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What Is Top-Up In Health Insurance Policy Coverage
Healthcare costs have risen, and the importance of tending to ailments has also increased. Having proper comprehensive health insurance coverage is extremely important during this time.
However, depending on your circumstances, even the best basic health plans may not suffice to cover all your medical expenses. This is where the health insurance top-up plan comes into the picture. This plan can offer an additional layer of financial protection and cover expenses that might not be covered in the basic plan. So, let’s dig into the details of Top-up health insurance plans.
What is Top-Up in Health Insurance?
Top-up health insurance plans provide an additional coverage option that policyholders can add to their existing policies. These plans provide extra financial protection beyond the coverage offered by basic health insurance policies.
When the coverage limit of the basic health insurance policy is exhausted, the top-up plan provides additional coverage.
Example: Your current health insurance covers ₹2 lakhs, and you purchase a top-up plan with a ₹8 lakh coverage and a ₹2 lakh deductible. Your total coverage then becomes ₹10 lakhs. If your medical expenses surpass ₹2 lakhs, the top-up insurance covers the remaining amount up to ₹8 lakhs.
How Does Top-Up Health Insurance Work?
Top-up health insurance works as an addition to your basic health insurance policy. It provides coverage for medical expenses exceeding your primary policy's coverage limit.
When you file a claim and the expenses surpass the threshold set by your primary policy, the top-up plan covers the remaining costs up to its specified limit.
Advantages of Purchasing a Top-Up Health Insurance Plan:
- Get Enhanced Coverage:
With a top-up health insurance plan, you can increase your coverage beyond the basic limits of your basic health insurance policy. This means you have added financial protection in case of major emergency medical expenses that go beyond your basic coverage.
- Lower Premiums:
Top-up plans are generally more cost-effective than increasing the base sum of your main policy. Going for a top-up plan can increase your coverage at a comparatively lower premium compared to purchasing a higher coverage amount in your base policy.
- No Restrictions or Sub-limits:
Unlike basic health insurance plans, top-up plans usually have no restrictions or sub-limits on coverage. This means you have more flexibility and freedom in choosing the coverage amount and using it according to your needs.
- Easily Convertible:
If needed, health top-up plans can be easily converted into full primary health insurance policies. This provides flexibility and continuity of coverage without the inconvenience of reapplication or medical screenings.
- No Pre-policy Screening Required:
Top-up plans often do not require pre-policy medical screenings, making them accessible to everyone regardless of their health condition. This simplifies the application process and provides quicker coverage initiation.
- Tax Benefits:
Premiums paid for top-up health insurance are potentially eligible for tax deductions under Section 80D of the Income Tax Act. This lets policyholders take advantage of tax benefits on the premiums paid, which in turn can potentially reduce their taxable income.
- Peace of Mind:
By having a top-up plan, you gain peace of mind knowing that you have additional financial protection in case of unexpected medical emergencies. This added security can reduce stress and worry during challenging times, ensuring that you can focus on recovery without financial burden.
What is Included in a Top-Up Health Insurance Plan?
Top-up health insurance plans typically cover a wide range of hospitalisation expenses, including room rent, doctor's fees, surgical costs, diagnostic tests, medication expenses, and even pre and post-hospitalization expenses. They act as a financial cushion by providing coverage for medical expenses that exceed the coverage limit of your primary health insurance policy.
How Does Top-Up Insurance Differ from Basic Health Insurance?
Unlike basic health insurance plans, which provide primary coverage for medical expenses up to a specified sum insured, top-up insurance supplements your existing coverage. It kicks in only after the coverage limit of your primary policy is exhausted, offering additional financial protection for higher medical expenses.
How Does Top-Up Insurance Differ from Super Top-Up Insurance?
While top-up and super top-up insurance give additional coverage beyond the basic policy, they are different in terms of coverage.
Top-up insurance covers only a single claim over the coverage limit of the primary policy. In contrast, super top-up insurance covers multiple claims within a policy year once the aggregate limit is crossed. Super top-up insurance offers more coverage for recurring medical expenses within a policy year.
How to Select a Top-Up Health Insurance Plan?
