa.
You can take super top up on your base policy from Max itself.
Dear Sreekanth,
this is a very nice article with very good explanation. One small doubt. When we make a claim from two different insurance companies, as both of them require original bills to be submitted. In such cases how we can get two original bills for these companies. Usually hospitals does not provide two original bills. ( In our hospital also we dont provide). In such cases how they honour the claim?
regards
RAJ
Dear Raj,
The policyholder has to inform both the insurance companies simultaneously regarding the claim. The first company that receives the original bills will share them with the other one. Also, advisable to save a copy of all the bills.
thanks a lot for clearing the doubt
regards
RAJ
hi Mr Sreekanth Reddy,
your article is quite simple but covering all aspects of policy thus very useful for a layman like me.
i need your advice.
i am a 43 yrs old executive working in a PSU that almost fully covers me and my family for all type of diseases without any upper limit and provides cashless facilities with MOU hospitals and the bills amount is also unknown to the employee.However an employee has to bear some cost of non-refundable things and partial payment of medical tests.So
1.Should I go for regular family floater plan?What would be the mechanism for interfacing between my employer’s facility and the insurer in such case?
2.Or Would you suggest me to go for a top up/super top up plan? If yes, then how my bill amount will be known to the insurers?
thanks in advance
Ranjan Sharma
Dear Ranjan…Is this cover available even after you retire from the Org?
I have check some super top up plan for my mother from apollo , religare and L&T, however when I have check the cost of these plans, their price are too steep and if When I have compared super top against policy with higher sum insured cover, there was no difference .
my mother age is 60 as of now.
I am bit confused to go with smaller cover and then super top up it or buy the policy with higher sum insured.
Could you suggest.
Dear manish ..Kindly go ahead as per your requirements & affordability.
Read: Best Health insurance plans for Parents or Senior Citizens.
dear Srikanth ,
My fathers age is 62(retd. state govt employee) and mothers age is 56 both are covered under State Govt Employees Pensioners Health Cards ,both are healthy at the moment no bp or sugar , iam confused wether to take any meidcalim policy or top up since they are already covered under NTR health plan however the wordings of the plan are (In AP, Medical Expenses Limit is Rs2,00,000. However, in the cases where the cost of treatment exceeds Rs.2.00 lakhs, cashless treatment will continue. No network hospital shall deny the treatment in such cases.) so please advice me whether that would be sufficient or take a new plan to cover extensively ,if so please advice me
thanks and regards
Anil
Dear Anil ..Whether the amount is sufficient or not, it is very tough to say and predict, am I right?
We all know that one requires lakhs of rupees for any major surgery or treatment if any unforeseen things happens.
You may consider buying at least a Super Top-up plan (floater) for them.
Thank you so much for your suggestion .
regards
Hi Shreekanth,
The policy wording for New India Top Up Mediclaim says the following…
“This policy will respond only when the aggregate of all Hospitalisation expenses (except Pre / Post hospitalization expenses) of one or all members of the policy, exceeds the “Threshold” stated in the policy.”
Doesn’t the above imply that this product is a Super Top Up plan?
—
Thanks
Hari
Dear Hari..The statement is not clear as to it is per claim’ / ‘per single hospitalization’. Suggest you to check with the company directly before buying the plan.
I just called: Each time the total cost has to be larger than the deductible. Then only the (Cost – Deductibe) will be covered by this plan. In summary: This is NOT super-top up!
wanted to take a super top up plan., Please suggest the best one among the market to avail.
Dear sunil ..Kindly go through the plans suggested in the article and pick one as per your requirements.
Kindly read below articles;
Evaluate these 11 factors when buying a health plan.
Best portals to compare health insurance plans.
Hi Srikanth,
My mother is 56 years old. since 3 years we have a Oriental Happy family floater policy. Now her office is providing corporate health care policy of 3Lakhs for their employees. Now i am planning to remove her name from oriental happy family floater since the premium is coming to 25000/- and take super top up plan for her. What insurance companies do you recommed for super top-up plans. She has hyper thyroid problem.
