Super Top-up Health Insurance

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. Let’s understand both these plans in details –

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.

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.

Even in 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 they would be no claim payout, However if the claim is 6 lakhs the payout would be only Rs 1 lakhs as deductible is applied in each instance of 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.

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 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 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,upto 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 many aspects but they are fundamentally different. 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 limith
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 –

Say you buy both health insurance top up plan and super top-up plan for a sum insured of Rs.10 lakhs and a deductible of Rs.5 lakh. Here’s how these plans would work in different instances of claims –

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 plan 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 plans would be upto the Sum insured.

Benefits of Top-up and Super Top-up Health Insurance Plans

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

  1. Increasing 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. 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. Both top up and 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 top up insurance plans on a family floater basis covering all your family members under a single plan which is also renewable lifelong. Thus, you get a comprehensive and continuous coverage under a super top-up and top up mediclaim policy for your health insurance needs.
  9. Tax Benefits
  10. Last, but not the 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 a 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 senior citizens) can be claimed. Thus, health top up plans helps 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

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 shouldchoose a super top-up plan, which would pay the claim once theaggregate 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, choosethe 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 health insurance policy that you would buy so that you don’t run out of cover.

Yes, you can buy both top-up and super top-up insurance plans. However, buying both the 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 family floater basis wherein coverage is allowed for you, your spouse, dependent children and dependent parents. Some super top-up plans might also allow coverage for your dependent parents-in-law.
The coverage duration of top-up and super top-up plans vary 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 range 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 consider 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 have a maximum entry age limit which is usually 65 years. Thus, senior citizens, up to 65 years of age can avail 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 calculateyour 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 wouldincrease to Rs.50, 000 if your parents are senior citizens.
Yes, cashless claim facility is available under top-up plans. However, to avail cashless claims, you should seek treatments at a hospital which 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 thetop-up health insurance plan. The medical expenses which exceed the deductible wouldbe paid as 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.
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.