Should you buy top-up plan to enhance group health insurance?

I work for a private firm, and the group mediclaim insurance of 3 lakh covers me, my wife and children. To enhance my group cover, can I buy a cover of 3-5 lakh or a top-up plan, which is cheaper but at the same time complements my group cover?

-Name withheld on request

A group mediclaim floater policy essentially covers the insured and his family. As you and your family are already covered under a group mediclaim of 3 lakh, you can go for a top-up cover with a deductible of 3 lakh. This will enable you to get a policy cover of a higher sum insured at a much lower premium. Minor hospitalisation expenses can be covered under your group mediclaim and a claim that arises exceeding 3 lakh would be taken care of by the top-up health insurance policy.

In case you plan to move out of employment in near future, you will be left with only top-up cover and there will be no cover available for the first 3 lakhs. It is always advisable to have an individual/family cover at base levels and build it over time as it will give you benefits of cumulative bonus; pre-existing diseases cover and so on. Getting insurance covers at an advanced age is expensive and at times unavailable.

My father aged 55 would need to undergo a one-day ligament tear procedure at a hospital, what is room rent eligibility during hospitalisation?

-Name withheld on request

Room rent eligibility is the per day hospitalisation charges which depends upon the type of room opted by you. These are mentioned in your policy copy under the scope of cover, and these are usually Room, Boarding & Nursing Charges as provided by the hospital/nursing home. These charges are as below:

• Normal room – Up to 1% of the sum Insured or as mentioned in policy schedule

• Intensive Care Unit – Up to 2% of the sum Insured or as mentioned in the policy schedule

For more details, you must refer to your policy document.

Answered by Atul Deshpande, head claims, digital & projects, SBI General Insurance. Queries and views at [email protected]

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