Super Top-up Health Insurance
If your health insurance sum insured is not enough to meet the rising medical expenses then a super top-up plan is a cost effective option to ensure that you are insured for any medical uncertainties in life.
A super top-up health plan covers the total hospital bills up to the limit specified in your super top-up plan above the deductible amount. Hence, once your deductible is paid, the super top-up policy becomes active for subsequent claims. It covers cumulative expenses unlike a regular top-up plan that covers single clams over and above the deductibles.
This deductible amount is pre-decided, for example, if you have a Super top-up plan of Rs 10 lakh and it has deductible limit of Rs 3 lakh then the super top-up policy will cover medical expenses over and above Rs 3 lakh. This deductible amount can be paid from your current health plan and the remaining can be paid by the super top-up insurer.
Here is an illustration table to help you understand better:
|Super Top-up Plans
||Rs 4 lakh
||Rs 12 lakh
||Rs 8 Lakh
||Rs 4 lakh
||Rs 4 lakh
Highlights of Super Top-up Health Insurance Plans
||Need to be paid only once
|Online Purchase and Renewal
||Available on Policybazaar
Who Should Buy a Super Top-Up Health Plan?
There are several reasons to buy a Super-top up plans and some of them are given below:
- For Senior citizens (above 60 years) and parents- With the age of the insured the premium also becomes higher. Buying a super top-up policy can considerably reduce the premium. The only drawback is that you need to pay the deductibles from your existing health or corporate plan or your pocket.
- Upgrade Employer Health Plan- Buy a Super top-up health plan to upgrade corporate health insurance in case your sum insured does not suffice. With a super top-up plan, you can enhance your coverage amount without the need to pay as much as a standard health plan!
- If Your Existing Coverage is Insufficient - If you feel that the sum insured of your existing mediclaim policy is low and comes with limited benefits, then a super top up plan can boost your coverage, without any hassle of buying or porting to a new comprehensive health plan.
Features and Benefits of a Super Top-up Health Insurance Plan
A super top-up medical policy includes the following features and benefits:
- Covers Treatment for Coronavirus Pandemic- In addition to other illnesses, super top-up medical plans are designed to cover the treatment cost of the COVID-19 pandemic.
- Pay Deductibles only once- In this type of insurance, you are required to pay the deductibles only once and can claim it multiple times during a policy term.
- Customizable- You can choose any limit of deductibles as per your existing plan and sum insured.
- Higher Sum Insured- Your coverage amount can be increased over and above your corporate plan at a lower premium so that you never fall short of the sum insured.
- Lack of benefits in the Existing plan- Many corporate policies do not offer extensive coverage benefits like Ayush treatment and critical illnesses cover but your super top-up plan will.
- Greater coverage for seniors and parents- The premium for health insurance plans for elderly people and seniors can be too high. But with a super top-up plan, you can enhance your coverage for your parents at a lower premium.
- Additional Tax Saving- Like all the other health insurance plans, a super top-up health plan offers tax-saving benefits on the premium paid.x
- Get treated at Network Hospitals- You can avail cashless treatment in any of the hospitals in your insurer’s network. You can also get reimbursement of expenses.
