Your health insurance cover may not be enough!

Muktha Tavane
PhonePe
Published in
3 min readMar 10, 2022

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The average health insurance policyholder in India opts for coverage of Rs.3–5 lakh. Though this would have been sufficient a few years ago, the same cannot be said in today’s circumstances. A report from The Hindu shows that healthcare inflation has been rising in the higher single-digit over the last couple of years. Thus, a simple treatment that cost Rs.1,000 prior to the pandemic would cost over Rs.1,500 today!

Moreover, a sedentary lifestyle, pollution, stress, and poor eating habits have made dangerous and terminal diseases more prevalent across age groups. Some accidents and illnesses like cancer can cause medical bills upward of Rs. 10 lakh!

If you want to get treatment at better hospitals, you might have to shell out more money than what you probably provisioned for. For e.g., treatment at metro city hospitals cost much more than those in towns.

Considering the changing healthcare dynamic, it’s critical that you upgrade your health insurance cover.

How do you get more coverage for a lower premium? Voila … Super Top-up!

So let’s dig in to see what Super Top-up cover is and how it works.

What is Super Top-up?

A Super Top-up cover is a health insurance plan that increases your overall health cover up to Rs.1 crore, with an array of choices in sum insured and deductibles. The premium is affordable and is only a fraction of what you pay for your base cover.

Here’s how Super Top-up works

A Super Top-up plan comes into play once the threshold or deductible of the base cover has already been claimed. The remaining amount can be claimed under the Super Top-up.

Let’s understand this with the case of Mr Joshi.

Mr Joshi possesses a health insurance policy of Rs.10 lakh sum insured. During the policy period, he was admitted to the hospital for which the bill went up to Rs.21 lakh. Thanks to his wise decision to get a Super Top-up plan of Rs.1 crore with a deductible of Rs.10 lakh, he was able to claim the additional Rs.11 lakh from the Super Top-up policy, thus protecting his savings.

You should note here that claims are processed after non-medical and other miscellaneous costs not included in the plan are deducted.

Terms you should understand

If you are new to insurance, it’s good to get the hang of the jargon used. Here are two terms you’ve come across in this blog:

Base cover (or existing health cover)

The base cover referred to here is the smaller health insurance plan you may already have. That being said, it is not necessary to have a base cover. A Super Top-up plan has a deductible — as long as that’s been met, there would be no issue to claim from the Super Top-up amount.

Deductible

The deductible, in the context of Super Top-up, refers to the minimum amount of the hospital bill that needs to be covered either by existing health insurance (base cover) or out of pocket.

For instance, if the deductible for a Rs.10 lakh Super Top-up is Rs.2 lakh, and the hospital bill is Rs.5 lakh, the Super Top-up plan will cover the additional Rs.3 lakh. All subsequent hospitalisations in the same policy year will also be covered under the Super Top-up.

On the other hand, if the hospital bill was Rs.1 lakh, the Super Top-up cannot be claimed for that particular hospital bill since it is below the deductible amount.

(You should note here that claims are processed after non-medical and other miscellaneous costs not included in the plan are deducted)

By paying a small premium today, you can secure your financial future with a Super Top-up plan and live worry-free!

Sources:

https://indianexpress.com/article/business/go-for-higher-sum-assured-when-you-renew-your-health-insurance-plan-7296888/

If you are planning to buy health insurance, click on the links mentioned below to know more

Arogya Sanjeevani Insurance

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Muktha Tavane
PhonePe

Editor @ PhonePe Blog