My one more doubt is , how to get cashless treatment if the hospital bill is more than 3Lakhs. And one more doubt is how to claim above 3 lakhs hospital bill. since, all original bills will be submitted to New India insurance for cashless treatment. What to submit to the super topup policy insurance claims department?. please reply me in detail.
Dear Mahesh,
Ideally it is not prudent to include senior or parents in family floater policy if the age gaps is on a higher side. Because the premium on floater policy is based on the senior member’s age.
May I know her retirement age? Will the corporate group cover be continued even if after her retirement?
You have to take photocopies of all bills and can get Claims settlement summary from insurer X (New India). These bills will need to get attested by the hospital and you can submit the attested photocopies along with the claims settlement summary to insurer Y (Top up). Insurer Y will then pay the remainder.
Hi Sreekanth,
I recently bought a Super Top Up from L&T, they declined my policy stating they don’t cover Non Alcoholic fatty liver i has in 2013, my recent medical reports being crystal clear and recently have purchased a life insurance
Now what do you advice?
Dear Faraaz..Based on their underwriting rules they would have declined. Did you mention about the medical condition (past data) in the proposal form? Suggest you to contact a different non-life insurance company.
Read: Best portals to compare Health plans.
Why do u suggest to go for super top up after 1 yr or two years after taking the policy.
I’m looking for an extended/top-up Health Insurance plans for dependents (Mother) heart surgery.
Currently I hold a policy of Rs 3,00,000 and cannot be claimed completely as there is a cap limit for each procedure i.e. in my case its only Rs 1,50,000.
Estimated cost of surgery would be around Rs 3,00,000 to Rs 5,00,000.
I have already enquired with HDFC ERGO, United Insurance for top ups plans but they said:
1. One cannot claim half amount from existing plan and remaining from top up plan.
2. Complete limit of existing policy should be exhausted. But we have cps limits for each procedure.
It would be great if anyone could advise some tips with respect to managing funds efficiently (i.e. any top up plans without restriction on above mentioned points or some efficient way that you have cracked)
Any immediate help on this is much appreciated.
Dear Vishnu,
The top up plans trigger after the utilization of the SA of base policy.
Suggest you to check out with other health insurance companies too.
I am working in a Central Govt PSU and covered with Employers Medical Benefit. Though there is no upper limit of SA but the hospitalization expenses are paid as per CGHS(Central Govt Health Scheme) rate. Presently I am posted in Kolkata and there are few Cashless Hospitals here. Many (though not all)of the Hospitals are empanelled under the employer and medical bills are re-imbursed after treatment as per CGHS rate.
My question is Do I need to take any Mediclaim/Health Insurance Policy? If yes, what SA should I take.
(In recent check I found my BP is 151/87 & Pulse rate is 101)
My age is 29. Weight 85 Kg, Height- 5’10”.
Dear Indrajeet,
It is advisable to have a health insurance plan which is independent of your employment.
Read : Best websites to compare health insurance plan.
Dear Srikanth
I have posted my query to know why do I need additional Health Insurance when I am being provided Medical Benifit by Central Govt till my entire life (even after my retirement) free of cost.
Would you please mind to explain the neccessacity (pros ) of taking independent policy?
Dear Indrajeet..You have not mentioned about the cover being applicable even during your retirement. Also, if there is no upper limit and you can afford to bear the expenses from your pocket and then reclaim later, you may consider not to buy an additional plan.
What about your family members? Are they covered under the same plan?
Hi Sreekanth,
Can you please help in confirming if Religare enhance is super top up or a top up plan?
I have health insurance from religare so thought of super top up from same company. Please advise on decision.
Dear Bhupendra..I believe that its a super top up plan. You may also check with the company itself.
Dear Sir,
I am 43 years old (businessmen) with a Mediclaim policy of 7 Lacs from National Insurance Co.
Now I wish to take Mediclaim policy for My wife-43 years, Son-18.5 years and Daughter-17.6years.
should I buy a Family Floater for all of 6Lacs and then take a Super Top up plan. Or shall I take a Super Top up plan for 15Lacs, with some threshold limit (say 50 thousand)?
