Super Top-up Health Insurance

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Clarify All Doubts Related To Super Top-up Health Insurance

Having a high sum insured in a health insurance plan is important given the ever-increasing medical expenses. However, affording a high sum insured year on year can prove to be challenging and this is where top up health insurance plans come into the picture.

Health insurance top up plans provides supplementary coverage on your existing plan. These plans come with a deductible limit and if your claim exceeds the given deductible limit, top up health insurance plans pay the excess claim. Besides health top up plans, there is super top up health insurance plans too which go a step above top up plans and provide a wider scope of coverage.

Yes, you can buy both top up and super top up insurance plans. However, buying both plans is not a wise choice. You should, instead, buy a super top up plan which covers your aggregate claims. Make sure to choose a high sum insured and the deductible limit of the policy should coincide with your existing health plan’s sum insured so that claims up to the deductible are paid by the existing policy and excess claims are covered by the super top up plan.
Yes, super top up plans are available on a family floater basis wherein coverage is allowed for you, your spouse, dependent children and dependent parents. Some super top up policy in health insurance might also allow coverage for your dependent parents-in-law.
The coverage duration of top up and super top up plans varies across companies. Usually, annual coverage is available under all plans and many plans allow long term coverage too wherein you can get covered for two or three continuous years by paying the lump sum premium at once.
Yes, almost all health insurance providers offer their top up and super top up plans online so that you can buy the policy with ease.
Yes, top up and super top up plans cover pre-existing conditions. However, such coverage is allowed after a waiting period. The waiting period for pre-existing conditions ranges from 2 years to up to 4 years depending on the plan selected.
There are a few top up and super top up plans which cover maternity-related expenses. You should, therefore, compare the available top up plans and find out which plans allow coverage for maternity. You can then buy the plan where maternity-related expenses are covered.
top up plans considers each claim against the deductible limit. Thus, since the second claim is also below the deductible limit, the policy would not pay the claim.
Top up plans has a maximum entry age limit which is usually 65 years. Thus, senior citizens, up to 65 years of age can avail the coverage under top up plans.
Health insurance companies allow online premium calculators which help you calculate the premium of the policy that you want to buy. So, if you have finalized the top up plan, you can visit the website of the insurance company and use the premium calculator to calculate your premium. Alternatively, you can use the premium calculators used by insurance aggregators to find the premium of different top up plans at once and then compare the quotes and choose the best policy.
Yes, you can pay the premium of the top up policy online through net banking, credit cards, debit cards, mobile wallets, UPI or any other digital payment channels.
Yes, top up and super top up plans do allow different types of premium discounts. You can get discounts for choosing long term policy tenure, for including your family members under the coverage, for buying the policy online or for maintaining a healthy life. Different plans offer different types of discounts which range from 5% to up to 20%. So, find the applicable discounts in the available plans and use them to reduce your premium outgo.
Yes, the premium that you pay for a top up health insurance policy qualifies for tax benefits. You can claim a deduction of up to Rs. 25,000 on the premium paid under Section 80D of the Income Tax Act, 1961. This deduction increases to Rs. 50,000 if you are aged 60 years and above. Moreover, if you buy a top up plan for your dependent parents, you can claim an additional deduction of up to Rs. 25,000 which would increase to Rs. 50,000 if your parents are senior citizens.
Yes, a cashless claim facility is available under top up insurance. However, to avail of cashless claims, you should seek treatments at a hospital that is tied up with the insurance company.
The list of networked hospitals is available on the insurance company’s website. You should check the list of hospitals in your city and find out which hospitals are tied up with the insurance company to offer you cashless claim settlements.
The claim amount depends on the actual medical costs and the deductible limit of the top up health insurance plan. The medical expenses which exceed the deductible would be paid as a claim under top up health plans. For example, if you have a deductible of Rs. 2 lakhs and you incur medical costs of Rs. 2.5 lakhs, the claim paid would be Rs. 50,000.
A reimbursement claim means that you pay for your medical expenses as and when they occur. Thereafter, after you are discharged from the hospital, you file the claim with the insurance company and the company reimburses you for the medical costs that you incur. Reimbursement claims are applicable if you get treated in a non-networked hospital or if the insurance company does not approve cashless claims.

Both health insurance top up plans and super top up plans have been developed so that they offer additional coverage to the existing health plan that you have. They act like a Stepney that you can use if you have exhausted the sum insured limit of your plan and are in need of more money.

Let’s understand both these plans in detail –

What is a Top-up Health Insurance Plan?

A top up insurance plan is a health insurance plan where you choose the sum insured and the deductible limit. Thereafter, if you incur a claim which is more than the deductible limit, the top up medical insurance plan pays the excess claim. The deductible limit is applicable in each instance of the claim and only when the claim amount exceeds the deductible, the top up insurance policy would be triggered.

