Super Top-up works for any number of claims in a policy year. It kicks in once the threshold deductible is reached.
Let's say you have the following insurance
Super top-up health insurance is an additional policy that works with your existing insurance policy. It kicks in when you have exhausted your deductible amount in your base policy.
For example, if your base policy has a deductible of 3 lakhs, and you’ve exhausted this amount, you can use your Super top-up insurance to foot the rest of your bills.
Pre-existing disease (PED) refers to the diseases or ailments you were suffering from at the time you bought this policy.
Let us clarify further, a “pre-existing disease” is any ailment or condition diagnosed, while (and in some cases before), buying your insurance policy. PEDs can range from serious medical conditions like cancer or diabetes to ailments like blood pressure or allergies.
So, if your doctor diagnoses you with a thyroid disorder or asthma, and prescribed you medication some time back. Then, your health condition – that is, thyroid disorder or asthma – is a pre-existing condition.
Your Super top-up remains with you even after you leave your company.
You also get additional tax benefits under Section 80D.
Additionally, buying a super top-up cover is more cost-effective than paying a higher premium to increase your existing coverage.
The primary member, purchasing the cover, has to be part of the group health insurance cover provided by Plum.
Individuals with pre-existing diseases are not eligible for the cover.
Yes, the plan is available to individuals below the age of 75. Children should be of age between 90 days and 24 years.
No, super top-up does not cover maternity.
Yes, AYUSH treatments are covered by Super top-up.
Yes, parents (up to 75 years) can be covered in separate individual policies.
As your parents get older, there is the possibility of rising healthcare costs. There is always a chance that your existing health insurance cover may not meet their healthcare expenses. A super top-up can help enhance their existing health insurance cover (which they may have purchased in a personal capacity or may have obtained through your insurance plan) if they don't have any pre-existing conditions.
Deductible refers to the amount paid by the policyholder (via out-of-pocket or other medical insurance policy) before the super top-up kicks in.
Simply put, if you opt for a 20 lakh sum insured with a deductible of Rs. 3 lakhs, then you will pay 3 lakhs, and the rest will be paid for by your super top-up plan. Do note that the deductible can be exhausted over a period of one year (since the date of purchase of your Super top-up and need not be a one-time expense).
A 30-day waiting period from the policy start date is applicable, except for injuries and accidents. There is additionally is a 12-month waiting period for the following illnesses/surgeries.
Buying a super top-up cover does away with the need to undergo any medical tests. Instead, you will be required to provide a declaration of good health. This includes acknowledging that you and your family members are not consumers of alcohol/tobacco/recreational drugs and are in good health (not having any pre-existing diseases or health conditions).
You will essentially have to file two claims since you will utilise two policies. First, make sure that the deductible amount has been either exhausted through another policy or through out-of-pocket expenditure. Before raising the claim, reach out to us at email@example.com for the best assistance and advice on using your super top-up policy.
Your Super top-up policy remains active for one full year from the purchase date. It remains active irrespective of you leaving the company or your company discontinuing Plum. The deductible amount can then either be covered by your personal health insurance policy or out of your own pocket. You can access your policy document via the confirmation email you received in your personal email ID.
P.S: it’s hence very important you share your personal email ID with us at the time of a policy purchase!
To upgrade, downgrade, or edit your plan, reach out to firstname.lastname@example.org for assistance.