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The average medical cover provided by an employer is generally in the range of Rs 3 Lakh to Rs 5 Lakh, however considering the medical expenses in current medical settings, do you think that the coverage by the employer is enough?

Yes and No.

Yes because:

  • 85% of treatments currently in India get done within 3-5 lacs.

No because:

  • The cost of healthcare is increasing exponentially. It is increasing at a much higher rate than normal inflation and our normal salary increases per year. So the gap is fast increasing and Insurance can cover that gap.
  • New diseases every year like Ebola, Corona, Swine Flu etc., are further increasing the risk.
  • Advancement in medical technology like Robotic and stem cells are blessings for mankind. But these blessings come at cost.

Around 3-5 lacs expenses on health care may not impact my lifestyle. We can always depend on my friends and relatives or on my savings. But imagine if the treatment cost goes beyond 20 lacs or 40 lacs.

It happens in accidents, cancer, joint replacements, heart attacks, kidney transplantation etc..

Many of us will go back 2-5 years financially. Many will have to sell their houses to cover the cost.

This is when we actually need health insurance.

This is where Super Top Up Health Insurance helps.

It covers higher value of claims and surprisingly very low cost of premiums. It does not cover the lower value of claims and that can be covered from your pocket or from your employer group health insurance or from any other regular health insurance policy.

In-fact it is a wise idea to first cover ourselves with a higher amount of claims through Super top up Insurance and then if our budget permits, we can cover for a lower amount of claims too

Mr. Raju had a major surgery for which the medical expenses were Rs 9 lakhs. His insurance policy provided by his company had a threshold limit of Rs 3 lakhs. When his boss asked how he would manage the rest of the expenses, Mr. Raju said that he had a Super top-up plan.

A regular health insurance policy has a sum insured limit, beyond which it does not cover any expenses. This is when a Super top-up policy is useful. It becomes effective soon as the sum assured from a health plan is exhausted. Therefore, Ms.Raju can claim the balance amount of Rs 6 lakhs from his super top-up health cover. So essentially, he has a super top up plan with a deductible of Rs 3 lakhs.

Let’s say you have taken two policies

  • A Normal Health policy of 3 lacs and (it could be your corporate policy or you may choose to cover up to 3 lacs from your pocket.)
  • Super top up policy of 10 lacs with 3 lacs deductible.

Case 1: If the claim is for 9 lacs

Policy 1: will pay 3 lacs which is equal to its sum insured. If you don’t have a base policy or corporate policy, then this amount will be paid from your pocket.

Policy 2: This policy will pay above 3 lacs (which is deductible). That means 6 lacs (9-3=6) will be paid from this policy.

You will still have a balance sum insured of 4 lacs (10 lacs – 6 lacs = 4 lacs) in the super top up policy which can be utilised in any future claims.