Kindly suggest that what shall I do, please.
Dear Amit,
You may consider taking stand-alone mediclaim policies for all three. Most of the family floater plans offer health cover to kids till they attain 18/21 years only.
If you can afford the premiums, you can also buy a Super top up family floater plan with deductible (based on the regular policies Sum Assured).
Read:
Best portals to compare health insurance plans.
Best Family Floater health insurance plans.
As per my understanding, Max Bupa Health Companion is one of the best Super Top-up policy available currently. It sounds strange. But surprisingly, this plan from Max Bupa is unique since it can be taken both as a base plan or Super top-up plan. The added advantage here is that the deductible can be removed in future to covert the plan to a base policy. Also, unlike normal Top-up or Super Top-up plans, this policy provides No Claim Bonus.
Do you have any feedback about this?
Dear Mr.Mishra..Thank you for sharing the information.
Dear Mr. Mishra,
Can you please let me know what premium you paid for Max Bupa Health Companion?
Thanks
Vik
Dear Sreekanth,
Please can you let me know which of the super top up plans can be converted to a regular policy without any threshold limits? Is Religare enhance also super top up or only a top up plan?
If one has an insurance policy from employer, then will it be beneficial taking only super top ups? What will happen post retirement?
Thanks,
RV
Dear RV,
Super top up plan can be taken without having any regular plan.
After retirement, if opne deos not have a regular plan then up to the deductible amount he/she has to bear the expenses from his own pocket.
Dear , my parents have a claim free family policy of Rs 5 lacs from NICL named BOI SWASTHYA BIMA since last 7 yrs .
My father is aug 1952 born and my mother is aug 1956 born . Now i wamt to buy a top up or super top up plan of Rs 10 lacs .Kindly suggest me the best plan which could adjust with my basic policy .
Dear Avtar,
It is very tough to advise best health insurance plan.
Suggest you to kindly visit ‘Best portals to compare health insurance plans‘ and shortlist as per your requirements.
You may also go through;
Health insurance plans for Parents.
Hi Sreekanth,
Thanks for providing so much useful information. Hope you are doing great. I have a Mediclaim of Rs. 5L with Apollo Munich and now looking for a Super top-up of Rs 20L, I have shortlisted L&T Super topup .. is it a good option? Any other option you can suggest.
Dear Ashish,
It is a good option.
Kindly read this: ‘Best portals to compare health insurance plans’. This can be useful to you.
my mother age 55 have star health insurance 2 lakhs for 8 yrs i need super top up plan 10 lakhs Sum assured with best company without medical test my mother B.P so i try to top up plan
Dear feroz,
Suggest you to kindly go through the above product links and decide.
Super top up can be more beneficial.
You may also visit health insurance comparison websites.
Hi Sreekanth,
Last year I bought star health insurance policy for my parents aged 67 and 66 respectively with a cover of 2 lakh each. I need to renew the policy now but I have read very bad reviews about their claim settlement.
Please suggest if I should renew the policy or buy new policy from some other vendor.
Also please suggest if I should buy super top up policy or increase the coverage amount as 2 lakh seems to be really less in today’s time.
Dear Vibhuti,
As long as you have disclosed all the details in proposal form honestly, the company has to honor claims (if any).
However, if you are not happy with them, you may PORT the existing policy to another non-life insurance company (do not let it lapse).
Super top-up is very much beneficial, do consider it.
Thanks sreekanth for the prompt reply. Please suggest any other company which provides good insurance for senior citizens.
Also please suggest whether I should increase the sum assured or get a super top up plan in addition to the current policy of 2 lakhs.
A
Dear Vibhuti..Yes, you can surely consider opting for a super top up plan.
You may read : Best Portals to compare Health Insurance Plans.
31.10.2015
Dear Sreekanth
A very good afternoon to you and all our blog readers!
