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What's the deal with top-up plans?

Pacific Prime looks at top-up insurance options for group medical plans and when they can be used.

Posted on Sep 08, 2015 by

Generally speaking most companies in Asia offer their employees some form of health insurance, with the majority offering at least a group plan that has been purchased by the company and subsequently offered to employees. Ask anyone about their company's health insurance plan and, while some will say it's great, many will say that it offers adequate coverage, but wish it was better.

This is true for people with ongoing conditions or even dependents who may not be covered by any company health insurance resources, especially because one of the biggest trends in this type of insurance is the implementation of caps or limits on claims; potentially leaving you to pay for extra care out of your pocket. Even more so if you decide to seek private care, which is becoming increasingly expensive.  

While there are many other health insurance options out there that you can purchase yourself, it may seem a bit redundant to purchase an entirely new plan. One of the best options available is a top-up plan. These plans offer additional coverage over an existing plan, or expand coverage elements that may not be offered in your existing plan.

A good example of how top-up plans can help is if you need to go for a day-surgery. Most group health insurance plans will cover a large portion of the cost, but some plans may have a set claim limit on day procedures. If the cost goes over this limit, you will be left paying the remainder, which can be quite costly, especially so if you select to go to a private facility in a country with pricey healthcare like Hong Kong or Singapore. A top-up plan can start covering costs after you have reached your claim limit on your main plan. In theory, this can give you access to better care than is available to you through just your group medical plan.

As with almost everything else in health insurance however, there are a wide number of different top-up options available, and when they may be right for you. To help, here are four of the most common medical situations where top-up plans can come in handy.

Situation 1: If you have pre-existing conditions

Group health insurance plans tend to look more favorably on pre-existing conditions, and may cover these conditions. If you have this type of plan, then a top-up may not be necessary. However, if your plan doesn't cover pre-existing conditions, especially the more costly ones like asthma, diabetes or high blood pressure, you could be left with exceedingly high bills.

There are top-up plans out there that can cover pre-existing conditions, or at the very least offset the ongoing costs so that they are more manageable for the policy-holder. Beyond that, these specific plans can offer increased coverage that allows you to see a specialist out of the public or insurer-mandated network.

Situation 2: If you think you may incur high inpatient expenses, or would like to visit private clinics

The fact of the matter is, as an expat in a foreign country, when you are sick you are probably going to want to see a doctor who can speak your language. While this can be easy to find in, say, the public hospitals in Hong Kong, or Singapore, it's not necessarily easy in other locations. Because of this, many expats turn to the private system where their group medical plan may not fully cover expenses.

For example, if you are in Thailand and need to have a skin-graft and subsequent treatment, most group insurance plans will not cover the full expense of the surgery at a private hospital - a logical choice for expats, as many public hospitals don't have staff who can speak enough English to provide efficient care - leaving you to pay out of pocket.

A top-up plan is a way for you to offset the risk associated with the cost of this level of health care, while still allowing you to receive the type of care you need.   

Situation 3: If you plan to travel or be away from your country for an extended period of time

With many countries in Asia seeing an unstable business environment and increasing costs, companies are instituting cost cutting measures in order to stabilize profits. Often, one of the first things cut is the level of health insurance coverage offered. For example, a company may change their region of coverage from worldwide to just Asia, or even a local plan.

While this will be ok for most situations, if you need to travel for work or pleasure outside of your area of coverage, you may be left paying the full bill should you need medical care. One option is to secure a top-up plan, which bumps up your area of coverage or may introduce coverage elements such as world-wide medical evacuation or even a travel-oriented health care plan.

Situation 4: If you need other types of care

Sometimes your medical needs may go beyond an existing condition, travel, or inpatient procedures. For example, you would like to have dental coverage, coverage for ongoing physiotherapy, or even coverage for mental issues. These are all coverages that may not be offered by your company health insurance plan.

Top-up plans can expand the coverage available to you, meaning you can rest assured knowing that you will be able to secure care for whatever you need, and, should your company plan fall short, a coverage net will still be available.

The key here is to be aware of the fact that you are not stuck with just your company health insurance plan. There is always an option available and top-up plans can often be the best of them. To learn more about these plans and how they can help, contact one of our experts today.


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