Everything you need to know about top-up health insurance plans

Top-up health insurance can be taken as an add-on policy with any health insurance policy, with the same or a different insurer. Top-up plans come with a ‘deductible’ or threshold limit, which is chosen by the insured at the time of purchase. In case of a claim, the amount equal to the deductible is borne by the insured or by the existing policy, the balance is paid by the insurer.

Deductible

Insurance firms disclose a range of options for the minimum and maximum amounts of deductible and sum assured. Deductible should not be more than what the insured (or basic health policy) can comfortably pay in case of an emergency.

Premium

Premium is a function of the age, sum assured and the deductible. Higher the deductible, lower the premium.

Exclusions

One must check whether expenses towards day-care procedures, pre-existing diseases, pre and post hospitalisation are included.

Proposal form

The proposal form must be filled up by the insured, including the personal details, the plan chosen, health details and information about any existing health insurance.

Age and tests
The eligibility age is typically 18 years, but some floater policies may be available to infants as young as three months. Requirement of medical tests also varies across insurers.

Super top-ups
Some top-up plans get activated if the single claim amount exceeds the deductible. Super top-up plans offer the benefit of aggregate claim over a certain period.

Points to note

1. Free look-in period facility is available for top-up health insurance plans.

2. Income tax benefit on the premium paid under section 80D.

3. In case of a floater top-up policy, the deductible may be applied to each individual claim and not in aggregate.



Courtesy Centre for Investment Education and Learning (CIEL). Contributions by Girija Gadre, Arti Bhargava and Labdhi Mehta.