How low can the Sum Insured of the base plan be, when purchasing a combo of base plan + super top-up?

One of the best ways to be equipped against uncertain health risks is by buying health insurance that provides financial support in times of medical emergencies. Healthcare inflation, combined with the rise in lifestyle diseases and novel virus outbreaks, means we should be prepared for future medical expenses.

In India, most people have low-cover (Base) family floater health insurance policies or employer provided insurance that may have a limited (Base) Sum Insured. Therefore, it is important to invest in a parallel and supporting health insurance plan that can offer you the right financial support. If you feel your current (Base) Sum Insured will not be adequate to cover rising healthcare costs, one option is to purchase another Health Insurance policy that will provide additional Sum Insured over and above your existing policy. Purchasing a Super Top-up plan may be a more economical option than buying a completely new policy with a higher Sum Insured. It is designed to supplement your base plan at an affordable premium.

An important point to note here is an amount called Deductible. Deductible is the threshold level fixed by the insurance company on any Super Top-up plan. A regular health insurance policy reimburses hospital bills up to the Sum Insured, while a Super Top-up plan covers  claims beyond the Deductible amount.

Some important points to note:

  • For quality health insurance coverage, ensure that your base plan equals your Deductible amount. You should use your base health insurance policy for expenses up till the Deductible and use your Super Top-up plan for additional claims.
  • Other important considerations while selecting a Super Top-up plan include options like no-claim benefits, maximum pre, and post-hospitalisation coverage, cover for the organ donor and the option to renew the policy annually and lifelong.
  • Pro: A big benefit of Super Top-up policies is that they come at a very low premium, primarily due to the deductible clause. These plans are available in both individual and floater options.
  • Con: A key watch out is that hospitals today may not yet be geared to handle cashless settlement for the top up policy. So you may have to pay out of pocket and get reimbursed later from within the top up policy. In which case, you need to ensure that a full set of original or certified true copies of bills and reports are submitted to the insurer for top up.
  • Additionally, premiums paid for a super top-up policy are eligible for tax deduction benefits under Section 80D.

A factor to keep in mind regarding your Base Sum Insured amount is - if the coverage amount is too low, some advantages of a comprehensive health policy with adequate cover may not hold. For example, uncapped room rent coverage and coverage of all day care procedures may not be present in a low-coverage base policy. Additionally, a low coverage policy may also put restrictions on the treatment of certain diseases.

It is always useful to have the top up cover from the same insurer as then you need to submit your cashless request only once, to the insurer under both the base and top up insurances. It becomes a seamless process to get claims under both the policies. However, if you find a suitable plan from another insurer, then make sure that both the insurers are informed simultaneously when being admitted to the hospital.

SANA.Insure is here to help you compare multiple plans with numerous benefits and features, to help you choose both the best base health insurance policy and the right Super Top-up plan.

SANA.Insure is a health insurance portal that conveniently provides access to complete information on various health insurance plans in India. You will be provided expert advice and can select the ideal plan that fits your specific needs. For assistance with any health insurance related query, you can chat with us on WhatsApp at 8278271818, or call our toll-free number at 1800 202 8118.

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