As I said earlier, I have purchased
1) Online term insurance, “HDFC Click2 Protect Plus” for 55 lacs,
2) Stand alone Personal accident policy for 50 lacs from “Apollo Munich”
3) Super top up mediclaim policy for 10 lacs with 1 lac deductible from “Apollo Munich” beside my company’s group medicliam policy for 2 lacs.
I would like to share my experience with the Companies while purchasing the policies, so that it will be useful for other readers.
1) Apollo Munich’s services are very very good, with one single personal meet at my home, just within 7 working days, I have received Policy document in hand both soft copy by email and hard copy by post. and
2) HDFC Life Insurance company, for my term life insurance, they have taken 45 days to issue a policy though it was purchased “ONLINE”. For each and every email communication, they took 3-5 working days to respond, acknowledge or confirmation whatever the communication is.
As I am 41 years old, as I mentioned “Hypothyroid and heavy snoring” in my proposal form, they have advised me to undergo medical checkup at their prescribed diagnostic centre, I have under gone. Further, they have loaded me with 90% extra premium.
Even, they have reduced my sum assured amount from 75 lacs to 55 lacs.
My over all experience with HDFC is “Very good” though it is delayed and loaded with extra premium, but they have taken all required steps, so that, I believe, when ever claim is required, my family members may not face any difficulty in claiming process.
Dear Sreekanth, Thank you for your advises through your blog, which were helpful for so many lakhs of people like me while taking such big decisions.
I would like to post the same info in your 2 – 3 relevant articles, which will be helpful for all other readers.
It is good to see that you have relocated to Proddatur, so when I visit my native place Kadapa, with your prior confirmation I would like to see you.
Thank you
Krishna KP
Dear Krishna,
I am very happy to know that ReLakhs.com helped you in making financial decisions 🙂
Thank you so much for sharing your real-life experiences with the financial service companies.
Which option under HDFC Click2protect plus did you take?
By the by, we can surely plan to meet 🙂
Are there any health policies which offer policy or top up for existing diseases .( cancer). They say that pre existing conditions are covered after a specified period (4 years or less) .but will they offer policy even for extra premium.If so please inform
Dear Satyanarayana,
Do you have any existing health insurance plan ?
My parents have a 5 lacs sum insured family floater policy from National Insurance (Parivar Mediclaim). My father is 58 years old and mother 52 years. Its a claim free policy since last 7 years. However, there is a limitation to the policy which allowes only 50% S.I as the maximum amount for one claim which limits the coverage to 2.5 lacs for my mother and father each.
Additionally i have a family floater plan from my employer covering my parents for 5 lacs. I am trying to buy a Super Top Up Plan for 15 lacs with a 5 lacs deductible limit. However, there is a condition that my father suffers from Hypertension (BP) and is on a regular medication. Moreover, he had an Angioplasty way back in 1998 and since then he is leading a normal healthy life. As he has crossed 55 years age, most companies want medical tests to be conducted. But, as we know his reports (ECG) specially doesnt come out to be perfect because of the angioplasty done in 1998. I am afraid, if we propose to buy a Super Top Up policy, this would be a big issue for my father to get coverage.
Otherwise, i had selected L&T’s and Religare’s Super Top Up Plan. Can you advice on this case. Many thanks.
Regards
Ankit
Dear Ankit,
Suggest you to consider buying an independent policies for your father and mother separately.
hello shree
I have a family floater policy of SI Four Lakhs. after the age of 55 as per the policy norms 20% co- pay for all hospitalizations upto 80 years. It means if a medical bill is 4 lakhs and 20% co pay 80,000/- I have to pay from my own pocket
So if I buy United india health super top up policy , that ratio is 3 rest to 5 and 7 lakhs
It means united india will pay that amount or i have to pay
Kidly guide me
Dear praveen..I am unable to understand this sentence of yours : ” that ratio is 3 rest to 5 and 7 lakhs”. Kindly rephrase it.
i found the artcle very useful. thanks. we are 3 seniors , self 75, wife 69 and motherin law 86! i am porting from National healths varishta to united india. because:
varishta in critical illness component (CIC) does not cover angioplasty, as per the policy. in small print it also says for bypass limit is 20% of insured amount ie rs 60000. and when one gets hospitalised for other than CIC, the max cover is Rs one lakh. it cannot be increased. i think the policy is a real rip off for seniors.
