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Differences between top-up health insurance vs super top-up plans

Team AckoFeb 7, 2023

Top-up and Super Top-up plans are like boosters to your health insurance coverage. They come to your rescue when the primary policy’s sum insured amount is comparatively low. Their biggest advantage is that both these plans increase the sum insured over and above your primary health insurance plan. But how are the Top-up and Super Top-up health insurance different? Read on to find out.

Differences between top-up health insurance vs super top-up plans

Contents

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Types of additional health insurance plans in India

There are two types of Top-up health insurance policies in India. Here are the details.

  • Top-up plan: The Top-up insurance plan provides insurance coverage by replenishing the sum insured up to a certain amount. Once the medical expenses cross the deductible limit, the Top-up plan gets activated.

  • Super Top-up plan: After the medical costs exceed the threshold limit, this top-up plan provides additional insurance coverage. While the Top-up plan considers the threshold limit/deductible for every claim, the Super Top-up plan considers all the claims put together in a policy period.

Learn more about: What is Super top-up health insurance?
Also, check What is Health Insurance?

In both plans, if the illness relapses within 45 days of discharge from the hospital, it is usually considered a single illness. However, if the illness relapses after 45 days from discharge, it is generally considered a fresh illness.

Difference between Top-up and Super Top-up plans in health insurance

Both plans provide financial support when the medical costs surpass the sum insured limit. While their main goal is to provide additional financial security, they differ in terms of coverage. In other words, a Top-up health insurance plan will provide financial support for medical costs when your claim crosses the threshold limit. In contrast, a Super Top-up health insurance plan will provide for medical expenses when one or more claims (during the policy period), put together, crosses the threshold limit. Here is an example of the differences between Top-up and Super Top-up in health insurance. Note that the sum insured of the base plan is Rs. 5 lakhs, and the deductible on both plans is Rs. 3 lakhs.

Factors Base plan Top-up plan Super Top-up plan Remaining sum insured
Sum insured Rs. 5 lakhs Rs. 5 lakhs Rs. 5 lakhs Rs. 15 lakhs
1st claim of the year is Rs. 8 lakhs
What the insurer pays Rs. 5 lakhs Rs. 3 lakhs NA Rs. 7 lakhs
What you pay Nothing Nothing Nothing Nothing
- 2nd claim of the year is Rs. 4 lakhs - - -
What the insurer pays Nothing (as the sum insured is exhausted) Rs. 1 lakh (as the deductible limit is Rs. 3 lakhs) NA Rs. 5 lakhs
What you pay Rs. 3 lakhs (deductible) - - -

Which plan should you choose?

The Top-up and Super Top-up health insurance act as a shield that helps if you exceed the limit of the existing base plan. But both have different benefits.

Generally, if you do not suffer from a chronic illness or run the risk of a terminal ailment, you should choose the Top-up plan. However, if you have the risk of a chronic disease that may require you to be hospitalised more once, you should choose the Super Top-up plan.

Super-top Health Plans offered by ACKO

Importance of buying Super Top-up and Top-up health insurance: Additional cushioning at lower costs

Here is why you should get a Super Top-up or a Top-up health insurance plan.

  • Increasing healthcare costs: There is no denying that healthcare costs are rising daily. This means you need a comprehensive health insurance plan that offers a higher sum insured amount than a regular health insurance plan. The plan should also have the option to include a Top-up or Super Top-up plan that gives you an advantage when the sum insured amount has been exhausted.

  • Higher sum insured: Top-up plans (regular or Super Top-up) would not exist if there was no need for a higher sum insured amount. These plans offer you coverage over and above the base policy or a corporate health insurance policy at a much lower premium than individual health plans.

  • Higher coverage for senior citizens: You get extensive coverage at a much lower health insurance premium with a Top-up plan.

  • An additional benefit to the existing plan: Compared to the regular health insurance plans, Top-up and Super Top-up plans provide additional coverage during unforeseen emergencies.

  • Additional tax savings: Similar to other types of health insurance plans, Top-up and Super Top-up plans come with tax-saving benefits.

