Meet Neha Jain – a marketing executive with a multinational company. In 2021, she bought a health insurance policy worth Rs. 7.5 lakhs, which she recently realised is not a sufficient amount. If she falls ill or sustains a bodily injury, given she travels a lot for work, her medical bills can run significantly higher.
So, can Neha purchase two health insurance policies? Well, she can, but a far better idea would be to opt for a super top-up health insurance plan. Not only will this reduce Neha’s paperwork and headache in searching for another ideal health insurance, but it will also make things seamless when she applies for a claim.
This is precisely what Neha did. She got a super top-up plan worth Rs. 5 lakhs added to her pre-existent health insurance policy of Rs. 7.5 lakhs. With Super-top-up health insurance in place, Neha is covered, even if her healthcare bills run up to more than Rs. 10 lakhs.
The minute Neha exhausts her base health insurance policy; her top-up plan kicks in to ensure she stays solvent in the face of an unforeseen medical emergency.
What is a Super Top-Up Health Insurance?
Super top-up health insurance provides financial cover after you have exhausted your base health insurance plan. Like a top-up health insurance policy, a super top-up plan covers expenses exceeding a particular disease’s threshold amount.
But isn’t this the same as top-up health insurance? While both top-up and super-top plans offer coverage over and above your base health insurance plan, they do come with a critical difference.
Difference Between Super Top-Up and Top-Up Insurance
|Super Top-Up Insurance||Top-Up Insurance|
|A super top-up plan provides coverage for total hospitalization bills above the base policy threshold within a single policy or calendar year depending upon your insurer. This means you can claim multiple hospital bills within a policy year.||A top-up insurance plan will indeed replenish the total sum insured once you exhaust your base healthcare policy. But, this replenishment will only be for a single claim over the deductible amount once during a policy year.|
Let’s Understand this better with an example
|Factors||Super top-up plan + Base Plan||Top-up plan + Base Plan|
|Base plan sum insured||Rs. 5 lakhs||Rs. 5 lakhs|
|Top-up/Super top-up plan sum insured||Rs. 10 lakhs||Rs. 10 lakhs|
|Threshold/deductible limit||Rs. 5 lakhs||Rs. 5 lakhs|
|1st claim of the year||Rs. 8 lakhs||Rs. 8 lakhs|
|What the insurer pays||Rs. 5 lakhs (base policy) + Rs. 3 lakhs (super top-up policy)||Rs. 5 lakhs (base policy) + Rs. 3 lakhs (top-up policy)|
|What you pay||Nothing||Nothing|
|2nd claim of the year||Rs. 4 lakhs||Rs. 4 lakhs|
|What the insurer pays||Rs. 4 lakhs||Nothing|
|What you pay||Nothing||Rs. 4 lakhs|
Note: Top-up plans work on a per claim basis. Hence, the deductible rule will apply for each claim and not the total medical expenses incurred during the policy year. Meaning, only if the claim amount exceeds the deductible limit, the top-up plan will be active.
Key Benefits and Inclusions of Super Top-Up Health Insurance Plans
Both top-up and super top-up health insurance plans come with a bouquet of benefits listed below:
Additional Coverage at Low Premiums: Top-up plans extend additional coverage at low premiums that help cover medical expenses. They also pay for hidden costs that are part of pre and post-hospitalization.
Covers In-Patient Hospitalisation: From hospital room rent and nursing charges to doctor’s consultation and procedural expenses, your super top-up amount can be used to cover various costs.
Cashless Transactions: Just because these are “top-up” amounts doesn’t mean they behave differently from the base plan. Depending on your base insurance and super top-up insurance contract, you are entitled to cashless transactions from both pools.
Free Emergency Ambulance: Many insurers include emergency ambulance expenses up to a certain threshold which can come out of the super top-up pool if you exhaust your base plan.
Super Top-Up Health Insurance Exclusions
Although a super top-up health insurance plan offers a comprehensive cover, it does leave out a few things.
- Covers pre – existing illness only after waiting period.
- It may not cover chronic diseases.
- In special cases, it may not cover psychiatric illnesses.
While a standard super top-up plan may not include the aforementioned ailments, you can still negotiate them into your contract. To do so, you must inform the insurer in advance, as it may influence your premium amount. However, know that it can be done hassle-free!
Should You Consider a Super Top-Up Insurance Plan?
Given that a super top-up health insurance plan allows you to dig into its pool as often within a policy year as you want, it’s an excellent investment for individuals at a higher risk of hospitalisation.
However, the benefits of a super top-up plan are universal, and anybody looking for bulletproof healthcare without paying hefty bills should get it.
In the End
Looking for someone to help you pick the right health insurance plan for yourself and your family? Who better to trust than Tata Capital Wealth? Head over to our website to request a call-back for curated health insurance plans. Allow our experts to guide you into making the right decision with your health insurance policies.