- Quick and Hassle-free- The policy can be purchased online and the claims are also quick and hassle-free
Difference between Super Top-up and Top-up Health Plan
Check out the difference between top-up and Super top-up plans as given in the table below:
||Top-up Health Insurance Plan
||Super Top-up Health Plan
||Provides single claim cover above and beyond the threshold limit of the existing medical insurance
||Similar but they cover cumulative medical expenses exceeding the deductible and sum insured. It pays for expenses that are not covered by a top-up plan
|Policy ( Mr. Gupta has a policy of Rs 5 Lakh)
||In case he gets a Top-up plan of Rs 10 lakh with Rs 5 lakh deductibles
||In case he get a Super top-up policy of Rs 10 lakh with deductible of Rs 5 lakh
|In the event of a Single claim of Rs 12 lakh
||Basic health plan covers Rs 5 lakh. Top-up plan pays for remaining Rs 7 lakh above the deductible
||Basic health plan covers Rs 5 lakh. Super top-up will pay for remaining Rs 7 lakh above the deductible
|In the event of two claims of Rs 4 lakh each
||Your health plan will cover Rs 4 Lakh and Rs 1 lakh for the 2nd claim. As the amount is not more than Rs 5 lakh, the top-up health plan won’t be activated
||Your health plan will cover Rs 4 Lakh and Rs 1 lakh for the second claim. The remaining Rs 3 Lakh will be covered under the Super top-up health plan
|In the event of a claim of Rs 7 lakh and Rs 4 lakh
||Your health insurance will pay Rs 5 lakh from 1st claim and remaining Rs 2 lakh to be covered under the Top-up Plan for the 1st claim. The 2nd claim is not covered under the top-up policy as it does not surpass the deductible limit
||Your policy to pay Rs 5 lakh for 1st claim and Super Top-up to pay the remaining Rs 2 lakh and Rs 4 lakh for the 2nd claim
Medical Expenses Covered under Super Top-up Health Insurance Plans
It pays claims for cumulative medical expenses during the policy term once it exceeds the deductible, vs. a regular top-up insurance that covers only a single claim above the threshold limit.
All Hospitalization: This covers fees charged by the Doctor, Surgeon, Medical Practitioner, Anesthetist, and Nurses. Diagnostic tests, anesthesia, surgical appliances, blood, oxygen, medicines, and OT charges Cost of artificial body parts and internal implantations like a pacemaker, if required as a part of the surgery
- Pre/Post Hospitalization: It includes expenses before and after hospitalization
- Day Care Procedures: Daycare treatment expenses during the treatment that do not require a 24-hour of hospital stay shall be covered
- ICU Room Rent: Room Rent, Nursing Expenses, and ICU Expenses are covered
- Road Ambulance Charges: It is one of the most basic facilities that are required during a medical emergency. The cost of the same is included in a super top-up plan.
- Complimentary Annual Health Checkup: Medical expenses towards any annual medical checkups are claimable after completion of certain duration of the policy period
What is Not Covered under Super Top-up Health Insurance Plans?
- You cannot file a claim until your policy deductible limit is exhausted
- Medical expenses of the newborn baby
- Organ donor pre and post hospitalization expenses
- Dental surgeries unless requires hospitalization
- Any loss of damage due to war, rebellion, acts of foreign enemies, invasion, hostilities, civil war etc.
- Plastic surgeries
- Cost of contact lenses, spectacles or hearing aids
- Congenital diseases and stem cell implantation surgery
- Drug or alcohol abuse
- Treatment of venereal diseases
- HIV/AIDS treatment
- Vaccination or inoculation unless required for an animal bite or as part of the treatment
- Vitamins and supplements unless required as part of in-patient hospitalization
- Experimental treatments
How to file a Claim for Super Top-up Health Plan?
- Reimbursement Claims - In case of hospitalization you need to inform the insurer about it as soon as possible. You can also register your claim over email. Nowadays, even claims are digital, all you need to do is submit your hospital bills and all relevant documents to initiate the reimbursement process.
- Cashless Claims – For cashless treatments you need take admission in a network hospital. You can display your e-health card to the hospital helpdesk and ask for the cashless request form. If all is good, your claim will be processed then and there.
For claims related to Coronavirus, make sure you have a positive test report from a government authorized Centre.
Ans: A super top-up health insurance plan covers medical expenses above the deductible limit. It helps you enhance your policy cover once the existing sum insured is exhausted.
Ans: While purchasing a super top-up health insurance policy you need to opt for the right deductible limit. It is the limit of your regular health insurance plan. You are advised to compare your policy options thoroughly without only considering the premium. It is also important to check the list of network hospitals, coverage amount, benefits, and claim settlement record of the insurer before finalizing a super top-up health insurance policy.
Ans: A deductible amount in health insurance is the amount the insurer or the policyholder has to pay before availing the benefits of a super top-up plan.
Ans: Yes, most of the super top-up plans provide coverage for Ayush treatment.
Ans: Yes, you can choose a higher deductible up to Rs 20 lakh depending on the policy you have purchased.
Written By: PolicyBazaar - Updated: 14 April 2021