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What is Top-up Health Insurance?

A top-up health insurance plan offers additional coverage over your existing health insurance policy and enhances the sum insured limit of the plan. After you have utilised the coverage amount under your existing health policy, top-up insurance provides further financial protection. So, you can rest assured in case you exhaust the available sum insured and seek healthcare without any trouble! After all, with soaring medical care costs, you must have 360-degree protection for all kinds of emergencies.

How Does Top-up Health Insurance Work?

The top up health insurance plan covers your medical bills after you have exhausted the coverage amount under your existing insurance plan. But your insurance claims need to surpass the deductible applicable under your health plan in order to activate your top-up insurance policy.

 

For example, let us assume that you have a health plan with a sum insured of ₹6 Lakhs, a top-up insurance policy of ₹10 Lakhs and a deductible of ₹3 Lakhs. If you raise an insurance claim of ₹8 Lakh, your top-up plan will become active as the deductible has been surpassed. The insurance provider shall pay ₹6 Lakh from the base plan and ₹2 Lakhs from the top-up insurance policy.

What is Super Top-Up Health Insurance?

Super top-up health insurance plans are similar to top-up plans as they help enhance the insurance coverage over your existing policy. But the key difference is that super top-up plans cover the total medical expenses incurred after the deductible has been paid during the policy period. Once the deductible has been exceeded, the super top-up plan shall be active for subsequent claims and you need not surpass the deductible for a fresh claim. With the help of a super top-up plan, you can make the most of your insurance plan and prioritise your health!

How Does Super Top-Up Health Insurance Work?

The super top-up insurance secures the medical expenses incurred after you have utilised the sum insured under your plan. Once you clear the deductible applicable under your health policy, subsequent claims over and above the sum insured of your plan shall be covered by super top-up insurance.

 

For example, let us assume that you have opted for a health plan of ₹6 Lakhs with a super top-up policy of ₹10 Lakh and a deductible of ₹4 Lakh. If you have exhausted your current insurance coverage and raised a second insurance claim of ₹5 Lakh, the entire claim shall be covered by the insurance company. As you have already surpassed the deductible during the policy period, you don’t have to pay for it again.

Top-Up Vs Super Top-Up Health Insurance: Which One to Choose?

Let us compare super top-up health insurance vs top-up insurance plans with some examples:

Parameters

Top-Up Health Insurance

Super Top-Up Health Insurance

Applicability

The medical expenses should exceed the deductible for every insurance claim.

The medical expenses should exceed the deductible once during the policy period.

Number of Claims

A single claim is accepted over and above the deductible.

Multiple claims are accepted once the deductible has been cleared during the policy term.

Here’s a scenario to help you understand the concept of top-up and super top-up health insurance plans:

Example

You have health insurance coverage of ₹5 Lakhs, top-up insurance of ₹10 Lakhs and a deductible of ₹5 Lakhs.

You have health insurance coverage of ₹5 Lakhs, super top-up insurance of ₹10 Lakhs and a deductible of ₹5 Lakhs.

1. A single claim of ₹12 Lakhs

The existing health plan will cover ₹5 Lakhs and the remaining sum of ₹7 Lakhs shall be covered by the top-up policy.

The existing health will cover ₹5 Lakhs and the remaining amount of ₹7 Lakhs will be covered by the super top-up plan.

2. Two claims of ₹4 Lakhs each

The existing health policy shall cover the first claim of ₹4 Lakhs and ₹1 Lakh from the second claim. As the second claim hasn't exceeded the deductible, the top-up will not cover anything.

The base health insurance plan will cover ₹4 Lakhs from the first claim and ₹1 Lakh from the second claim. The remaining ₹3 Lakhs will be covered by the super top-up plan.

3. Two claims of ₹4 Lakhs and ₹7 Lakhs

The existing health plan will cover ₹4 Lakh from the first claim and ₹1 Lakh from the second claim. As the second claim surpasses the deductible, the top-up shall cover the remaining amount of ₹6 Lakh.

The base health plan will cover ₹4 Lakh from the first claim and ₹1 Lakh from the second claim. Whereas the super top-up plan shall cover the remaining amount of ₹6 Lakh.

Importance of Buying Super Top-Up & Top-Up Health Insurance

Now that you know both of these health insurance policies in detail, let’s understand the importance of opting for super top-up and top-up health plans:

  • Rising Healthcare Inflation

Healthcare inflation has been on the high, impacting rural as well as urban regions of the country. During such times, having the financial backup of a top-up or super top-up plan can go a long way. In case your existing health insurance coverage is utilised, a health insurance top-up plan can enhance the cover and offer protection against inflation.

  • Additional Savings

Super top-up and top-up insurance plans are quite budget-friendly when compared to getting a new individual health insurance plan. You can avail enhanced coverage and enjoy more protection without incurring higher premiums.

  • High Sum Insured

Many a time you might not be able to opt for a higher sum insured and upgrade your existing plan. A top-up or super top-up policy provides additional coverage over and above your current coverage amount. And do not forget the affordable premiums!

  • Extra Coverage for Senior Citizens

Senior citizens can enjoy extensive coverage with top-up or super top-up plans without having to bear hefty premiums! Thus, such an insurance policy makes it possible for older policyholders to gain security at cost-effective rates.

  • Tax-Savings

Now you can save up on taxes by claiming tax benefits for both super top-up and top-up policies. Under Section 80D of the Income Tax Act, 1961, you can claim the premiums paid towards the insurance plan without much hassle.

