A Handbook to Understand Top-up and Super Top-up Plans

Regular health insurance plans cover the medical expenses of the insured up to the sum insured limit. Once your sum insured gets exhausted, you will have to pay your medical bills on your own. However, a top-up and super top-up plan is a solution to the rigid sum insured. They enable you to pay your medical bills even when your basic health policy’s sum insured has exhausted. Know everything about top-up and super top-up health insurance plans. 

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      What’s Top-up Cover?

      A top-up plan, as the name suggests, provides coverage over and above the current sum insured. It is a safety net which comes to one's aid in difficult financial situations. Contrary to a top-up plan that only provides cover if the cost incurred in a single hospitalisation exceeds the sum insured, a super top-up plan provides coverage in multiple cases. Super top-up plans have more advantages over a top-up plan due to the allowance for many claims. 

      Why Should You Consider Top-up Cover?

      One might ask the question, why they can’t opt for a plan with a higher sum insured if they expect expenses beyond their current plan. The main answer to this will be that a higher sum insured will lead to the drawback of a higher premium. Top-up plans have a high deductible and hence are considered to be highly beneficial with less risk associated with it. An individual can opt to buy a top-up plan even without having a regular health insurance policy in India. Adding to the array of positives is the fact that any individual plan or family insurance plan availed from one company can be enhanced with a top-up plan from a different health insurance company. It is not mandatory for the top up plan to be belonged to the same company. Each top-up plan is available as an individual or a family insurance plan. 

      Moreover, there is no contribution clause stating that if an individual has a top-up policy in addition to a regular policy that both providers must provide their share. It is, however, essential to read the policy carefully before purchasing because many top-up plans have restrictions and rules on pre and post hospitalisation expenses, pre-existing diseases, and some health insurance policies in India might exclude certain diseases.

      Super Top-up Cover

      When you are in a situation where an exceeding of the insurance amount occurs not just for one claim but for multiple claims, a super top-up plan comes to one’s rescue. The policy only lapses when the entire cover is exhausted, as opposed to a top-up plan which exhausts after a single claim.

      Take the example of Mr ABC, who has ischemic heart disease. He has suffered from one heart attack, which cost him 6 lakh to treat when the sum insured is only 4 lakh under his regular policy. If he owns a top-up plan, it would cover the remaining 2 lakh. However, if he had a second heart attack needing two procedures, costing 3 lakh each, he cannot avail his top-up plan since his deductible is 4 lakh. If he had a super top-up plan, he could pay off 2 lakh via the super top-up plan, as it would be applicable for the second claim as well. That is where a super top-up plan, overrides the benefit of a top-up plan. It takes into account the entire amount, which is very useful.

      Popular Top-up/Super Top-up Plan

      The various top-up and super top-up plans offered by different health insurers are:

      Plan

       

      Sum Insured

      Eligibility

      Features

      Bajaj Allianz Extra Care

       

      10 to 50 lakh

      18 to 70 years old

      • No medical tests till the age of 55
      • Pre and post hospitalisation covered for 60 and 90 days respectively
      • Emergency ambulance charges covered

      Care (Formerly known as Religare) Enhance  

       

       

      1 to 30 lakh

      1 day and above

      • Admission in a single private room
      • No limit on ICU charges and physician fees
      • Organ donor expenses included
      • Pre-existing diseases included after 4 years

      HDFC Health Suraksha Top-up Plus 

      2 to 10 lakh

      91 days to 65 years

      • Pre-listing diseases covered after 4 years
      • Up to 15,000 tax benefit under section 80D* (tax benefits are subject to change as per the prevailing income tax laws)
      • No room rent cap

      Star Health Super Surplus 

       

      Silver Plan –

      7 to 10 lakhs

      Gold Plan – 5 to 25 lakh

      18 to 65 years

      • No pre-policy health check-up
      • Pre-existing diseases are covered after just 36 months
      • Family floater and individual
      • Organ donation expenses covered

