सुपर टॉप-अप हेल्थ इन्श्युरन्समध्ये वजावट म्हणजे काय?

हेल्थ इन्श्युरन्स प्लॅन वैद्यकीय आपत्कालीन परिस्थितीत सुरक्षा उपाय म्हणून कार्य करते. टॉप-अप हेल्थ इन्श्युरन्स प्लॅन वाजवी किंमतीत बेस मेडिकल इन्श्युरन्स पॉलिसी पेक्षा जास्त कव्हरेज रक्कम वाढवते.

टॉप-अप हेल्थ इन्श्युरन्स प्लॅन्सचे दोन प्रकार कोणते आहेत?

There are two types of top-up health insurance plans?—?regular and super top-up plan.

1. A regular top-up plan

विद्यमान हेल्थ इन्श्युरन्स प्लॅनच्या वजावट किंवा सुरुवातीच्या मर्यादेच्या पलीकडे अतिरिक्त कव्हरेज ऑफर करते. हे प्रति वर्ष वजावटीच्या वर केवळ एकाच क्लेमची पूर्तता करते. जर हॉस्पिटलचे बिल वजावट योग्य नसेल, तर टॉप अप हेल्थ इन्श्युरन्स ॲक्टिव्हेट होणार नाही.

2. A super top-up plan

वजावट रकमेपेक्षा जास्त अतिरिक्त कव्हरेज ऑफर करते आणि एका वर्षामध्ये वजावट रकमेवर संचयी वैद्यकीय खर्चासाठी अनेक क्लेम कव्हर करते. सुपर-टॉप-अप प्लॅन पॉलिसीधारकाला कोणत्याही मर्यादेशिवाय वैद्यकीय उपचार मिळण्याची खात्री देतो.

How Does the Deductible in Super Top-Up Health Insurance Work?

A deductible in Super Top-Up Health Insurance refers to the amount a policyholder must pay out-of-pocket before the insurer steps in to cover medical expenses. The deductible applies per policy year and is typically lower than a traditional health insurance policy. Once the deductible is met, the insurance covers additional hospitalisation costs, offering enhanced coverage at a more affordable premium. This type of plan is ideal for those with existing health insurance, as it provides extra protection without increasing premiums significantly. It helps in managing large medical bills, especially for major illnesses or surgeries.

Why Should You Opt for Deductibles in Health Insurance?

Opting for deductibles in health insurance can significantly reduce your premium costs. By choosing a higher deductible, you agree to pay a certain amount out-of-pocket before the insurer covers your medical expenses. This makes your health insurance more affordable, as the insurer takes on less risk. Deductibles are ideal for those who are healthy and unlikely to require frequent medical treatment. They offer a balance between cost savings and coverage, making them a smart choice for individuals looking to manage their healthcare expenses while still being protected in case of major medical issues.

सुपर टॉप-अपमध्ये वजावट म्हणजे काय?

वजावट ही हेल्थ इन्श्युरन्स कंपनीद्वारे खर्च सामायिक करण्याची आवश्यकता असते. सोप्या पद्धतीने, वजावट ही पॉलिसी कालावधीत हॉस्पिटलायझेशन क्लेमची पर्वा न करता इन्श्युरन्स कंपनीद्वारे भरली जाणारी निश्चित रक्कम असते. वजावट हेल्थ इन्श्युरन्स कंपन्यांना पॉलिसीधारकासह खर्च शेअर करण्यास मदत करतात. जेव्हा पॉलिसीधारक सुपर टॉप-अप हेल्थ इन्श्युरन्स प्लॅन खरेदी करतो, तेव्हा त्याच्याकडे विशिष्ट वजावट रक्कम निवडण्याचा पर्याय असतो.

For instance, Ms. Kaur purchases a medical insurance policy of INR 3 lakhs. One day while having a conversation with her sister Ms. Singhania, they discussed medical inflation in today’s world. It makes Ms. Kaur worried about the policy amount won’t suffice for her medical emergency in the future, and what if there will be significant events? Her sister Ms. Sighania asked her instead of increasing the medical policy amount and paying a higher insurance premium. She suggested that she buy a super-top up plan of INR 7 lakhs.

