Individual policy, family floater, or top-up: Which is the most cost-effective?

My employer provides a group health cover of 3 lakh for my family. My wife is covered separately under her employer’s group policy. We feel the combined cover is inadequate given rising medical costs. Should we buy an individual policy, a family floater, or a top-up plan? Which is the most cost-effective option? We are both in our mid-30s with two children.

– Name withheld on request

Supplementing employer-provided cover with a personal policy is a prudent move. Group insurance comes with a structural risk: it lapses if you change jobs, are laid off, or if the employer withdraws the benefit. A personal policy serves as a long-term safety net independent of employment. As a rule of thumb, aim for total health cover at least equal to your annual family income.

The most cost-effective way to build this cover is through a top-up plan. Such plans kick in only after a specified deductible is exhausted, making them significantly cheaper than standard mediclaim policies. You can align the deductible with your existing group cover. For instance, a top-up with a 3 lakh deductible will cover expenses above that threshold—your group insurance pays the base layer, and the top-up covers the excess.

When choosing a top-up, focus on two features. First, some plans allow you to remove the deductible later. This can be useful if both of you lose corporate cover, letting the same policy function as full insurance.

Second, opt for a plan with an annual aggregate deductible rather than a per-claim one. Under an aggregate structure, once your total claims in a year cross the deductible, subsequent claims are covered in full without resetting the threshold. This is far more favourable in years with multiple hospitalizations.

Abhishek Bondia is the co-founder of SecureNow

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