Top Up Cover
GUARDING YOUR REAL WEALTH- We all need a Health Plan to safeguard our real Wealth but not too many people have understood the importance of it…You too may fall in the same category.
To ensure that customers always get a winning proposition, health insurance companies are redefining the health insurance category with a revolutionary product – the New Generation Super Top Up Plan (NGSTUP). Whether it’s today or tomorrow, you can rest assured that it will take care of your healthcare needs in a flexible and comprehensive manner. NGSTUP is a win-win health insurance plan through which you not only insure your health today but also secure your health for the future. NGSTUP doesn’t let you lose your sleep or money over healthcare.
With an NGSTUP don’t just be insured. Be win-sure. With the old-generation plans, many questions come to mind. Such as: Why go for Health insurance when you have to fall ill to utilise it? Can I afford the budget for Health Insurance? How is it useful for healthy people? You still have to pay for OPD, right? Is there a way in which my investment in health insurance will fund my premium? How is it a good policy when the premium amount will rise as we grow older? Do you have similar concerns too?.
Worry no more because you now have the perfect solution. To ensure that our customers always get a winning proposition, health insurance companies are redefining the health insurance category with a revolutionary product – the NGSTUP. The product is right blend of Top-Up, Normal Plan with cumulative bonus and OPD as additional cover. Whether it’s today or tomorrow, you can rest assured that it will take care of your healthcare needs in a flexible and comprehensive manner.
The NGSTUP has been introduced giving benefits equivalent to normal Mediclaim but including more features than Super Top Up at reasonable pricing. The main difference between Super Top Up and NGSTUP is that the latter provides a Cumulative Bonus for the claim-free year which enhances the coverage whereas, in the case of the former, the coverage never increases with or without claims in the Policy.. It’s important to understand one can upgrade to this plan from the existing ones in case you already have one. NGSTUP is a complete solution for someone who is looking to buy comprehensive and complete coverage for his family making it a cost-efficient option. It not only gives you a New Generation Mediclaim cover but also gives you OPD cover which could be considered as a refund of the premium since it would have been spent even if you would not have this policy. This means the cost of the premium after the deduction of the return of premium by way of OPD charges would be significantly low with the additional covers of a normal policy. It is advisable to complete the buying of such coverage sooner than later to free yourself and your family of all critical illness worries.
NGSTUP is a win-win health insurance plan through which you not only insure your health today but also secure your health for the future. NGSTUP doesn’t let you lose your sleep or money over healthcare-related issues. With NGSTUP you not only save but also earn a bonus. It provides you with comprehensive protection by paying for in-patient and all out-patient expenses and saves you from future financial worries.
BENEFITS
OPD BENEFIT OPD benefit also takes care of your out-of-pocket expenses. With OPD benefits you can now not only pay for consultations with a medical practitioner, physiotherapist, dietician, and speech therapist, but you can also make purchases of medicines, vaccinations, dental expenses, spectacles, contact lenses, medical devices like blood pressure and sugar monitors, oxymeters, prosthetics, etc. It also covers your outpatient diagnostic test and purchase of special health food supplements and many more. OPD benefit also gives you the flexibility of paying for non-payable items that are generally excluded from any health insurance claim such as co-payment and/or deductible. With OPD benefits you can also pay for other medical expenses that are not payable otherwise under any medical insurance plan. Use it as you want.
RESTORE BENEFIT Another striking feature of the NGSTUP is Restore Benefit which automatically restores the sum insured if the base sum insured and Cumulative Bonus (if any) is exhausted during the policy period. The restored sum insured (equal to 100% of the base sum insured) will be automatically reinstated for that policy period. However, unlike normal restore benefit, it is not applicable for the same person same ailment i.e. Restore Sum Assured will be available for other family members and/or another ailment for the same person who has consumed the entire base cover and cumulative bonus.
CUMMULATIVE BONUS NGSTUP comes with an amazing feature called Cumulative Bonus. In case of a claim-free year, your basic sum insured will increase by 50% at the time of renewal. And if you do not claim even in the 2nd policy year, your basic sum insured gets doubled.
INCIDENTAL EXPENSES To cater to incidental expenses, NGSTUP offers you a lump sum amount of `Rs 10,000 in case your hospital stay exceeds 10 continuous days.