Eligibility Criteria for Super Top-Up and Top-Up Insurance

The eligibility criteria for super top-up and top-up plans are similar to the criteria for health insurance policies. You might find a minimum and maximum entry age applicable for both these insurance plans but they may vary from one insurance provider to another. So, we recommend you to compare various top-up plans online and check the eligibility criteria.

Who Should Opt for Super Top-Up and Top-Up Health Insurance?

Although top-up and super top-up health insurance plans are suitable for all, here are some key categories of individuals who should definitely opt for one:

  • Policyholders Having a Low Health Cover

It is possible for your insurance needs to change with time. If your current existing health plan isn’t sufficient to secure your medical requirements then you should consider opting for a top-up or super top-up plan. This will boost your coverage and save the trouble of buying a new health plan or porting it for a higher sum insured.

  • Senior Citizens

Senior citizens are more likely to incur higher medical expenses during the policy year which is why they need more coverage. Due to their increased age, the premiums shall be expensive and hence, top-up and super top-up insurance plans are a lucrative option for senior citizens!

  • Individuals Who Raise More Claims

If you tend to file more claims due to your health while your insurance plan falls short to cover you, top-up and super top-up plans are a must! They are pocket-friendly and enhance the coverage amount over and above the existing policy. So, you can avail healthcare treatment during the policy period without any worries.

  • Corporate Employees

In case you are already covered under a group health insurance plan provided by your employer, a top-up and super top-up plan shall satisfy your insurance needs. If the limited sum insured available under group insurance is utilised, you can use super top-up plans to cover further expenses.

What’s Covered Under Super Top-Up and Top-Up Insurance

Here are the inclusions of top-up and super top-up health insurance policies:

 

  • Pre and Post-Hospitalisation - The pre and post hospitalisation expenses incurred by the policyholder for diagnostic tests, scans, blood tests, follow-ups, etc. shall be covered under the plan.

  • Daycare Procedures - Treatments or procedures that do not require hospitalisation for 24 hours are covered by the insurer.

  • Road Ambulance - Top-up and super top-up plans offer an ambulance cover to secure the expenses incurred for a road ambulance during an emergency.

  • ICU Room Rent - The room rent for an ICU is also covered under the insurance policy.

  • In-Patient Treatment - The expenses incurred for an operation theatre, nursing charges, anaesthesia, doctor’s fee, etc. are covered by the insurance provider as in-patient treatment.

What’s Not Covered Under Super Top-Up and Top-Up Insurance

Below are some exclusions of top-up and super top-up health insurance:

 

  • Pre-Existing Ailment - Any insurance claims made for pre-existing conditions will not be covered under the plan before the applicable waiting period is over.

  • Self-Inflicted Injuries - The hospitalisation expenses arising from self-inflicted injuries or attempted suicide are not covered.

  • Lifestyle Diseases - Medical expenses resulting from lifestyle diseases such as liver cirrhosis caused due to excessive drinking aren’t included in the policy.

  • Dental Treatment - The health insurance policy does not cover the expenses of dental procedures except in case of accidental damage.

  • Waiting Period - Any healthcare expenses incurred during the waiting period.

  • Plastic Surgery - Any cosmetic treatment or surgery is not covered by the insurer.

  • Sexually Transmitted Diseases - Health insurance does not cover the expenses incurred due to sexually transmitted diseases such as HIV/AIDS.

Final Thoughts

The comparative view between top-up vs super top-up health insurance must have helped you understand their applicability and benefits. Now that you have learnt how both of these plans work in the case of health insurance claims, you can choose the right one for you. To make sure you opt for the right insurance backup, we advise you to understand your insurance requirements and pick one of the two accordingly. With a top-up or super top-up plan, you can gain security against medical emergencies and prioritise your health without worrying about your finances. But ensure you compare plans online to get the best features and an affordable premium quote!

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FAQs - Top-Up Health Insurance VS Super Top-Up Health Insurance

  • ✔️What should I consider before purchasing super top-up health insurance?

    It is recommended to consider the deductible limit of your super top-up health policy while purchasing the plan. Moreover, you can also consider other aspects such as the coverage, sum insured in health insurance, premium, etc. under super top-up before settling with an insurance policy

  • ✔️What is a deductible in a top-up or super top-up health insurance plan?

    A deductible is an amount that you must pay under your health plan before the insurance provider starts covering the remaining claim amount.

  • ✔️What are the factors that affect my top-up or super top-up insurance premium?

    There are numerous factors that play a role in deciding the top-up or super top-up insurance premium. These include your age, sum insured amount chosen, the deductible of the plan, etc.

  • ✔️Can I purchase a health insurance plan from one insurer and a top-up plan from another insurance company?

    Yes. You can easily buy a top-up or super top-up health insurance plan from a different insurance provider.

  • ✔️What will happen if my top-up or super top-up health insurance plan expires?

    If your top-up or super top-up insurance policy expires, you won’t be able to raise any insurance claims when your base plan coverage gets exhausted. You will have to renew the plan to start availing its benefits again.

  • ✔️Can I purchase a top-up or super top-up health insurance plan with a family floater policy?

    Yes, you can buy a super top-up or top-up insurance plan with a family floater insurance policy as well as an individual health plan.

  • ✔️What is the difference between super top-up vs top-up health insurance?

    A top-up insurance plan offers coverage on exhausting your existing plan and exceeding the deductible for each claim. Whereas, a super top-up health insurance plan offers protection on utilising your base health plan and exceeding the deductible once during the policy year.

  • ✔️How do I choose between top-up vs super top-up health insurance?

    It is recommended to understand your insurance as well as health needs to choose between the two plans. In case the risk of getting hospitalised during the policy period is higher, a super top-up plan is suitable. But if you want to enhance your health cover against higher insurance claims, you can opt for top-up plans.