please advice on this matter: when we took varishta 7 years back we had no BP. now with age it is there though under treatment. if asked by united, is it better to declare BP and pay higher premium. if so will there be a period where they will not cover BP related surgeries like angioplasty or by pass?
very informative article. thanks for the same. we are family of 3, self 75, wife 69, mother-in-law 86! i am shifting from national insurances varishta mediclaim to united india insurance, because:
varishta’ s critical illness component does not cover angioplasty (as mentioned in the policy). it covers by pass surgery but limit is 20% of insured amount. i guess this limits the expenses paid to rs 60000, which is a measly amount.
other than critical illness component, cover is max rs 1 lakh. so if one gets hospitalised due to other than critical illness, what one gets is peanuts. i think the policy is a rip off for seniors.
please advice on this matter- when we took varishta about 7 years back we did not have BP. now when i port the policy to united, is it better to declare the BP which has come with advancing age and under medication, and pay additional premium if asked ?
Dear Subbarao,
It is advisable to disclose all the details pertaining to Pre-existing disease(s) (if any) while shifting from national to united.
Hello Sir,
I am 24 years old and I have a floater policy (Group Policy) from Company’s side (Of UIIC-Tailor made policy). Sum Assured is Rs. 4 lacs. I have a younger sister who is 20 years old. My parents are 51 years old. I want to provide my family a larger cover, with minimum premium possible due to financial burdens. Keeping in view the age constraints and the situation in which after marriage, they no longer be covered, Please suggest a good policy such that they are covered for maximum possible tenure. Please help. Thank you so much.
AkG
Dear AKG,
Suggest you to buy an independent mediclaim policies for three of them. Consider policies provided by United india / national insurance / star health.
Pl refer to your reply dated July 15,2015 to a query by Mr Anurag Kalra. His query was that if he has a base plan cover of Rs. 3 lacs and if he buys an additional super top plan of United Insurance, then whether the total c over available to him would be 3+7=10 lacs or 3+4=7 lacs. You have mentioned 7 lacs. I believe your reply requires more elaboration else it is confusing. I believe that the Total cover available to Mr Anurag would be 10 lacs [3 from base policy and 7 from super top us] ;whereas the liability of United Insurance would be limited to 7 lacs beyond expenses of 3 lacs. Please confirm if I am correct or not. Example : if the bill is 11 lacs. 3 lacs would come from the base policy. 7 Lacs from supertop up and 1 lac from his own sources
Dear Aggarwal,
Yes, it is Rs 10 Lakh. I have corrected my comment. Your understanding is right.
Hi Guys ,
If Your Are Looking Good Health Insurance Policy , You can Go for , iffco tokio`s Skp, and Health Protector Series, competitive Rate and Good Penetration of Company`s Representative and Service Offices .
Under super top up policy issued by UIICL, my wife was operated for her bilateral knee replacement surgery, after 4 days of hospitalization she was discharged; she had physio-therapy treatment from a registered qualified Dr. Physio Therapist for 60 days (since the surgery was for both the legs). Is physio therapy treatment payable ? The policy conditions provide (clause 5.4) that “IN CASE OF POST -HOSPITALIZATION, TREATMENT (LIMITED TO 60 DAYS), ALL CLAIM DOCUMENTS SHOULD BE SUBMITTED WITHIN 15 DAYS AFTER COMPLETION OF SUCH TREATMENT” Pl advise.
Dear Malesha,
Looks like you can claim the expenses. Kindly talk with the company’s customer care executive or your agent.
1. United India has a super top-up plan, Insurance cover 7 lacs and threshold limit 3 lacs. This means total insurance cover is Rs. 10 lacs ( 3+7) or 7 lacs ( 3+4).
2. Can we combine 2 policies. For example if I have one policy of 3 lacs and it gets exhausted and I have another policy of 2 lacs. Can two different policies be used for one treatment in continuation.
