Most of us will have a regular health insurance plan that covers medical expenses up to a certain amount. But with rising medical costs, the sum assured seems less after a few years especially for critical illnesses/accidents. Purchasing another health insurance plan or increasing the sum assured of the existing policy is not the only ways to increase the health cover. They are not cost effective many times. So what’s the solution?
Top Up Vs Super Top Up
You can purchase top up and super top up health plans to increase your existing cover. Top up plans are insurance policies that give cover above a certain threshold limit. For example, if you have a top up plan with sum assured of Rs. 5,00,000 and the limit as Rs. 2,00,000, you will be able to claim if your expenses go above Rs.2,00,000. So if you spend Rs. 2,00,000, you cannot make a claim. If you spend Rs. 7,00,000 in one issue, you can make a claim for Rs. 5,00,000 as your medical expenses are above the defined limit.
Super top up plans are a variation of top-up plans. All the medical bills for the year are considered. If the sum of all bills is above the threshold limit, you can make a claim for the amount above the threshold limit.
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Apollo Munich Optima Super Review
Apollo Munich has launched a new insurance plan called Apollo Optima Super. This plan is super top up plan with a high deductible. The deductible considers all the claims made during the year. It also has the facility of almost zero deductible. Let us look at all the features of the plan –
Features
- The Optima Super is a top-up plan with a high deductible. It is available for a sum assured of Rs. 5 lakh, Rs. 7 lakh and Rs. 10 lakh. There are various deductible options available for each of these ranging from Rs. 1 lakh to Rs. 10 lakh.
- Individual plans and family floater plans are available. There are discounts on premiums on family floater plans.
Eligibility
- It covers individuals from the age of 91 days to 65 years though there is no maximum age limit on renewals.
- In case of a family floater plan, a maximum of 2 adults and 2 children can be covered and the age of the eldest person is used for premium calculation.
- If the parents have a policy, dependent children from the age of 91 days to 5 years can also be covered.
- In an individual policy, a maximum of 6 people can be added to the policy.
Read: Best Medical Insurance for Parents in India
Apollo Optima Super Top Up for corporate employees
What makes the policy Unique & beneficial for employees who already have insurance from employer? The plan can be converted to a normal health plan with almost zero deductible between the ages of 55 and 60 if the customer wishes. This can be done without any medical tests. This is helpful if a company has taken this insurance for employees as when the employees are nearing retirement, it can be converted to a normal health plan.
Other Benefits and Features of Apollo Optima Super Top Up Review
- The policy offers a discount on the premium for the second year if a two year policy is taken.
- Apollo Munich offers counselling for health related issues for customers who have this plan.
- There is the facility of cashless hospitalisation in about 4000 hospitals.
- Pre hospitalisation up to 60 days prior to hospitalisation and post hospitalisation up to 90 days post hospitalisation are covered.
- 144 day care surgeries, organ transplant and ambulance service up to Rs. 2000 are covered.
- It is a portable insurance policy with tax benefits under Section 80D of the Income Tax act.
Read: Apollo Munich Optima Restore Review
Exclusions
The policy does not cover –
- Treatments within 30 days of buying the policy unless it is an accident
- AIDS, congenital diseases, mental disorders, obesity and cosmetic surgery are not covered
- Pregnancy is not covered.
- Medical expenses incurred due to substance abuse, war and unproven treatment methods are excluded.
Pre-existing conditions will be covered only after 4 years of buying the policy though some conditions like cataract, joint replacement surgery, hernia are covered after a 2-year waiting period.
Let us look at the premium payable for some options of the policy.
For an individual with a sum assured of Rs. 5,00,000, the premium payable for various deductibles are –
| Individual | Deductible 2 lakhs (Rs.) | Deductible 5 lakhs (Rs.) |
| 18-35 years | 2,055 | 1,620 |
| 36-45 | 3,055 | 2,235 |
* Please check with the company for exact premium amounts.
For a family with a sum assured of Rs. 5,00,000, the premium payable for various deductibles are –
| Family Type | Age of Oldest Member (Years) | Deductible of Rs. 2 lakhs (Rs.) | Deductible of Rs. 5 lakhs (Rs.) |
| Family+1 child | 35 | 4,315 | 3,400 |
| Family + 1 child | 45 | 5,915 | 4,385 |
| Family + 2 children | 35 | 4,935 | 3,885 |
| Family + 2 children | 45 | 6,535 | 4,870 |
* Please check with the company for exact premium amounts.
The premium for a normal insurance plan of Rs. 5,00,000 for a 35 year old individual is above Rs. 5000. If he/ she feel that this coverage is not adequate and goes to buy another plan or increase coverage, it will be more expensive. For example, if he/ she buys another insurance policy for Rs.3,00,000, additional insurance premium of Rs. 4,000 and above will have to be paid which turns out to be more expensive.
Should you buy Apollo Optima Super Top Up Plan?
The Apollo Optima Super top up Plan is cost effective and provides the unique feature of getting converted to a normal health plan during a certain phase. If you are looking to increase your health coverage, it is a good plan to consider. If you have a health cover from your employer only, this is a good plan to consider as it has the option to convert to a normal health plan.
* Please check with the company for complete details before buying the policy.Do you have a top-up or super top up health insurance plan? Let us know which one you have and what your view on it is.
Hi Hemant,
I was planning to buy a health insurance since long.
I am 24 and having Type-1 Diabetes.
Can you please suggest me some Health insurance which covers Diabetes?
Or which Health insurance would be the best for me?
P.S. : I have a health cover from my employer.
Tejal,
Many PSU General insurer cover diabetes within their general health policy by paying an extra premium. You can get in touch with any of them and find out the details.
Hello Mr. Hemant,
Admire your good work for educating people in your own simple way.
Please suggest a good health plan for –
Me (43 yrs) /wife (43 yrs)/ Daughter (5 yrs) and parents (Father 71 / Mother 69).
A family floater or a family floater + individual plan.
I count on TFL suggestion.
Regards / Prashant
Prashant,
For your parents at this age only senior citizen policies are available. But the premium will be high. In my view you should opt for building a health insurance fund. Alternatively you can check the premium rates with different companies and take a decision.
For you, your spouse and your daughter you can consider a floater plan from Apollo, Religare or Max Bhupa.
Hi Hemant.. Nice one. I have a HealthCover for self & wife for Rs 5 Lacs ( total) thru Max Bupa Gold Heart. I want to go in for additional Top up plan .. Iam 61 yrs old. Which one would you suggest?
Dr M. Chandrashekhar,
There are two variants -Top up and super top plans. In both these options super top up are more beneficial but only few companies have it. Currently United India Insurance, Bajaj Allianz and Apollo offer it. You can check with these companies.
Maximum age of entry
I am 39 years,I have bharti axa optima RS 5 lakgst, hdfc super top up 20 lakhs.
If I take one more super top.
Touch wood I am hospitalized,entire 25 lakhs over with in year then can I use second top up.
I took bharti axa 5 lakh policy as they pay RS 5 lakhs ,if I get any critical illence.
Any better one