Understanding top-up and super top-up health insurance plans

Medical inflation continues to rise at an unprecedented rate. Healthcare in a private hospital could set you back a few lakhs, which makes having health insurance all the more important. But what happens when your healthcare requirements fall outside your range of coverage? Paying for things from your pocket could ruin all your careful financial planning. That’s where top-up and super top-up health insurance plans come into the picture. You can purchase a top-up or super top-up at an affordable price to get additional cover after you exhaust your existing policy’s sum assured, which is equal to your top-up or super top-up policy’s deductible. Let’s take a closer look at how these policies work.

A top-up health plan provides financial coverage once you exhaust the maximum claim amount on your health policy. It works as an additional layer of protection for you and your finances. Top-up plans come with a mandatory deductible that we can understand better with an example. Mr Varun has a health policy with a sum assured of INR 5 lakhs. He purchases a top-up policy of INR 15 lakhs with a deductible of INR 5 lakhs. After an accident, he ends up with a medical bill worth INR 8 lakh. His regular health policy takes care of INR 5 lakhs, and the top-up pays the additional INR 3 lakhs. The deductible of INR 5 lakhs gets offset against his regular health policy. But, if Mr Varun had to make two claims, one for INR 3 lakhs and another for INR 4 lakhs, he would not be able to file a claim against the top-up policy. For these plans to work, you need to exhaust your health plan sum insured in a single claim and the deductible of INR 5 lakhs is applicable on every claim.

Super top-up plans also provide an additional layer of cover. But they differ from top-up policies in the way they function. Super top-ups work on all medical expenses incurred through the year on an aggregate basis. Let’s assume Mr Kumar has a base health insurance policy from his company that offers him a sum insured of INR 5 lakhs. For enhanced overage, Mr Kumar purchased a super top-up policy with a sum insured of INR 8 lakhs and a deductible of INR 5 lakhs. He meets with a terrible accident and gets admitted to the hospital for treatment. At the end of his hospitalisation, the claim amount is a total of INR 9 lakhs. Mr Kumar’s health insurance policy will pay the claim amount of INR 5 lakhs, and the super top-up plan takes care of the additional INR 4 lakhs.

You can also use super top-up plans in isolation. Let’s look at Mr Amit’s situation. He has a super top-up plan that offers coverage of INR 15 lakhs with a deductible of INR 2 lakhs. Over a year, he has many health issues and files multiple claims. Let’s take a look at how his super top-up plan helps him. The first claim he makes against the super top-up policy is for INR 3 lakhs. He pays the deductible of INR 2 lakhs and the super top-up policy takes care of the remaining INR 1 lakh. A few months later, he has to make a claim for INR 2 lakhs. Now, he doesn’t have to worry about the deductible. His super top-up plan settles the entire claim amount. Mr Amit makes a final claim for INR 12 lakhs, which is settled entirely by his insurer.

All the best health insurance providers offer top-up and super top-up plans. You can choose a Zuno health insurance policy and enhance your cover with add-ons and a Zuno health top-up. You can also purchase the Zuno health top-up policy without a base health insurance. Make sure you do your research on what’s the best possible option for you before you purchase a health policy or top-up plan.

ARN: Zuno/Blog/0323/22