Health insurance is a vital asset in today’s world. You never know what the future holds, and safeguarding your health and finances should be your number one priority. With that said, the higher your required coverage, the higher your premium rates.
To circumvent this, insurance providers offer health insurance top-up and super top up health insurance plans that can be bought along with medical policies. These plans increase your medical coverage while keeping your overall premiums low.
Read on to learn their differences and to find out what type of health insurance top-up plan you should opt for to maximise your health insurance policy coverage.
Types of Health Insurance Top-Up Plans
When your health Insurance amount is low compared to the coverage you require, top-up plans can be a viable option. They are much more affordable than opting for a high-coverage medical policy and come into effect when you exhaust your sum insured.
However, these plans come with a mandatory deductible or threshold limit and only provide coverage after you have paid the deductible amount. There are two types of health insurance policy top-up plans:
- Top-Up Plan
A top-up plan compensates the sum insured to a certain amount when your medical costs exceed the deductible/threshold limit. It applies to each and every claim.
- Super Top-Up Plan
A super top-up plan factors in all the claims in a policy period. In other words, you only need to pay the deductible once during the policy year.
Difference Between Top-Up and Super Top-Up in Health Insurance
| Parameters | Top-Up Plan | Super Top-Up Plan |
| Activates When | When the claim exceeds the deductible/threshold limit. | When cumulative claims within the policy year/tenure exceed the deductible/threshold limit. |
| Number of Claims | A single claim or each claim that exceeds the deductible/threshold limit. | Cumulative claim amount/bills that exceed the deductibles during a policy term/year. |
| When does the Insured Pay the Deductible? | On every claim | Once during a policy year |
An Example Illustration Indicating the Difference Between Health Insurance Top-Up Plans
| Parameters | Top-Up Plan | Super Top-Up Plan |
| Claim 1 | ||
| Health Insurance Sum Insured | ₹15 lakhs | ₹15 lakhs |
| Policy Deductible | ₹2 lakhs | ₹2 lakhs |
| Claim 1 Amount | ₹10 lakhs | ₹10 lakhs |
| What You Pay | ₹2 lakhs | ₹2 lakhs |
| What the Insurer Pays
(Claim Amount – Policy Deductible) |
₹8 lakhs | ₹8 lakhs |
| Claim 2 | ||
| Claim 2 Amount | ₹5 lakhs | ₹5 lakhs |
| Policy Deductible | ₹2 lakhs | – |
| What You Pay | ₹2 lakhs | – |
| What the Insurer Pays
(Claim Amount – Policy Deductible) |
₹3 lakhs | ₹5 lakhs |
In the table above, both plans had a sum insured of ₹15 lakh, and the deductible is ₹2 lakhs. The amount claimed was ₹10 lakhs. Under both plans, the insurance company paid ₹8 lakhs to the insured.
However, during the second claim (₹5 lakhs):
- If you have a health insurance top-up plan, you would need to pay the deductible amount (₹2 lakhs) while the insurer covers the rest (₹3 lakhs).
- If you have a super top-up medical insurance plan, you would not need to pay anything, as the insurer will cover the whole claim amount.
What is a Deductible in Top-Up/Super Top-Up Medical Insurance?
Deductibles are limits set in place by the health insurance provider. Simply put, you – the insured must pay a predetermined amount when filing a claim, while your insurer pays the rest.
Health insurance providers impose deductibles on their plans to prevent people from filing smaller, frequent/trivial claims. Hence, your insurance company will only pay claim amounts that are over and above the deductibles.
For example, say your health insurance plan has a deductible amount of ₹3,000, and you filed a policy claim of ₹10,000. Your insurer will only be liable to pay ₹10,000 – ₹3,000 = ₹7,000 as you will pay the percentage of deductible, i.e., ₹3,000.
Top-up Vs Super Top-up Health Insurance Plans: Which One Should You Buy?
- A super top-up health insurance plan is beneficial if you or an insured family member suffers from a chronic illness that requires multiple hospitalisations in a year. It is also suitable for senior citizens who require regular medical treatments.
- If you do not suffer from pre-existing or chronic conditions, a health insurance top-up plan should be enough to cover medical emergencies without you having to opt for higher coverage plans.
For example, say an insured family member is pregnant, and their maternity insurance does not provide enough coverage. In that case, a top-up plan can help as it can account for emergency medical expenses if complications arise.
Conclusion
Health insurance top-up plans are a great way to increase your base policy coverage without paying excessive premiums or buying a higher coverage health insurance plan. Moreover, you can also buy top-up plans from different insurance providers.
We recommend buying your medical policy and top-up plans from reputed online insurers like Tata AIG, as buying from the same insurer allows you to claim cashless facilities and several other benefits.
