Personal Finance

Ways to boost your health insurance

Dhuraivel Gunasekaran | Updated on April 21, 2019 Published on April 21, 2019

Opt for a base health plan with restoration feature, and add a super top-up to it

Healthcare costs in India have been rising at a double-digit rate over the past few years.

The mediclaim insurance provided by your employer or the personal health policy that is taken for a sum insured (SI) of ₹2-3 lakh may not be sufficient to meet your future medical expenses.

Hence, along with the regular health policy, opt for a super top-up health plan for a cost-effective combo that will enhance your health cover with a lower premium.

Super top-up plans

Super top-up plans are similar to regular insurance plans, but will reimburse you only if your hospital bills cross a certain threshold, called a ‘deductible’.

For instance, if you have a top-up plan with a deductible of ₹3 lakh and an SI of ₹10 lakh, the top-up plan will come into force only once the combined medical bills in a policy year exceed ₹3 lakh, and it will reimburse you only for the amount exceeding ₹3 lakh. You have to pay the ₹3 lakh from your pocket or your existing regular health policy.

Since these top-up plans have a deductible, insurance companies consider them less risky and are made available at relatively low rates.

Super top-up plans score over the other variant — top-up plans. In top-up plans, insurers reimburse up to the SI only if every single claim amount individually exceeds the deductible.

But in super top-up, multiple claims in a policy year are summed up and the reimbursement is made once the aggregate amount exceeds the deductible.

Cost-effective

HDFC ERGO my: health Medisure, ICICI Lombard Health Booster, Bajaj Allianz Extra Care Plus, Apollo Munich Optima Super and Religare Enhance are some of the super top-up plans currently available.

For a 30-year-old man, his wife and two children (family floater), a super top-up plan with an SI of ₹10 lakh and a deductible of ₹5 lakh will have a premium of ₹3,500-7,600.

Having a super top-up plan along with a base health policy with an SI of ₹3-5 lakh will lower your premium.

The premium charged in a regular health policy with an SI of ₹5 lakh for a family (two adults + two children) will be ₹15,000-17,000.

Hence, for a total cover of ₹15 lakh, the aggregate annual premium would be ₹20,000-22,000.

But if you buy a base health policy with an SI of ₹15 lakh, it will cost you ₹23,000-30,000.

Restoration benefit

Buying a base health policy with a restoration or recharge or refill feature will also enhance your health cover. It is a benefit that reinstates the entire SI in a policy year when it gets exhausted due to incurred claims.

This is more beneficial under family floater plans, wherein there is a chance that the entire SI may get exhausted due to a serious illness of a member, leaving the other family members vulnerable without a health insurance cover.

In such a situation, the insurance company immediately restores the entire SI (usually just once in a policy year) without you having to pay an additional premium. This can be utilised for any subsequent claims in the same year.

Almost all comprehensive health policies including Apollo Munich Optima Restore, Star Health Comprehensive, Max Bupa Health Companion, CignaTTK ProHealth, HDFC ERGO Health Suraksha Gold Regain, Aditya Birla Activ Assure Diamond and Reliance Health Gain offer such restoration benefits.

The premiums for these policies are slightly higher than the regular plans’, and the restoration benefit comes with different conditions.

Check them before buying. Here are a few.

One, most health policies restore only upon complete exhaustion of the SI. However, some policies such as Max Bupa Health Companion refills the SI even in case of partial exhaustion of the base SI.

Two, most policies do not offer the restoration SI for the same illness for which you had made the claim in a policy year.

However, Bajaj Allianz’s Health Guard and Star Family Health Optima-recharge allow to utilise the restored SI for the same ailment for which you had made the claim during a policy year.

Three, most policies recharge the SI only once in a policy year.

However, Religare Care offers unlimited recharges during a policy year, provided you pay for an add-on which costs around ₹1,000 for a ₹5- lakh SI.

Published on April 21, 2019

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