All you need to know about supplementary health insurance plans – Forbes Advisor INDIA

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The current Covid-19 pandemic and the global health crisis it has caused have shown very clearly that individuals cannot be prepared for unprecedented medical emergencies. The only way to have a safety net and not spend all your hard-earned money on treatments is to invest in comprehensive health insurance coverage that takes care of all the medical needs for you and your family. .

Where we previously depended on health insurance coverage provided by our employers, Covid-19 has made us realize the importance of investing in a separate plan that provides protection against a number of unrelated health scenarios. covered by the plan offered by the companies.

Health insurance has never been more important than it is today, especially since entire families can contract communicable diseases like Covid-19 and require expensive treatments. In such situations, comprehensive healthcare insurance can ensure optimal care and medication for the whole family, without adding to the stress already borne by breadwinners.

Moreover, with the constant increase in medical inflation, it has become crucial to have adequate health insurance. Indeed, many are those who often choose health coverage with the lowest premiums and fall prey to insufficient insurance in the event of an emergency. Mistakes like this then force people to dip into their savings when the insurance limit runs out, something you wouldn’t have to do if you invested in comprehensive and adequate health coverage in the first place. And, even if you have already taken out a contract but want to increase its ceiling, you can always opt for complementary health insurance.

What is a complementary health?

A prudent supplement to your existing mutual health insurance contract, complementary health insurance offers you medical coverage in addition to the contract that you have already subscribed to or received from your company. This is an indemnity policy that allows you to cover medical expenses beyond the sum insured offered by your regular policy, protecting you from costly medical emergencies. The main things you need to know about supplemental health insurance plans include:

  • The supplemental plan involves a mandatory deductible and you will only be covered after paying the deductible amount. For example, suppose your company offers you a medical policy with a guaranteed limit of five lakh INR and you invest in a top-up worth an additional seven lakh INR for additional protection.
  • You can only benefit from the top-up plan after your initial sum insured has been exhausted. And, if you undergo treatment worth nine lakh INR, 5 lakh INR will be paid by the original policy and the remaining four lakh INR will be paid by the top-up.
  • If you are worried about the coverage provided by your regular policy, top-ups are a wise and affordable decision as they are more economical compared to basic health insurance.
  • Supplemental plans typically provide coverage for hospitalization expenses, pre-hospitalization and post-hospitalization expenses up to 60 days and 90 days respectively, child care procedures, certain organ donation expenses , emergency ambulance costs and home treatment costs.
  • Supplemental plans don’t require a medical exam until you’re over 55, so investing in plans at a younger age can protect you longer and at a lower cost.
  • When choosing the best plan for your needs, look for plans with higher deductibles and also make sure there is no duplication in the benefits offered by your base plan and the add-on you are considering.
  • Most exemptions in add-on plans would most likely be covered by your basic plan, so you don’t have to worry much. However, check the waiting period on the plan, when considering pre-existing health conditions and also look for plans with adequate coverage for pre- and post-hospitalization costs. You should also consider maternity coverage and single illness deductible criteria before choosing your top-up.
  • Also, make sure your supplemental plan provides adequate protection for your family members, including your parents, children and spouse.

Different types of supplemental plans

When considering supplemental health insurance plans, there are two types you should consider.

This plan offers you insurance coverage in addition to the sum insured by your basic policy, up to a certain ceiling. Your supplemental plan is activated once your medical expenses have exceeded the plan’s deductible limit.

Offering more benefits and sum assured compared to supplemental plans, super supplements provide additional insurance coverage even after your medical expenses exceed the limit. The difference between the two plans is that the supplemental plan considers the limit/deductible threshold when processing each individual claim, while the super supplement assesses all claims arising during the term of the policy.

Super supplemental plans cover claims based on the total medical expenses incurred during the policy period, while a supplemental plan only works on individual claims. Additionally, the top-up plan only covers claims when a single claim exceeds the sum insured limit, while the super top-up provides protection when the total claims during the policy period exceed the threshold.

While both plans have their benefits, it’s up to you to decide which plan is best for you and your family. If you and your family members are in relatively good health and not at risk of developing a chronic disease, a supplemental diet would be sufficient. However, if you have pre-existing health conditions and you or your dependents are at risk for chronic conditions in the future, then Super Supplemental Plans will serve you well.

Benefits of Supplemental Health Insurance Plans

Benefits of investing in a supplemental health plan include:

  • Curb medical inflation

The cost of hospitalization and medication continues to rise, and your basic insurance plan may not be enough to cover the costs for you and your family. In such a situation, it is prudent to invest in a supplemental plan as it protects you from spending your savings even when your basic health insurance plan runs out. Thus, a complementary formula can allow you to access quality care without worrying about additional expenses.

  • Possibility of increasing your insured capital

Investing in an additional formula offers you the possibility of increasing the coverage of your contract while keeping your basic contract. As top-ups are more affordable than basic plans, it is better to increase your insured amount by investing in top-ups instead of investing in higher sum insured basic plans, as these would cost more in terms of premiums paid.

  • Protection of seniors

Supplemental insurance plans provide broader and more comprehensive coverage for seniors, and they do so at very affordable premiums, compared to a higher basic health insurance policy. Additionally, many supplemental plans have no restrictions or sub-limits on hospital expenses, making them extremely beneficial for seniors who may need frequent treatment.

  • Family reductions and tax reductions

Some supplemental plans give you family discounts, including coverage up to a specified limit for dependents like parents, children, and spouse. In addition, you may also receive tax benefits on the premium paid, under Section 80/D of the Income Tax Act.

  • Easy convertibility and lifetime renewal

Many supplemental health care plans offer you the option to seamlessly convert to basic health plans. Plus, you also get the lifetime renewal option, making it a constant in your life.

If you end up not needing the additional insurance during the period of insurance, you can benefit from a cumulative bonus, up to a specified limit, for each claim-free year.

Conclusion

You should invest in a supplemental plan if you are a company employee with a company-provided insurance policy, or a senior citizen, or if your basic healthcare plan has a low insured amount. Even if you don’t fall into any of these categories, it’s always better to be prepared than to be unprepared for the eventualities of a medical emergency.

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