67440Looking for health insurance? Treatment cost of these maladies will not be covered!

Buying a health cover for a senior citizen is a troubling process, especially when he or she is suffering from pre-existing diseases. Some insurers may offer a health plan by charging a high premium but taking additional cover may not be possible. We received following query on Money9 Helpline:

I already have Rs 5 lakh health cover for my mother. She is a patient of high blood pressure and cardiac Bypass Surgery has also happened. Waiting period on pre-existing disease is applicable. I want to get more coverage for Her. I read about super top-up plans. Following are my questions:

1) How will the deductible work here? Will my base policy make up for deductible?

2) Should my dates for base plan and Top-up/Super Top-up be in sync? I bought the base plan in May this year.

3) My employer provides group coverage that covers both my Mother and me. How should I treat it as I plan higher coverage for her?

4) Can I get additional Rs 1 crore coverage for her?

– Harish Agnihotri

We approached Naval Goel, founder & CEO, Policyx.com to address the query:

Unfortunately, she is not eligible for the super top plan due to her serious medical conditions. There are some serious pre-existing diseases such as cardiac in which the patients don’t get the super top-up plans easily. I would still advise to check with the same insurer which has sold you the base policy. It is not mandatory to sync dates of your base policy and super top up plan. In case you renew your base policy then the existing super top up plan will start working with the renewed base plan. In case, your base plan is expired and then you make a claim then you will need to pay deductible from your pocket and the rest of the amount will be paid via super top-up.

So far as group coverage is concerned, the plan must be having a cap on the sum insured amount and you and your mother can only utilise the allotted coverage for the medical purposes. Super top-up plans are effective when you have a group cover as they give you added shield. In case she doesn’t get the super top up plan, she will have to manage within the given coverage.

Again because of her age and medical conditions, it would be difficult for her to get Rs 1 crore coverage. However, there are a few plans that can be purchased for her such as Care Heart by Care Health Insurance, HDFC Life Cardiac Care and Star Health Cardiac Care plans. These plans are specially designed to provide coverage to the patients having existing cardiac issues and she can get coverage up to Rs 10 lakhs.