When you choose a top-up health insurance plan, it's important to consider various factors such as the deductible amount, coverage limit, premium cost, waiting periods, and policy exclusions.
Analyse your healthcare needs, financial capacity, and risk tolerance to select a plan that offers enough coverage at an affordable cost.
Conclusion
Top-up health insurance is a great way to boost your existing health insurance coverage, giving you greater protection against emergency medical costs. With all the information about top-up health insurance plans laid out, you're well-prepared to choose the right plan for your specific needs.
If you're looking for reliable and comprehensive coverage, check out the Arogya Sanjeevani or Arogya Top-Up plans from SBI General Insurance. These plans are packed with benefits to ensure you and your family are covered when it really counts.
Ready to step up your health insurance game? Take a closer look at SBI General Insurance’s health insurance plans today and give yourself the peace of mind you deserve!
FAQ’s
Who can benefit from having a top-up in their health insurance policy?
Top-up health insurance benefits anyone who wants increased coverage beyond their basic health insurance policy.
Are there any limitations or exclusions with top-up health insurance coverage?Top-up health insurance may have limitations or exclusions such as waiting periods, pre-existing conditions, and specific medical procedures not covered.
Do I need to undergo medical underwriting for a top-up health insurance policy?Depending on the insurer's terms and conditions, some top-up health insurance policies may require medical underwriting, while others may not.
How do I file a claim under a top-up health insurance policy?To file a claim under a top-up health insurance policy, you must submit relevant medical documents, bills, and receipts to the insurance company within the specified period
Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.
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Health Insurance
How to File a Health Insurance Claim?
With the rising medical expenses and changing lifestyles, it has become imperative to purchase a comprehensive health insurance plan in today‘s time. Additionally, the recent COVID-19 pandemic has further established the importance of health insurance even firmly. A health insurance policy is the finest way to receive the best medical treatment without burning a hole in your pocket.
Be it an unforeseen medical emergency or a planned treatment, a health insurance policy can always come to your rescue. However, to avoid any last-minute hassle, you must be well aware of the process to file a health insurance claim beforehand. Below is a quick guide on how to file a health insurance claim.
But firstly, let‘s understand what a health insurance claim is.
Health Insurance Claim
A health insurance claim is a request that a policyholder must submit to the insurer for getting the services that are covered in their health insurance policy. Depending upon their convenience, policyholders can either opt for a cashless claim settlement option or reimbursement for the availed medical services.
Cashless Claims
For cashless claims, the insurance provider settles the hospitalization bills directly with the hospital. However, to get the benefits of a cashless claim, the policyholder should be hospitalized only at a network hospital of the insurer.
Reimbursement Claim
In case of reimbursement claims, the policyholder pays for the hospitalization expenses and later requests for reimbursement by the insurance company. The reimbursement facility can be availed at both network and non-network hospitals.
Now that you are well aware of the types of health insurance claims, let‘s understand how to file a health insurance claim
How to File a Health Insurance Claim?
1. Get in touch with the insurance help desk at the hospital
2. Show the ID card of the insured provided by the insurance company
3. The hospital will verify the insured‘s identity and will submit the pre-authorization form to the insurance company
4. The insurance company will then review all the documents submitted and process the claim as per the terms and conditions of the health insurance policy.
5. For reimbursement claims, you will also have to submit original bills to the insurance provider. The insurer will then evaluate the claim and make a payment to the insured. In case the treatment is not covered under the health insurance policy, the claim will be rejected.
Make sure that you have the following documents readily available with you before filing a health insurance claim.
Documents Required to Make a Claim
Valid photo ID cards such as Aadhaar, PAN, and Driving License
Copies of prescription for diagnostic tests, treatment advice, and medical references
Original set of investigation reports
Original hospital and pharmacy bill
Original discharge card or discharge certificate
It‘s always advisable to opt for an insurance company with a high claim settlement ratio and a large number of network hospitals. This makes the claim settlement process completely hassle-free.