The super top-up health insurance plan will kick-in if the hospitalization bill will be above the deductible amount. But the question arose in Ms. Kaur’s mind, as there will be the deductible in health insurance policies, what is deductible in super top-up? Her sister told her that in super top-up health insurance, the policyholder could choose the fixed deductible. Hence she determines a deductible amount of INR 3 lakhs.

In Ms. Kaur’s case, along with the medical insurance premium, she has to pay INR 3 lakhs as a deductible amount of the super top-up health insurance policy she purchases for the extra coverage. Later after a year, Ms. Kaur needs to undergo heart surgery, and her hospitalization bill raises to INR 5 lakhs. As the hospitalization bill amount is above the deductible amount; thus, INR 3 lakhs will be covered by medical insurance, and a super-top up plan insurer will cover INR 2 lakhs.

Within six months, she again needs to be admitted, and the hospital bill is raised to 4 lakhs. In a Super top-up health insurance plan, the policyholder can claim multiple tabs in a year. Thus Ms. Kaur’s bill of INR 3 lakhs will be settled by the medical insurance company, and INR 1 lakh settled by the super top-up health insurance company. Therefore, Ms. Kaur didn’t have to pay anything extra from her pocket.

निष्कर्ष

जर तुमच्याकडे मूलभूत हेल्थ इन्श्युरन्स किंवा मेडिक्लेम पॉलिसी असेल तर सुपर टॉप-अप हेल्थ इन्श्युरन्स पॉलिसी खरेदी करण्याचा सल्ला दिला जातो. टॉप-अप प्लॅनमध्ये, वजावट प्रत्येक क्लेमवर लागू केली जाते, तर सुपर टॉप-अप हेल्थ इन्श्युरन्स प्लॅनमध्ये, वजावट वर्षामध्ये झालेल्या एकूण वैद्यकीय खर्चावर लागू होते. पॉलिसीधारक त्यांच्या गरजेनुसार खरेदी करीत असलेल्या पॉलिसीनुसार वजावट जास्त होऊ शकते. काही इन्श्युरर्स कडे संपूर्ण कुटुंबासाठी एकाच सम इन्श्युअर्डचा लाभ घेण्यासाठी 70 वर्षांपर्यंत वयाचे प्रपोजल असते. लाभ हे एका इन्श्युररपासून दुसऱ्यापर्यंत भिन्न असू शकतात.

एफएक्यू

1. Which health insurance policy recommended for the family floater plan and has a sufficient deductible amount?

Bajaj Allianz Extra Care policy offers coverage ranging from INR 10 lakhs to INR 15 lakhs, with the deductible ranging between INR 3 lakhs and INR 5 lakhs. It comes with a family floater medical insurance plan; hence its works per claim basis.

2. When does the super top-up health insurance policy lapse?

जेव्हा संपूर्ण रक्कम वापरली जाते तेव्हा सुपर टॉप-अप हेल्थ इन्श्युरन्स पॉलिसी लॅप्स होते कारण एकाधिक क्लेम साठी ती विचारात घेतली जाते.

3. What is the deductible in health insurance super top-up?

The deductible in a health insurance super top-up is the amount you must pay out-of-pocket before the insurer starts covering medical expenses. Once the deductible is met, the policy provides additional coverage for hospitalisation and treatment costs.

4. What are deductibles in health insurance?

A deductible is the amount you are required to pay for healthcare services before your insurance policy kicks in. It’s a way to share the cost between the insurer and the policyholder, often resulting in lower premiums for the policyholder.

5. What is the difference between a top-up and a deductible?

A top-up policy increases your existing health insurance coverage. It only kicks in once the coverage limit of your primary insurance is exhausted. A deductible, on the other hand, is the amount you need to pay upfront before your insurance policy starts covering the costs.

6. What are the disadvantages of super top-up?

The main disadvantage of a super top-up is that the deductible must be paid each year before the policy starts covering your medical costs. This can lead to higher out-of-pocket expenses for policyholders, particularly in case of multiple claims within the year. Additionally, the deductible only applies once per policy year, and the claim amounts must exceed this threshold for coverage to begin.