      United India Insurance Top Up 

       

      Multiple options with a different sum insured

      18-80 years

      • Hospital expenses, rent expenses, surgery fees all covered
      • For the group insurance, a single sum can be insured for family members and a separate one for parents
      • Family floater and individual plans available

      United India Insurance Super Top Up 

       

      1 to 10 lakh

      18 to 80 years

      • Hospital expenses, rent expenses, surgery fees all covered
      • ICU care and OT charges covered
      • Family floater and individual plans available

      *Policybazaar does not endorse, rate, or recommend any particular insurer or insurance product offered by an insurer.

      • Bajaj Allianz Extra Care - Bajaj Allianz Extra Care is a diverse plan that offers sums ranging from 10 to 50 lakhs with deductibles between 3 to 5 lakh mostly. Being a reliable health insurer in India, they offer health insurance for individual and families. For policyholders under the age of 55, no medical tests are needed. The plan covers pre and post hospitalisation costs too, for up to 60 and 90 days respectively.
      • Care Enhance: This plan offered by Care Health Insurance Ltd. (formerly known as Religare Health Insurance Co. Ltd.) ensures the entire family is protected under the family insurance plan. With a range from 1 to 30 lakh, the policyholder can choose their sum as per their needs. There is an option for admission in a single private room. The top-up plan also allows for no limit on ICU charges and physician fees. It includes organ donor expenses as well.
      • HDFC Health Suraksha Top-up Plus – With a wide cover for 2 to 10 lakh, this plan is a good top-up to any existing plan. Hospitalisation and pre and post hospitalisation costs are covered. There is no room rent cap. 
      • Star Health Super Surplus – An affordable health insurance policy in India that offers both individual and family plan options. There are two variants under this plan – the Gold and Silver. The Silver Plan is for sums between Rs 7 to 10 lakh, while the Gold Plan offers sums between Rs 5 to 25 lakh. This is one of the few health insurance plans that do not mandate a pre-policy check-up. Pre-existing diseases are covered after just 36 months of purchase of insurance. Maternity benefit, organ donor cover, air ambulance cover etc. are some of the features of this plan.
      • United India Insurance Top Up - This plan allows policyholders to avail cashless treatment at many network hospitals in IndiaThe sum insured varies as there are many options available.
      • United India Insurance Super Top Up – This plan allows policyholders to avail cashless treatment at many network hospitals in IndiaWith both an Individual and family floater plan, it caters to everyone’s needs. The sum insured ranges from 1 to 10 lakhs, and it can be purchased by people ranging from the ages of 18 to 80. All hospital expenses, rent expenses, surgery fees are all usually covered under this plan.

      The aforementioned are some of the plan options you can consider. However, it is always recommended to compare various insurers basis on their offering under various top-up pr super top-up plans.

      Many organisations offer various health insurance policies in India which may be an individual or a family insurance plan. However, this is usually one uniform plan that is offered to all employees of the company. Some individuals might need an extra cover or might feel that the plan is insufficient. They can opt for a top-up or a super top-up health insurance policy complementing their basic cover. 

      For instance, most workplaces issue a standard coverage of 3-4 lakh. To complement this, you can choose a top-up plan with a 3-lakh deductible. With ever-climbing hospital fees and increasing uncertainty, one can ensure that their family will remain safe and taken care of in case of any emergency. It is in most people’s interest to purchase a top-up or a super top-up plan. In addition, the policyholder can also avail tax benefits under section 80D of the tax laws.

      Final Word!

      Top-up and super top-up plans are the great options if you want an extensive insurance coverage without having to pay a higher premium. These plans come to your rescue when the basic health cover becomes insufficient to pay your medical bills. Bear in mind that, such plans are active only when the incurred amount is higher than the plan deductible amount. So, you should be careful while choosing the top-up or super to-up sum insured.

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      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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