Top-Ups Covers In Health Insurance: Standard or Super Top-Up?

The ever increasing medical inflation makes it essential to have a medical insurance cover. Living your life without one is like throwing caution to the wind. A health insurance plan ensures you have both mental as well as financial stability knowing an unforeseen medical emergency is covered by your insurance company.

But in this time of rising medical inflation, it often happens that your insurance cover may get exhausted. If not exhausted, it might seem insufficient after a few years. In such times, wouldn’t it be handy to have a facility to enhance or insurance coverage? Top-up health insurance plans are the ones you should definitely look for. Let us understand more about top-up covers in health insurance.

What is standard top-up health insurance?

Top-up plans are in addition to your health insurance policy and come into the picture once you exhaust your base insurance cover. Top up health insurance plans have a deductible component to them. A deductible is that threshold which your hospitalisation expenses are required to cross before the top-up coverage kicks in. The claims under standard top-up plans are considered on an individual basis and multiple claims are not aggregated.

What are super top-up plans?

Super top-ups, on the other hand, are plans similar to a standard top-up cover. The only difference is that super top-ups are available for multiple cases of hospitalisation unlike a single case for standard top-up policies.

Now that you know about top-up covers, let us understand how to leverage it to your advantage.

Buying a top-up cover is not the same purchasing standard individual health insurance. Here you need to carefully read the terms of the policy and its various conditions so that there is no gap in your policy coverage. Make sure the deductibles of your to-up plan are equal to the sum assured of your base insurance cover. This way you can have an extended coverage by your top-up plan as the coverage under the base policy ends. Further, selecting whether to purchase the standard or super top-up cover depends on the medical requirements. It can be further explained using an example.

Situation Standard Top-up plan Super Top-up plan
Policy Mr Kedar has a base insurance policy with ₹10 lakhs of sum assured. Note that the top-up cover can be used without a base health insurance policy as well.
He adds a standard top-up policy of ₹20 lakhs with a deductible of ₹10 lakh to his portfolio He buys a super top-up policy of ₹20 lakhs with ₹10 lakh as deductible.
Scenario 1: One claim of ₹14 lakhs Here, the base policy will cover ₹10 lakhs of expense and the standard top-up policy will cover the balance ₹4 lakhs. The entire expense is covered in the same way as a standard top-up policy.
Scenario 2: Two claims of ₹8 lakhs each The base policy will cover first claim ₹8 lakhs and second claim up to ₹2 lakhs. The top-up policy will not kick in since the claim does not exceed ₹10 lakhs of base policy coverage. The first claim of ₹8 lakhs followed by the second claim of ₹2 lakhs is covered under the basic insurance cover. Further, the super top-up plan will provide coverage for the balance expense of ₹6 lakhs on the second claim.
Scenario 3: Claim of ₹14 lakhs and ₹6 lakhs The claim of ₹14 lakhs will be paid by the base policy along with ₹4 lakhs of top-up cover. The next claim will not be paid since the base coverage is exhausted. The super top-up policy will provide for ₹4lakhs from the first claim after ₹10 lakhs is covered by the base policy. The next claim of ₹6 lakhs shall also be included in the super top-up plan’s coverage.

Deciding on which policy to select depends on your future requirement for medical assistance. Factors like outgo for premiums, budget, medical history are some that should be considered before making the final choice.