Dear Anurag,
1 – It is Rs 10 Lakh
2 – Yes, you can claim.
Hi, I am trying to understand these concepts and this article explains what I am looking for. I still have few queries to clarify. Let’s consider the same example as above where the person has 3 Lakhs base cover and 7 Lakhs top up cover. Let’s assume this as scenario 10. What if there are multiple claims in a year with claim1 – 3 Lakhs and claim2 – 4 Lakhs ? I understand the first claim will be paid by the base policy and it will be exhausted. For claim 2, will the topup plan pay the entire 4 Lakhs or just 1 lakh after deducting the threshold limit from the claim??
Scenario 11- what if the first claim is for 2 Lakhs and he still has 1 lakh left in the base cover and he has a second claim for 4 Lakhs in the same year? How much will the topup insurance provider pay?
Dear Sabari,
Scenario 10 – Claim 2 will be covered under Top up plan as it is above the Threshold limit of Rs 3 Lakh.
Scenario 11 – Calim 1 will be paid by regular plan and Rs 4 lakh (claim 2) will be serviced by top up plan.
My father age is 58, My mother age is 54. Please suggest good health insurance plan for them alone.
Shall i go with Star health family floater.
You can go ahead with Star’s family floater plan.
Hi,
As per the different discussion – over the internet , it shows that “room rent limits” is the worst clause in buyinh Health insurence.
My under standing as per the below link
If so , then we have only 2 options
1) If we go to the Govt comp, then buy SA atleast 7-8 L
else
2) Have to go with private organization …
I guess my under standing is correct ?
Thank you,
shankha
Dear Shankha,
Kindly note that it is highly impossible to fine the best health insurance plan.
Each plan has its own merits & de-merits. So, kindly opt for a plan which meets most of your requirements.
Hi,
Can you please explain – how limitations on room rent, copay/sub limit will affect a policy with
5 L SA
Most of the Govt. sector provider (New India, United India, Oriental, National Insurance) has same type of limitations on room rent, copay.
Please explain.
Thank you,
/shankha
Dear Shankha,
For example – You may Rs 5 L policy, but if there is a sub limit for room rent say maximum allowed is Rs1k per day, you can not claim charges under room rent beyond Rs1k.
Regarding co-pay clause, the policyholder has to pay certain agreed portion of claim amount, this can be say 80:20,in this case 20% of claim amount should be paid by the policyholder and the remaining 80% will be borne by the insurance company.
Hi ,
Thank you for your reply.
I have good 8 L insurence coverage for my family , from office.
But I have to do M. Insurence personally as I am working in private sector.
As per my convenience, (Age 34 ) I can took Rs 5 L SA .
1) Should I buy Super -Top-up with this 5 L SA?
2) What will be the good amout for Super -topto with 5 L SA?
3) If I buy 5 L SA from New India and Super -top-up from United India , How the claim will be done when we go for Super -top-up ? Beacuse all original documents needs to be submitted to the 5 L SA claim.
Thank you,
shankha
Dear Shankha,
It is a good decision to buy an independent medical insurance cover. Go ahead!
Suggest you to buy a regular health plan first for Rs 5 Lakh and then may be a year after you can buy a Super Top up plan with a deductible of Rs 5L or Rs 13L .
The policyholder has to inform both the insurance companies simultaneously regarding the claim. The first company that receives the original bills will share them with the other one.
Hi Sree,
Thanks for such nice information.
Don’t we have any good term insurance plan + critical illness plans from any company , as this might be beneficial in those cases where employer is providing regular medical plan.
Dear Prashant,
SBI Smartshield has good CI rider.
But stand-alone mediclaim cover is very important as CI covers only few major illnesses.
Hello Sreekanth,
Firstly I wanted to thank you for the useful information you have posted.
My son had leukemia last year, I did the treatment thru my company’s insurance(3 lacs). The total hospital charges costed me around 11laks. Now I am planning to take my personal Family Floater plan for 5 lacs (independent plan) and also take a family floater super top up plan for 10 lacs from United India.