Frequently Asked Questions (FAQs)
1. When can my health insurance claim be rejected?
Your claim can be rejected if you file a claim for an ailment that isn‘t covered by your health insurance policy. Moreover, your claim can also be rejected if you fail to submit the necessary documents or file a claim during the waiting period
2. What is the minimum time limit for hospitalization to make a health insurance claim?
You can file a claim if your hospitalization is for more than 24 hours. However, for certain treatments, such as dialysis, chemotherapy, etc., the stay could be less than 24 hours
3. What is claim settlement ratio?
The claim settlement ratio is the ratio of number of claims paid to the number of claims received
Health Insurance
All About Adding Spouse To Health Insurance After Marriage
Marriage brings a lot of changes in your life. Not only does it affect your lifestyle, but it also requires you to switch your investments in a way that are better suited for a family. You will now want to include your spouse to your financial world by adding them as a nominee in your banking accounts and other investment assets. Amidst all these personal and financial changes, do not forget to add your spouse to your health insurance plan. Adding spouse to health insurance after marriage is quite easy and can be done in three ways.
Buying a new family floater plan
If you do not have an existing health insurance plan, now would be a great time to invest your money in a family floater health insurance plan. Health insurance plans for family members cover your spouse, parents, and dependent children. The family floater plan allows you to pay a single premium to cover all named family members for medical expenses.
When buying a family floater plan, do ensure that it offers adequate coverage for you and your family. It is also important to keep in mind that the coverage amount is directly proportional to the health insurance premium you need to pay. This means that a family health insurance plan that offers a sum insured of Rs 10 lakh will require you to pay lower premium as compared to a family health insurance plan that offers coverage of Rs 20 lakh. However, it is advisable to opt for a higher sum insured if you have senior members in the plan.
Adding spouse to insurance after marriage
If you already have an existing health insurance policy, you can extend the cover to your spouse by adding their name to the policy after marriage. Upon adding you spouse, the individual health insurance plan will be transformed into a family floater plan. Since the coverage amount will increase, the premium of the policy will be recalculated. You can also add your spouse to your existing health insurance policy at the time of its renewal. You will need an application form and a few KYC documents like identity proof, residence proof, marriage certificate and photographs, to get this process started. You can easily get the application form from the insurer’s website.
Adding your spouse to the health insurance plan offered by your employer
There are many companies that offer health plans to their employees. These plans usually extend the coverage to the immediate family of the employee. However, this condition varies from one insurer to the other. Hence, it is better to check with your insurance company if they allow you to add your spouse to the existing health insurance plan that is issued by your employer. Here, it is important to remember that the health insurance policies offered by employers are group insurance plans and may, therefore, have certain limitations to coverage. Still, these plans offer a great option for coverage in case you don’t have health insurance of your own.
It is quite important to avail the health insurance cover for your spouse after marriage. This can help the both of you to securely plan your financial future.
Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.
Health Insurance
Steps of adding spouse to health insurance after marriage
Marriage is a huge step in everybody’s life. And personal finance has a big role to play for a successful married life. Therefore, it is important to update the financial records, including the health insurance plan, post-marriage.
In case you did not have an individual health insurance policy before the wedding, you can invest in a family floater plan for yourself and your spouse. In case you already have an individual health insurance policy at the time of wedlock, then you do not need to buy another one for your partner. Instead, you can add your spouse to the plan and convert it into a single policy. It is a feasible and simple way of ensuring that you and your partner are adequately covered.
Porting health insurance after marriage is also important. When one of the partners already owns a plan, you simply need to add another partner to the current policy as the spouse. There is no specific rule which specifies who can add the partner. The process of adding the spouse to health insurance after marriage is simple. The one who owns the policy can start this process with the submission of KYC documents such as identity proof, proof of age, photographs and marriage certificate.
The change will come into effect in the next policy renewal by just submitting the additional form and paperwork. Once you do this, the premium will be calculated and pro-rated. It will become a family floater insurance policy that covers all the members of the family for a single premium. You will not have to worry about paying separate premiums for each member of the family. It will cover the entire family at the lowest premium based on the age of the members in the family. Let us take a look at the benefits of a family floater plan.