Example

For example, say you buy a top up health insurance plan with a sum insured of Rs.10 lakhs and a deductible of Rs.5 lakhs. A claim occurs which amounts to Rs.6 lakhs. In this case, since the claim is higher than the deductible, the top up insurance policy would pay the excess claim of Rs.1 lakh. However, if you incur a claim of Rs.4 lakhs or any amount below Rs.5 lakhs, the top up plan would not pay any claim and you would have to pay the difference from your pocket.

Even in the case of subsequent claims, the expense amount should be above the deductible limit to avail claim from the policy. Like in the above policy, if the second claim is 4 lakhs, which is below the deductible of 5 lakhs, then there would be no claim payout. However, if the claim is 6 lakhs the payout would be only Rs 1 lakhs as the deductible is applied in each instance of a claim.


What is a Super top up Health Insurance Plan?

A super top up plan is like a top up plan but with one main difference. Under a top up insurance plan, every instance of claim is measured against the deductible limit and claims exceeding the deductible are paid. However, under super top up health insurance plans, cumulative claims made in a policy year are measured against the deductible. If the aggregate value of all the claims exceeds the deductible, the excess claim would be paid.

Example

For example, say you buy a super top up policy with a sum insured of Rs. 10 lakhs and a deductible limit of Rs. 5 lakhs. In a policy year, the first claim is incurred which amounts to Rs. 2 lakhs. In this case, the super-top up health policy would not pay any claim.

Subsequently, another claim is incurred which amounts to Rs. 3.5 lakhs. In this case, the total claims made so far amounts to Rs. 5.5 lakhs. Since the aggregate value of claims exceeds the deductible of Rs.5 lakhs, the super top up health policy would pay the excess claim of Rs. 50, 000.

Thereafter, if a third claim is made, the super top up policy would cover that claim completely, up to the Sum insured, since the aggregate claim value has already surpassed the deductible in the second instance of a claim.


Difference Between top up and Super top up Health Insurance

Both the plans are alike in certain aspects but they have some fundamental differences. The differences between them can be checked in the following table –

Top-up Health Insurance

Super Top-up Health Insurance

The plan pays the claim if an independent claim exceeds the chosen deductible limit The plan pays the claim if the aggregate value of all claims occurring in a Policy year exceeds the chosen deductible limit
The premiums are lower The premiums are comparatively higher than top up plans but substantially lower than Regular Health Plans

Let’s understand the difference between these two plans through an example –

Policyholder “A” buys top up health insurance for a sum insured of Rs.10 lakhs and a deductible of Rs.5 lakh. Policyholder “B”, buys super top up insurance with the same sum insured and deductible. Let us take a look at how the claims would be made:

Incidence of Claim

Health Insurance Top-up Plan

Health Insurance Super Top-up Plan

1st claim of Rs.2.5 lakhs No claim would be paid as the deductible limit is Rs.5 lakhs No claim would be paid as the deductible limit is Rs.5 lakhs
2nd claim of Rs.5 lakhs No claim would be paid as the deductible limit is Rs.5 lakhs Aggregate claims = 2.5 + 5 = Rs.7.5 lakhs
Deductible limit = Rs.5 lakhs
Claim payable = up to Rs.2.5 lakhs
3rd claim of Rs.6 lakhs Claim = Rs.6 lakhs Deductible limit = Rs.5 Lakhs Claim paid = Rs.1 lakh Aggregate claims = 2.5 + 5 + 6 = Rs.13.5 lakhs
Deductible = Rs.5 lakhs
Claim payable = up to Rs.6 lakhs

As you can see, the top up insurance policy would be triggered only in the third instance of a claim when the claim exceeds the deductible limit. However, the super top up policy would be triggered by the second claim onwards. It would not only pay the claim in the second instance, but it would also be able to pay the entire claim of the third instance since the deductible limit was crossed in the second instance itself. The maximum payout in both top up and super top up health policy would be up to the Sum Insured.

Choosing the best super top up plan or the

Top-up Health Insurance

Super Top-up Health Insurance

The plan pays the claim if an independent claim exceeds the chosen deductible limit The plan pays the claim if the aggregate value of all claims occurring in a Policy year exceeds the chosen deductible limit
The premiums are lower The premiums are comparatively higher than top up plans but substantially lower than Regular Health Plans

Let’s understand the difference between these two plans through an example –

Policyholder “A” buys top up health insurance for a sum insured of Rs.10 lakhs and a deductible of Rs.5 lakh. Policyholder “B”, buys super top up insurance with the same sum insured and deductible. Let us take a look at how the claims would be made:

