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What is the difference between top-up and super top-up plans in health insurance?

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Published on February 13, 2023. EST READ TIME: 4 minutes

We all believe that we are leading a healthy life by consuming a balanced diet and following a fitness regime. But ailments and accidents don’t come with warnings. One visit to the hospital can mean spending lakhs on treatment. At times, the expenses are so huge that even your standard health insuranceplan’s benefits fall short. This can mean you dig deep into your savings to pay the medical bills. Health insurance top-up and super top-up plans can do wonders in such cases. These health insurance top-up plans are attached to your existing base plan and get activated when the sum assured is crossed. Let’s begin by understanding what top-up medical insurancemeans in the context of health insurancein India.

What is the difference between Top-up and Super Top-up?

Both top-up and super top-up plans enhance the coverage of your base healthcare policy, but the difference lies in the way the deductible chosen is applied. In simple words, top-up health insurance will provide coverage when a single claim crosses the deductible, whereas,in super top-up health insurance, the deductible will apply on cumulative bills during the policy period once it exceeds the deductibles.

For instance,assume you have an individual health insurance top-up plan with a deductible of INR 2 lakh.You get hospitalised twice in a year with bills of INR 1.5 lakh and INR 1.5 lakh each time. The top-up health insurance plan will not be triggered because the threshold of INR 2 lakh wasn’t crossed in a single claim. But a super top-up will help because it calculates the total amount in the policy period. Since now the expenses are INR 3 lakhs (1.5+1.5), the super top-up plan will get activated to meet your expenses.

Secondly, in top-up health insurance, the out-of-pocket expenses will be high because deductibles are paid on every claim, but in super top-up health insurance, deductibles are paid once a year.

What is a Deductible in Top-up/Super Top-up health insurance?

A deductible is an amount that a policyholder needs to pay before the insurance provider pays the remaining claim amount up to the sum insured. Suppose you have a base plan of INR 10 lakh and a top-up or super top-up of INR 5 lakh. The deductible is INR 2 lakh. While filing a claim, you have to pay for the first 2 lakhs (from your pocket), and the insurer will bear the remaining up to the sum insured of INR 10 lakh. Insurance companies set the limit for deductibles to prevent policyholders from making frequent claims.

Selecting the Best Option

Experts say the super top-up health insurance is more beneficial and cost-effective because it is applicable when total expenses cross the deductible in a policy year. Moreover, the deductibles are paid only once a year. If you have a chronic ailment and require hospitalisationmore than once a year, a super top-up plan will be the ideal option. It is also ideal for senior citizens who may undergo frequent medical procedures. But top-up health insurance gets triggered only when a single claim crosses the deductible.

Conclusion

Now that you know the difference between health insurance top-up plans, you can choose the one that best suits your needs. Both plans provide additional financial security during medical emergencies, but before you buy, make sure you compare the plans online to get maximum coverage. You can also buy an individual health insurance or family health insurance policy based on your family size and budget. Now that you have a better understanding of top-up medical insurance plans and what is deductible in top-up health insurance, you can choose wisely when it comes to buying a policy in terms ofhealth insurance in Indiaso that you have complete peace of mind in times of need.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.

 

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