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 –
- Increasing the Health Insurance Coverage 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.
- Affordable Coverage 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.
- Sufficient Coverage Against Multiple Claims in A Year 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.
- Comprehensive Coverage 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.
- Tax Benefits 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.