Kindly advice if the plan is good to go.
regards,
dinesh
Dear Dinesh,
Thanks for your appreciation!
How is your child now?
Go ahead! Do mention the treatment details in the proposal form of Family Floater plan.
Hello Sreekanth
By God grace…My son is doing good… He is into the maintenance cycle and he is going to Montessori. Secondly I wanted to ask your suggestion. I am planning to take up the family floater from Untied India. But how about the TPA service. Can I opt for Vidal Health which was formerly know as TTK. Which TPA service is good so that we don’t find any issue in the claims in the future… if in case touchwood.
kindly advice.
regards,
dinesh.
Dear Dinesh,
As long as we submit all the required details in proposal form honestly, chances of rejecting the claim are low.
I personally prefer private health insurance companies to PSU ones. (If ok, check out Apollo Munich / Star health / Cigna TTD ..)
Hello Sreekanth,
How are you doing,
Recently I enquired with one of insurance advisor (Maxbupa) regarding the Health insurance policy which I had early discussed with you. He confirmed that there are no insurance companies which will cover pre-existing disease i.e. for leukemia. I am bit tensed and worried when I heard about this. I am currently not able to think properly about my son future regarding with his health insurance. Do you know any insurance company which can cover my son pre existing disease converge.
regards,
dinesh
Dear Dinesh,
Your advisor can be right. Suggest you to check out with all major health insurance companies about this. Insurance company can cover the risk after initial waiting period for the pre-existing disease.
Kindly check out L&T insurance’s MY Health Medisure Classic plan, I believe it covers Leukemia, but has 3 year waiting period.
Thank you. Sir. I will check and keep you posted. I really want to thank you. You are really doing a great job and service. Thank you so much for your advice.
regards,
dinesh
Dear Sir,
My mother aged 66 years is covered under AP government pensioners scheme. i wish to take a supertop up policy for here. can you suggest. she is having mild hypertensive.
regards
gupta
Dear Gupta,
You may consider United India’s Super top-up plan. I have provided the link in the article itself.
You may also read my article – “Health insurance plans for Parents / Senior citizens“.
(Do mention about mother’s hypertensive thing in proposal form)
Hi
My parents have a 5 lac policy with oriental
We want to buy a top up from united india insurance now
a) Suppose mu parents make 2 claims in a year – 3 lacs and 7 lacs. Then will the super top plan reimburse the additional (7+3 – 5) = 5 lacs or it has to be a single claim ?
b) Any sub limits on different operations here in govt super top up plans?
Hi Sree,
One query regarding the claim process when you have a top up plan along with regular mediclaim policy…
Scenario: I have 3 L (Regular Cashless) + 10 L (Top Up).
Now suppose the toal bill for hospitalization is 6 Lakhs. My regular cashless policy will cover first 3 L of bill since it has tie up with hospital and the settlement of bills & documents will be done without hassles.
But for the rest of 3L bill how will I produce bills to top up insurer company, since the hospital will not issue me duplicate bills nor the top up company will entertain duplicate bills.
How does this work in such case?
Thanks,
Pawan
Dear Pawan,
If it is a cashless scenario (planned hospitalization), you may have to inform both the insurance companies (so it makes sense to have both the plans from the same company but not mandatory though).
If it is a reimbursement scenario, depending on the claim amount, you need to follow up..
Dear Sreekanth,
Your all articles are really getting useful for me.
I need your help.
I have health insurance policy with sum assured of 4 lakhs from my employer.
It is family floater plan. ( for Self+Spouse+Parents).
Recently we already spent more 3 lakhs (2 claims in 3 months) for my father’s treatment
( lungs and heart problem – Angioplasty).
Yesterday, I read your article regarding Health Insurance – Top up & Super Top up plans.
Please suggest me which super top up plans should I take ? or
Suggest me if some other plans are there…
Thanks.
Dear Jalpesh,
Suggest you to first take a Family floater plan for self & Spouse and then add a Super-Topup plan (may be after 1 or 2 years).