Parameters

Base Health insurance Plan

top up Plan

Super top up Plan

Deductible -NA- Each hospitalisation is accounted for separately All the hospitalisations are taken together in aggregate
Is there a Restore Benefit? Depends on the plan opted for Is not applicable Is not applicable
Is there a No Claim Bonus? Yes, (the percentage of NCB depends on the plan) Not applicable Not applicable
Is Renewability available? Can be Life long, depending on the plan chosen Can be Life long, depending on the plan chosen Can be Life long, depending on the plan chosen
Can I increase the SI? At the time of Renewal At the time of Renewal At the time of Renewal
Do I get Free Health Check-Ups? If offered under the plan Is not applicable Is not applicable
Is Co-Payment available? Possible, depending on the plan Possible, depending on the plan Possible, depending on the plan
What would be the Premium Cost? Highest, in comparison to all three Lowest Higher than top up but lower than the Base Plan

Benefits of top up Health Insurance and Super top up Health Insurance Plans

The reasons why top up insurance and Super top up Health Insurance plans become essential in your health insurance portfolio are given below –

  1. Increase the Health Insurance Coverage
  2. Medical costs are shooing up consistently and meeting the costs of a medical emergency proves to be challenging. In such cases, having a sufficient sum insured in your health insurance policy is needed. To ensure that you are sufficiently covered, health top up plans prove to be a great addition to your financial portfolio. When you buy top up health insurance or super top up health insurance they increase the existing coverage ensuring in times of a medical crisis you do not fall short on the coverage.
  3. Affordable Coverage
  4. One of the primary reasons why super top up and top up medical insurance plans are favoured is because of their cost-effectiveness. Under both these plans, the premiums are low which help you increase your existing coverage in an affordable manner. Thus, with the help of super top up and top up mediclaim policy, affording a high sum insured becomes possible.
  5. Sufficient Coverage Against Multiple Claims in A Year
  6. This is particularly relevant for super top up medical insurance plans which aggregate the claims incurred in a year and then measure them against the deductible limit. Thus, when you have multiple claims in a single policy year, you don’t have to worry about your coverage running out. Super top up medical insurance plans ensures that you have additional coverage in case of multiple claims.
  7. Comprehensive Coverage
  8. When you buy top up health insurance or super top up mediclaim policy cover you for inpatient hospitalisation expenses, pre and post hospitalisation costs, daycare treatments, organ donor treatments, etc. Thus, these plans provide a comprehensive scope of coverage. Moreover, you can buy super top up health insurance plans on a family floater basis covering all your family members under a single plan which is also renewable lifelong. Thus, you get comprehensive and continuous coverage under a super top up and top up mediclaim policy for your health insurance needs.
  9. Flexibility
  10. A top up, as well as a super top up plan, offers you flexibility and freedom to choose the base health policy from one health insurance company and the Super top up plan from another company. However, many consider buying the top up or the super top up from the same insurer, as making a claim may be comparatively easier when there is a single insurer. But, say you have a group health plan from your company/ employer, you can purchase a top up from any other company that you feel is offering a good deal.
  11. Tax Benefits
  12. Last, but not least, you get tax benefits on the premiums paid for super top up and top up insurance plans. Being health insurance plans, premiums paid up to Rs. 25,000 are allowed as a deduction from your taxable income. If you buy a top up or a super top up for senior citizen aged 60 years and above, the deduction limit would increase to Rs. 50,000.
    Moreover, if you invest in top up insurance plans for your parents too, an additional deduction of up to Rs. 50,000 (assuming your parents are over the age of 60 and you are buying a top up or a super top up for senior citizen) can be claimed. Thus, health top up plans help in reducing your taxable income by up to Rs. 1 lakh which also lowers your tax liability.

Best Health Insurance top up Plan in India

Almost all health insurance providers offer one or more health insurance top up policies. Thus, when you want to buy the best top up health insurance plan, you have many choices. Choosing one plan, therefore, might prove to be a challenge. You can compare the policy features and Buy online on Paybima.com. Doing a top up or a super top up policy comparison is very simple and quick.

A health insurance top up policy or super top up plan helps you in affording a high sum insured so that you can optimally cover against the expensive medical expenses. Understand how the health insurance top up policy works and then compare to choose the best top up health insurance plan. If you need coverage against multiple claims, you should choose a super top up plan, which would pay the claim once the aggregate deductible limit is surpassed. So, assess your coverage needs and then choose the best top up health insurance coverage for a comprehensive scope of coverage at the most affordable premium rates.

You can also buy a top up or a Super top up plan on a standalone basis, without any base health policy. However, to ensure maximum coverage, choose the deductible limit that coincides with your existing health insurance policy so that claims up to the deductible limit can be paid by the existing plan and excess claims can be paid by the top up or super top up policy in health insurance that you would buy so that you don’t run out of cover.