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Top Up & Super Top Up Policies: A Fine Backup to Your Health Insurance

Updated On Dec 04, 2020

Most of us are completely clueless about securing medical expenses in totality. Some might say they have medical insurance, but more often than not, the coverage value is Rs. 3 to 5 lakh. Do you think a low coverage value would serve the purpose when medical inflation is one of the most critical problems?

May your health thrive always!

But God forbid, what if you have a major operation and your existing health insurance is not enough to pay the hospital bills?

Let me share a short story!

Mr Sharma had a health insurance policy with the coverage value of Rs. 5 lakh. Needless to say, he underwent a surgery for which the hospital bills came worth of Rs. 7 Lakh. He filed the claim worth of Rs. 7 Lakh and received 100% reimbursement.

Wanted to know, how?

It’s possible because Mr Sharma had backed up his medical insurance with a top-up plan - a kind of policy that ensures the cushion of ample cover.

Sounds dramatic, right? 

It’s possible.

There are insurance plans like the top-up cover and super top-up cover that cover medical expenses when the sum insured of your basic plan exhausts.

Let’s discuss in this article how a top-up and super top-up plan is a fine backup for your regular health insurance policy.

Top-up Cover

A top-up policy is a stepney to your health insurance policy. It gets activated when the sum insured limit of your basic plan is exhausted. While a regular insurance product reimburses treatment/hospitalisation expenses up to the sum insured, a top-up policy covers expenses after a certain threshold is touched.

Therefore, Mr Sharma claimed the balance amount of Rs. 2 Lakh from his top-up cover.

Benefits of Top-up Cover

  • A better option: Many people think that choosing a regular health policy with a higher coverage is a better bet than going for a top-up policy. Yes, you can do. But, a higher cover comes with a higher premium amount that can put a big dent in your budget.
  • Low rates: A top-up policy comes with a high deductible. So, insurance companies consider these products less risky and offer them at low premium rates. The higher the deductible, the cheaper the plan!
  • Available without a regular plan: The good thing is that one can buy a top-up plan even if he/she has no regular health insurance policy.
  • Investment is simple: Purchasing a top-up plan is very simple. One can buy it from any insurance provider. It’s not mandatory to buy a top-up plan from the existing insurer. So, investing in a top-up cover is quite simple.
  • Individual & family floater: A top-up policy can be bought on an individual as well as a family floater basis as per your need of hours.

It’s important to note that top-up plans come with certain restrictions on pre & post-hospitalisation expenses, pre-existing diseases. Also, some insurers may exclude certain conditions.

Note: A top-up plan is designed to provide coverage for a single claim above the threshold limit.

Super Top-up Cover

A super top-up cover becomes effective when multiple claims exceed the threshold limit of your regular plan.

Say for instance if Mr Sharma filed two different claims of Rs. 3 Lakh and 4 Lakh respectively, the top-plan would remain ineffective because neither of these plans crossed the 5 lakh. In this situation, a super top-up plan would work as it covers total expenses/medical bills above the threshold limit incurred during hospitalization .

Since the first claim is worth Rs. 3 lakh, Mr Sharma’s regular health policy would reimburse it completely, leaving 2 lakh for the second claim. If he had a super top up cover, he would get all the claims reimbursed.

Choosing Top-up or Super Top-up Plans

When choosing a top-up or super top-up plan, going through the wordings of the health insurance policies carefully is essential. Pay attention to the points related to the following:

  • Pre-existing diseases
  • Coverage undertaken
  • Hospitalization and medical expenses
  • Pre and post hospitalization expenses

You may also like to read How Top-up Health Insurance Plans Help You Increase Sum Insured On a Budget

Above all, a top-up or super top-up plan is a good option to back up your health insurance policy. It’s a suitable option for those with low income. If you can’t afford a higher sum insured, you can go for a basic health insurance plan with reduced cover, and latter choose a top-up policy to increase the coverage amount. That would be a fine backup to your medical insurance. 

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