The COVID-19 crisis is actually a wake-up call for the rising cost of medical treatment in India. Post hospital bills and insurance claims were like fighting a financial battle in the midst of a crisis for a common man. After seeing the aftermath of the pandemic, it is natural for anyone to wonder whether they have enough health insurance to deal with a sudden medical emergency . Many of you would like to increase your health cover after evaluating the current treatment cost of hospitals . One way to do this is through a top-up or super top-up health plan.
top-up plan
If you are looking for additional cover to an existing health plan at an additional low premium, then a top-up health insurance plan can be opted for. Such plans offer financial security if the basic limit under the regular plan is exhausted. But there is a catch here. The cost of the top-up plan is linked to the deductible limit. This limit is pre-determined and mentioned in the policy document. Only if the cost of one illness crosses the deductible limit, then the top-up plan gets started.
think of it this way
Mr. X has a health insurance policy of Rs.5 lakh and he pays an annual premium of Rs.12,000 for the policy. Mr. X is hospitalized for 15 days due to brain stroke and the cost of treatment reaches up to Rs.8 lakhs. Ideally, his policy will pay Rs 5 lakh, while he will pay the additional amount out of his own pocket. But, if Mr. X had opted for a top-up policy of Rs 10 lakh with a deductible limit of Rs 5 lakh, then the additional amount (Rs 3 lakh) can be paid through the new policy. This will ensure that the insured remains financially secure even if the hospital bill exceeds the sum assured.
super top-up plan
A top-up plan will be effective only if the one-time hospitalization bill crosses the limit of the regular policy. On the other hand, a super top-up plan offers the facility of multiple claims. A super top plan helps when a single claim does not exceed the threshold limit of the insurance cover, as multiple claims can be made.
For example, if Mr. X has both a Super Top-up Plan and a Regular Top-up Plan, with a maximum Sum Assured of Rs.10 Lakhs (assuming deductible of Rs.5 Lakhs). Suppose more than one claim is made in a year, first for Rs 2.5 lakh and second for Rs 3.5 lakh. The basic top-up plan will not help in settlement of any claim. This is because the bill for a single hospitalization should be more than the deductible (Rs 5 lakh) to avail top-up benefits. However, in case of super top-up scheme, all claims will be considered. In this way, Rs 6 lakh (2.5 lakh + 3.5) – Rs 5 lakh deductible, i.e. Rs 1 lakh will be paid to the insured.
Simply put, a super top-up policy takes all the hospitalization claims together to calculate the deductible limit, whereas the top-up is calculated on the basis of a single illness during its single hospitalization. Remember that the higher the deductible, the cheaper the top up plan.
key aspects
Deductible is the base amount on which the top-up or super top-up policy is applied. For example, for a regular policy of Rs 5 lakh, the top-up is purchased for Rs 10 lakh, with the deductible being Rs 5 lakh.
Low Premium: The premium of a top-up health insurance policy depends on the deductible. Lower premium means higher deductible.
top-up vs super top-up
While the top-up works on the principle of ‘per claim’ or ‘per hospitalization’, the super top up plan has the facility of multiple claims. Top-up terminates after a single claim, whereas Super Top-up will end only when the entire cover is exhausted.
Some of the popular top-up and super top-up health insurance policies include Bajaj Allianz Xtra Care, ICICI Lombard Healthcare Plus, Star Health Super Surplus and HDFC Health Suraksha Top-up Plus.