CRITICAL ADVANTAGE RIDER BENEFIT (OPTIONAL) NGSTUP has an optional feature of Critical Advantage Rider that allows you to avail best in class quality healthcare across the globe for the treatment of Cancer, Coronary Artery Bypass Surgery, Heart Valve Replacement/Repair, Neurosurgery, Liver Transplant, Bone Marrow Transplant, Pulmonary Artery Graft and Aorta Graft Surgery. Besides the hospital bill, this benefit also covers the cost of a second opinion and post-hospitalisation expenses. And that’s not all, it also covers the cost of travel and accommodation expenses of the insured person along with an accompanying relative.
WORLDWIDE COVERAGE This covers in-patient treatment and daycare medical expenses incurred for emergency treatments for an illness or injury sustained or contracted outside of India which cannot be postponed until one returns to India, provided that such treatment was medically necessary and certified as an emergency by a medical practitioner.
DEDUCTIBLE (OPTIONAL) No problem if you already have health insurance coverage, you will still win with NGSTUP by opting for the deductible option. The deductible is cost sharing feature. It means that the insured takes care of his healthcare costs up to the deductible amount in the policy year by himself or through another existing policy. Healthcare expenses beyond the deductible amount will be covered by the insurer.
- The deductible will apply on an individual basis in the case of an individual sum insured policy and on a Family Floater basis in the case of a Family Floater policy.
- A deductible does not reduce the sum insured.
- Opted, it will apply to all insured person(s) under the policy
SWITCH OPTION (WAIVER OF DEDUCTIBLE) NGSTUP provides a unique option of converting into a full-fledged NIL deductible plan by using the waiver of Deductible Benefit. It is hassle-free with no re-evaluation of health status. This option for waiver of Deductible (Switch Benefit) can be exercised by you only at the time of renewal between the age of 55 and 60 years or at the beginning of the 6th policy year; provided that it has been bought before 50 years of age and has renewed with the insurer continuously and without any interruption.
AMBULANCE COVER BENEFIT NSGTUP covers expenses incurred on transportation of the insured person to a hospital for treatment in case of an emergency subject to `2000 per hospitalisation.
TAX BENEFIT The premium amount paid under this policy qualifies for deduction under Section 80D of the Income Tax Act, subject to applicable tax laws.
PREVENTIVE HEALTH CHECK-UP BENEFIT NGSTUP helps to keep track of your health status by offering a preventive health check-up at renewal irrespective of claims made. However, eligibility for the health check-up limit is based on the Reserve Benefit sum insured.
NO SUB-LIMIT ON ROOM RENT With this Mediclaim plan you can get the room you like and the treatment you deserve without a hassle within the sum assured limit. A new generation plan does not have such limits. You can avail of the plan without the hassle of a sub-limit.
PRE- AND POST-HOSPITALISATION EXPENSES The old generation plans provide 30/60 days cover but in the new generation plans 60/180 days cover is provided.
DAY CARE PROCEDURES All day-care treatments are covered.
ORGAN DONOR: Covered up to the Sum Insured.
NO GEOGRAPHY-BASED SUB-LIMITS No matter where you buy your policy, you can get treated in any hospital or city of your choice with no additional co-pays or sub-limits. NO CLAIM-BASED LOADING In this policy, there is NO loading of your renewal premium because you availed of a claim or fell ill during the policy period.
EXCLUSIONS
Please be aware of the list of exclusions under NGSTUP which are as follows:
- Expenses arising from HIV or AIDS and related diseases
- External Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments
- Expense attributable directly or indirectly to pregnancy (including voluntary termination), miscarriage (except as a result of an accident or illness)
- Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol
- Drugs or treatments which are not supported by a prescription
- Hospitalisation due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind
- Pregnancy, dental treatment, external aids and appliances Items of personal comfort and convenience
- Experimental, investigative and unproven treatment devices and pharmacological regimens
- Plastic surgery or cosmetic surgery unless necessary as a part of medically necessary treatment Please refer to the individual policy wordings for complete understanding of benefits, terms and conditions and exclusions.
ELIGIBILITY
NGSTUP is the perfect solution for any individual aged 91 days to 65 years who cares for his health and wallet and wants OPD Cover too. Children between 91 days to 5 years can be covered if either of their parents own NGSTUP.
Individuals can buy NGSTUP either for themselves or their family members which include spouse, dependent children, and dependent parents/parent in-laws.