A major perk of the floater plan is that you can cover yourself and your entire family in one policy. The policy is easier to handle and you do not have to worry about handling separate individual plans
You enjoy additional benefits like a newborn cover, maternity benefits, etc. It will be highly effective for young married couples who are on the road to starting a family. You must ensure that you choose a plan that covers yourself and the spouse and invest in one right after marriage
You must also get maternity cover at the earliest. It has a waiting period between 0 to 4 years and if you buy the cover on time, you will be able to enjoy the maximum benefits
With a family floater plan, you enjoy the same tax benefits under Section 80D as you do on individual health insurance
Many plans come with a reinstatement feature where you enjoy the reinstatement of the entire coverage after it is exhausted in the policy period. This is only applicable to unrelated claims but it is very useful.
If you do not have a policy and are looking to buy one, consider a joint life policy. It will work on the same lines and will provide coverage to your children in future if anything unfortunate happens to the parents. The main reasons couples should think of joint life insurance are premium reduction and waiver benefits. In this case, if one partner dies due to an unfortunate event, the spouse will not only be entitled to enjoy the full sum assured on the cover but will also be absolved of the responsibility of the payment of premium. Alternatively, the spouse may have to pay premiums only applicable for their own cover for the remaining period of the policy.
After your marriage, it is your responsibility to ensure the safety and adequate coverage of your spouse. You must include your spouse in the decision and speak to them about the coverage you wish to buy. Only then proceed with the decision. The right health insurance plan will offer acomplete protection and peace for the future.
Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.
Health Insurance
Advantages of Group Health Insurance
As the name suggests, group health insurance is aimed to offer health insurance cover to a group of people, usually employees, and if offered by an employer. It can also be offered to members of a professional association or a society. As compared to individual insurance, group insurance has many benefits for the employee as well as the employer who offers the insurance.
Comprehensive cover: Group health insurance plans offer wide coverage and can be customised by the employer. It comes with many benefits like cashless healthcare services at network hospitals. There is no waiting period which means the employee is covered from day one. Besides personal accident cover, some group health insurance plans offer cover to family members of the employee.
Guaranteed cover: All employees and in some cases their dependants are covered, even if they have existing medical conditions. A group insurance policy doesn't require a separate medical check-up. As long as an employee is working for the organisation offering group health insurance, he or she shall remain covered under the plan.
Low premium: As group health insurance plans are bought for a larger group of people, they offer comprehensive cover at affordable rates. The costs are much lower than individual health insurance plans. Group health insurance plans can be customised as per the employer’s budget and requirements.
Tax incentive for the employer: Besides safeguarding employees from health issues, group health insurance plans also provide tax benefits to the employer. Under Section 80D of the Income Tax Act, tax relief is offered to businesses that give their employees the benefit of group health insurance.
Happy employees: When companies offer health insurance plans to their employees, they help retain and attract good talent. A Group Health Insurance plan is a significant part of the employees’ total compensation. A group health insurance plan provides employees with financial security against accident and illness.
Rider options: With a nominal extra payment, employees can take advantage of other additional benefits. The employee can also opt for a corporate plan along with the base plan offered by the employer. The riders may differ from one organisation to another.
Provide your employees SBI General Group Health Insurance
Group health insurance is a very important benefit that makes employees feel like a valued part of an organisation. It helps companies retain as well as attract talent. SBI General Group Health Insurance plans offer multiple coverages: Individual, family floater. It offers wide coverage from Rs 1 lakh to Rs 7.5 lakh. The group health insurance plans offer pre- and post-hospitalisation expenses. With SBI General group health insurance plans keep your employees happy.
Disclaimer: SBI General Insurance Company Limited I Corporate & Registered Office: 'Natraj', 301, Junction of Western Express Highway & Andheri - Kurla Road, Andheri (East), Mumbai - 400 069. | The information in the advertisement is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale. * ‘Tax benefits are subject to changes in tax laws’ I 'For SBI General Insurance Company Limited IRDAI Reg. No. 144 dated 15/12/2009 | CIN: U66000MH2009PLC190546 | SBI Logo displayed belongs to State Bank of India and used by SBI General Insurance Co. Ltd. under license. | Website : www.sbigeneral.in,Tollfree 18001021111 | UIN: SBIHLGP21330V022021 | ADDIG/20-21/AUG/652
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