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What Are Top-up And Super Top-up Plans In Health Insurance?

Team AckoJul 22, 2021

When a person is healthy, he/she can achieve success without any limitation. But for someone who is not in the pink of health, meeting goals can be a problem. Apart from healthy eating habits and a good exercise regime, it is also important to overcome illnesses when they strike. And this might cost a lot depending upon the illness. With increasing costs of medical treatments, one of the most reliable back-ups is buying health insurance in India. It will ensure that you receive medical treatment without any financial hiccups.

Top-up And Super Top-up Plans In Health Insurance

Health insurance is not limited to just one type of policy, you can buy a plan that suits your requirements. For example, you can buy a family floater plan to cover all the members in your immediate family or a senior citizen plan for your parents (age above 60 years). Or, an employer can buy a group health insurance for his/her employees. Likewise, you can buy additional coverages if you feel that your current sum insured is not sufficient. This is where top-up and super top-up plans come into the picture. So, in this article, we will take a look at what these plans offer.

Top-up and Super Top-up Plans for a Health Insurance policy?

Top-up plans in Medical Insurance

A top-up plan comes into force when you exhaust your sum insured under a basic health insurance policy. Let’s understand this with an example. Mr. A has bought a personal health insurance plan with a sum insured of 3 lakhs. Which means, he can claim for the cost of medical treatments up to Rs. 3 lakhs from his basic health insurance plan.

Consider Mr. A got hospitalized for a major accident and the bill amount went up to Rs. 5 lakhs. In this situation, the basic medical insurance policy will bear the cost of up to Rs. 3 lakh and his top-up plan will get activated to pay the remaining 2 lakh rupees. If he had not bought a top-up plan, he would have to bear the extra amount from his pocket.

The major drawback of a top-up plan is that only one claim is allowed in a policy period.

Super top-up plans in Medical Insurance

Super top-up plans were introduced to nullify the drawback of the top-up plan. These are similar to top-up plans however, one can make multiple claims when the policy is active.

Consider, the same Mr. A from the above example. He suffered a heart attack 4 months after his accident. Consider he opted for a super top-up plan of Rs. 5 lakhs with a threshold of Rs. 3 lakhs, now he can easily claim for the bill of Rs. 4 lakhs for the treatment of his heart attack. Here his personal health insurance would pay Rs. 3 lakhs and the super top-up plan will pay Rs. 1 lakh. The top-up plan will not be of use because he had already made a claim at the time of his accident 4 months ago.

Key Differences in Top-up and Super Top-up Plans

To understand these plans in a better manner, here are a few key differences between the two:

Top-up health insurance in India Super Top-up health insurance in India
Only a single claim is allowed. Multiple claims are allowed
Policy deactivates after 1 claim Policy deactivates after the entire amount of sum insured is exhausted
Pays the bill once if the limit of the base plan exceeds Pays multiple bills when the limit of the base plan exceeds

Things to remember

It is not mandatory to buy a base plan in order to avail the benefits of top-up or super top-up plans. If you wish, you can bear the cost of medical bills up to the threshold of your top-up/super top-up plans.

In a normal health insurance policy, the word deductible would refer to the amount which a policyholder pays at the time of claim settlement. However, with respect to top-up and super top-up plans, the word deductible refers to the sum insured of the base plan. In the example given above example Rs. 3 lakhs would become the deductible of Mr. A’s super top-up plan.

When you have a higher deductible amount, the premium of your top-up/super top-up plan will be less and vice-versa. Thus, plans with lower deductibles have higher premiums.

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