For parents do consider separate Mediclaim policies. Kindly read my article – ” Best health insurance plans for parents / senior citizens“.
Hello Sreekanth,
Thanks for your suggestions.
Yea, I am planning to take family floater plan for my self U& my spouse.
I am confused between ” Apollo munich Easy health standard plan” & “L&T medisure classic plan”.
Can you please help me to pick one of these ?
I saw some other plans too, but, I feel, these 2 are good plans.
Thanks.
Dear Jalpesh,
I believe Apollo would be a better choice. Do remember to provide all relevant and accurate information in proposal form.
Dear Sreekanth,
Thanks for your suggestions.
I am going to take Apollo munich Easy health plan.
Thanks again.
Dear Jalpesh..good decision..keep visiting my blog! Cheers!
Hi Sreekanth,
I have 6L floater policy (3L basic + 3L additional top up) from UnitedHealthcare through my company.
Due to cancer medical treatment for my mother, we have claimed the full amount(6L) this year. we are left with zero medical cover now.
I want to take another health plan for this year.
Which super top up plan from which company will be suitable for me?
What are the main difference from super top up plan (except premium rate) compared to basic medical plan..because when i enquired some waiting period and Deductibles rules are applied in super top up plan.. please share me your opinion..should i go for basic medical plan or super top up plan ?
Dear Jebastan,
How is your mother now? Trust she is fit and fine.
How old is she? What is your age? Other dependents details?
Hi Srikanth,
Thanks for your help!.
She is getting better now. she is 60 now. my age is 31. and my wife age is 28.
Now i will (have to) spend other treatment expense from my hand for mother since no medical insurance company will accept her for top up plan now.
But i want to take another medical plan for me and my wife since we are left with zero cover now.
Kindly recommend a suitable medical plan.
[my company medical plan will be renewed in November]
Dear Jebastan,
Kindly buy a Regular Family Floater plan (covering self & spouse) immediately. Do not depend on employer’s group mediclaim alone.
Nest year or so, you may buy a Super-Top up plan with a deductible of say employer provided cover + new regular plan’s cover.
Hi Sreekanth,
I have coverage of 3 lakhs from my company. I’m planing to take super topup for 10 lakhs with 3 lakhs deductible. Do you recommend family floater super top up or individual super top plan?
Regards,
Rajesh
Dear Rajesh,
Did you include your dependents in group mediclaim (employer’s)?
Yes. Dependents are covered.
Dear Rajesh,
Suggest you to take personal Family Floater plan (independent plan) and consider taking a family floater super top up plan (may be with employer’s + this new plan coverage amount as deductible amount, the premium can be lower because of high deductible amount).
Hi Sreekanth, thats a good suggestion. But my company provider floater plan is having portable option so i can carry forward even if i leave company. Do you think i should still buy personal family floater.
More over there is only 200 to 300 difference in premium above 3 lakhs Deductible.
Dear Rajesh,
What if your company changes the Insurance provider? (I have seen this happening..)
It is always better to have you own personal health insurance cover.
thanks for responding to my quires My last query is if i go for another individual family floater of 3 lakhs. is it mandatory to take super top with 6 lakhs deductibles or i can take 3 lakhs as per my wish?
Dear Rajesh,
It is not mandatory.
Hi Sreekanth,
Kindly suggest me the best Mediclaim policy for my parent (Mother – 63 age, Father – 64 age)
My mother has arthritis and high blood pressure, I wanted to cover pre-existing diseases.
My father do not have any diseases.
1. Should I go with Individual policy or Family Floater policy ?
2. Wanted insure for max upto 5 lac or more.
3. Also settlement ratio should be better.
4. Wanted to avoid pre-health check up (optional).
Kindly guide me with best policies in current scenario.
Dear Chetan,
Consider Star health’s Red carpet plan (or) National insurance’s Varishtha Plan.
Kindly read my article on “Health insurance plans for Parents / Senior Citizens” for more details.
Kindly provide all material facts and accurate information in proposal forms. Do not hide any facts.
Guys I gone through through the Cigna Ttk policy much competitive.
My opinion catch them