Eligibility criteria for Top-up and Super Top-up Medical Insurance Plans

Top-up health insurance plans also come with the same eligibility criteria as other health insurance plans. While the exact details differ between insurers, the following are the main eligibility parameters to buy the Top-up and Super Top-up health insurance policy.

  • The applicant must be at least 18 years of age.

  • The applicant must be an Indian citizen.

Who should opt for the Top-up/Super Top-up health insurance?

With uncertainties such as the COVID-19 pandemic and rising healthcare expenses, it is apparent that you should have higher health insurance coverage. If you fall under the following categories, you must opt for the Top-up or Super Top-up plan.

  1. Corporate employees: Your employer's corporate health insurance plan may cover you, but the sum insured may be insufficient. By adding add-ons to your basic health insurance plan, you can increase your sum insured.

  2. Senior citizens: The medical expenses for senior citizens (for example, older parents) are undoubtedly higher. Hence, the premium is higher as people grow older. The coverage increases with a Top-up or Super Top-up plan and is relatively affordable compared to a regular health insurance plan.

  3. Policyholders with low sum insured: If the sum insured amount of your health insurance is inadequate and does not have many benefits, you can opt for the Top-up plans for a smaller premium compared to buying a new health insurance plan.

Inclusions in Super and Top-up Health Insurance Plans

Following are the coverage details of Top-up and Super Top-up health insurance plans depending upon specific coverage offered by an insurer.

Exclusions of Super and Top-up Health Insurance Plans

Here are the non-coverage details of Top-up and Super Top-up insurance plans depending upon the specific coverage offered by an insurer.

  • Undisclosed Pre-existing diseases

  • Self-inflicted injury

  • Infertility treatment

  • Plastic or cosmetic surgeries, if not medically necessary

  • Hospitalisation without a doctor’s recommendation

Role of Top-up and Super Top-up plans in Senior Citizen Health Insurance Plans

Top-up plans offer that extra edge at a lower premium when the sum insured is exhausted. Here is the role that Top-up plans play in senior citizen health insurance policies.

  • It protects against rising and higher healthcare costs for senior citizens.

  • It offers higher coverage at an affordable premium compared to regular health insurance plans.

  • It secures against financial risks of illnesses and diseases that may be common in senior citizens.

  • It helps save money since it offers tax-saving benefits.

Benefits of buying a health insurance plan from ACKO

ACKO is a digital-first insurance company, and most of the transactions are through the digital platform. Whether you want to buy a plan, raise claims against it, or renew the plan, you can visit our website or mobile app to transact directly with us. Here are some of the key benefits of buying health insurance from ACKO.

  1. Zero waiting period: With ACKO Platinum Health Insurance Plans and ACKO Super Top-up Health Insurance Plans, you get coverage from day 01 if you disclose all necessary information.

  2. Zero deductions at claim: We pay your entire hospital bill without any deductions for an approved claim.

  3. Continuous support: You can buy, renew, and register claims through the website or mobile app.

  4. Zero paperwork: You can ditch the tedious paperwork and documentation while buying ACKO health insurance plans. There is no paperwork involved, and the process is entirely online.

  5. A vast network of hospitals: You get access to over 7100+ network hospitals across the country to avail of cashless claims.

Frequently asked questions

Here are some common questions and answers about the difference between Top-up and Super Top-up Plans.

Can I purchase the base health insurance plan from one insurer and the top-up insurance plan from another?

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Yes, you can buy the top-up insurance plan from another insurer based on the choice of the sum insured, threshold limit and availability of the plan.

Can I buy both, Top-up and Super Top-up plans?

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Yes, you can buy both, Top-up and Super Top-up plans to strengthen your financial backup in case you face a medical emergency.

Can I buy a top-up health insurance plan for my family?

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You can buy top-up health insurance plans as a family floater plan or an individual plan.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on industry experience and several secondary sources on the internet and is subject to changes. Please go through the applicable policy wordings for updated ACKO-centric content and before making any insurance-related decisions.

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