Monday, August 25, 2025

How do I mix base and tremendous top-up medical insurance insurance policies?

A reader recommended we write an article about combining base and tremendous top-up medical insurance insurance policies — a dialogue.

First, allow us to level out some useful sources for these trying to perceive extra about medical insurance and the way to purchase one:

We will start by appreciating that insurance coverage is a sport of chance. Why are tremendous top-up (STU) insurance policies cheaper than regular (or base) medical insurance insurance policies?

STU insurance policies include a deductible clause. They won’t pay out if the bills are lower than or equal to the deductible quantity.  Suppose the STU coverage had a deductible of Rs. 3 lakhs and a protection of Rs. 5 lakhs.

For an expense of Rs. 6 lakhs,

  • If you happen to claimed Rs. 5 lakhs from a base coverage, the STU would pay Rs. 1 lakh
  • If you happen to claimed Rs. 3 lakhs from a base coverage, the STU would pay Rs. 3 lakhs
  • for those who didn’t have a standard coverage, the top-up would pay Rs. 3 lakhs. For extra examples, see the FAQ article linked above.

The upper the deductible, the decrease the worth (for a similar quantity of protection). It’s because the chance of a Rs. 5 lakh expense is way decrease than that of an Rs. 1 lakh expense. Bills right here imply hospitalization bills for the insured and potential payout or loss for the insurer.

So, an STU coverage with a Rs. 1 lakh deductible and Rs. 10 lakh cowl will value multiple with a Rs. 5 lakh deductible and Rs. 10 lakh cowl.

One other key side of STUs must be understood earlier than contemplating base + tremendous top-up mixtures.

  • If the bottom and tremendous top-up insurance policies are from totally different insurers, we should pay the hospital invoice after which declare from the top-up insurer. So there may be little use in saying I’ve Rs. 1 crore tremendous top-up until you have got that a lot in money (liquid internet price)!
  • Even when each insurance policies are from the identical insurer, the possibility of reimbursement is excessive if the insurer has some doubt concerning the expense record furnished by the hospital. In fact, the gross sales guys would say they might “help” throughout claims, however that’s extra of a gross sales pitch. You can’t financial institution on that.

Due to this fact, ideally, the upper the bottom insurance coverage, the decrease the possibility of utilizing the super-top coverage. Nevertheless, for those who hold rising the bottom insurance coverage protection, it’s going to grow to be increasingly costly as we age.

Find out how to mix base and tremendous top-up medical insurance insurance policies

  • Medical insurance buy (in contrast to time period insurance coverage) is all about how deep your pockets are.
  • There isn’t a proper or unsuitable base + top-up combo. We’ve got to make peace with what we are able to afford.
  • A mixture like Rs 5L base + tremendous top-up (Rs. 5L deductible, 50 L cowl) or Rs 10L base + tremendous top-up (Rs. 10L deductible, 100 L cowl) must be wonderful.
  • If you happen to can afford it (now and in future!), purchase a big base cowl (e.g. 25L household floater or particular person) with an excellent top-up of Rs. 1 Crore protection (household floater) and a deductible of Rs. 10 lakhs from the identical insurer (if doable). This may scale back the dependence on the tremendous top-up coverage (which is, anyway, fairly cheap). On the time of writing, this looks as if a sturdy mixture. Medical inflation will hike these numbers just a few years later.
  • Most essential: Attempt to make investments just a little additional to your monetary targets. That additional can function an emergency medical corpus. See: Why all of us want a corpus for medical bills and the way to construct it.

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