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Understanding the Basics About Top-up and Super Top-up Health Insurance Plans

Team AckoJun 15, 2021

Buying a health insurance policy is the key to mitigating financial losses in case of a medical emergency. One should buy a health insurance plan as early in life as possible to avoid paying high insurance premiums and to avail other benefits of these plans. The question is – are basic health insurance policies enough?

Top-up and Super Top-up Health Insurance Plans

One should decide if the coverage offered by basic health plans is enough to lend financial backing based on the quality of your health. If you feel that the coverage provided by your policy will not suffice in case of an emergency, you can opt for a Top-up or Super top-up health insurance plan instead of buying a policy with a higher sum insured. Here is an article that will help you understand how Top-up and Super Top-up plans work.

Basic Terms:

Base Coverage:

The coverage offered by your individual health plan is termed as Base Coverage. Top-up and Super Top-up plans come into action after the Base Coverage is exhausted. For instance, if your health policy offers a sum insured of Rs. 4 lakhs, that becomes your Base Coverage. This can also be referred to as the Base Plan.

Deductible Limit:

Usually, the deductible is an amount that the policyholder needs to bear at the time of the claim. However, when it comes to Top-up and Super top-up plans, the deductible is considered as the threshold beyond which the Top-up/Super Top-up plan is activated. If a Top-up plan has a deductible of Rs. 5 lakhs, its coverage will come into action after the hospital bill crosses Rs. 5 lakhs.

Top-up Plans:

Top-up plans provide insurance coverage above the base coverage. Here’s an example to understand it better.

Base Plan: 4 lakhs

Deductible: 4 lakhs

Top-up Plan: 8 lakhs

First Claim: 6 lakhs (4 lakhs settled by Base Plan, 2 lakhs by Top-up plan)

Second Claim: 5 lakhs (Base plan of 4 lakhs exhausted, remaining 1 lakh covered by Top-up plan as Deductible is 4 lakhs)

Super Top-up Plans:

Super Top-up plans offer an additional advantage over the Top-up plans. The difference between the two is that Top-up plans consider the deductible on each claim, whereas the Super Top-up plans consider the deductible on an aggregate basis. As a result, the second claim of Rs. 5 lakhs mentioned in the Top-up plans example will be taken care of by the Super Top-up plan.

Making the Right Choice:

Both Top-up and Super Top-up plans offer enhanced coverage. The question is, how much of this enhanced coverage makes you comfortable? If you feel that your health situation is such that you might have to raise multiple claims in a year, you can opt for a Super Top-up plan. Otherwise, choosing a Top-up plan should suffice to strengthen your health insurance cover.

Important Pointers:

  • The higher the deductible, the lower will be the premium of your Top-up/Super top-up plan and vice-versa.

  • One does not necessarily need to buy a base health insurance plan in order to buy a Top-up/Super Top-up plan.

  • Top-up/Super Top-up plan can be bought individually from different insurers.

  • Top-up/Super Top-up plan is low-priced as compared to a Comprehensive individual health insurance policy.

  • Both Top-up and Super Top-up plans usually do not support Cashless Claims Settlement. You will have to follow the Reimbursement Claims Settlement Process.

  • Tax benefits can be availed for Top-up/Super Top-up plans.

Choose Wisely:

Top-up and Super Top-up plans prove to be a huge financial backup in case of major claims where the base policy might not be enough. Choose your plan wisely and read the terms and conditions before making the payment.

Different health insurance companies might structure their plans in a different manner. Go through the plan’s Policy Wordings before buying the Top-up or Super Top-up plan. You can also speak with the insurer’s Support Team to get more clarity about the plans and resolve your issues.

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