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  • Top Up/Super Top Up Health Insurance Plans in India

    “Health is Wealth” – this old adage has become even more prominent in our fast paced world today, with incidences of unhealthy lifestyles impacting our overall quality of life. With costs rising every day, failing to secure one’s health can impact our bank accounts, pinching our wallets and leaving us dry. This is where health insurance plans come in, offering us ease of mind and helping us continue with our lives without having to worry about an unforeseen event. While health insurance plans offer protection, they can be taxing on our finances, with premiums costing a decent amount. Given our propensity to want more in life, it is only natural for us to want extra health care benefits, at nominal rates, of course. Getting additional benefits through an existing health insurance policy would mean higher premiums, but there is a smart way to get extra cover without having to empty your bank account.

    What are Top-up Health Insurance Plans?

    A Top-up health insurance plan, as the name implies is a scheme which provides additional cover, typically over and above the current available limit, at lower premium amounts. It can be considered as a safety net which helps you in case you exceed certain limits. Under a normal health insurance plan, the insurer pays the amount which an individual is insured for, but there could be cases when the expenses exceed this amount, which is where a top-up plan comes into play.

    Consider the example of Mr. Krishna, a manager with a bank who has a health insurance policy of Rs 5 lakh. He pays an annual premium of Rs 12,000 towards this premium. Unfortunately for Mr. Krishna, he is hospitalised due to a heart attack, the treatment for which goes up to Rs 8 lakh. Now under normal circumstances, his policy would pay Rs 5 lakh and he would have to pay the additional amount from his pocket. Now, if Mr. Krishna had opted for a Top-up policy of Rs 10 lakh with a deductible limit of Rs 5 lakh, this additional amount would be paid by his new policy, ensuring that he stays financially protected.

    In simple words, a Top-up health insurance policy provides protection after the basic threshold limit under a normal policy is breached.

    What is a Super Top-up Health Insurance Plan?

    A Top-up insurance policy has certain drawbacks when it comes to its implementation, which can be resolved by opting for a Super Top-Up policy. Unlike a Top-up plan which pays only if the threshold limit on a regular policy is exceeded on a single hospitalisation, a Super Top-up provides cover over the threshold limit in multiple cases.

    Let us take the example of Mr. Krishna again. Post treatment for his heart attack he suffers another one after 6 months, with the bill coming up to Rs 7 lakh, which comes outside the ambit of his top-up plan since only one claim can be entertained under its provisions. Now, if Mr. Krishna had opted for a Super Top-up plan with a cover of Rs 10 lakh and a threshold of Rs 5 lakh, this plan would pay the additional sum of 2 lakh.

    In simple terms, a Super Top-up Health Insurance policy has provisions for multiple claims, which are not offered by a regular top-up plan.

    Points to remember:

    There are a few key points which one should be familiar with before they consider a top-up or super top-up health plan.

    • Deductible – Deductible, in this context refers to base amount over which a top-up or super top-up policy comes into force. For example, Mr. Krishna has a normal health insurance policy of Rs 3 lakh and a top-up/super top-up policy of Rs 7 lakh with the deductible set at Rs 3 lakh. In this case, his top-up/super top-up plan will come into force only if the bill is over and above Rs 3 lakhs. If the bill is under Rs 3 lakh, i.e. below deductible, no benefit will be paid through the top-up/super top-up plan.
    • Base plan – While it is not mandatory for an individual to have a base health insurance plan in order to avail a top-up/super top-up, it is recommended that a base plan is in place to cover amounts below the deductible.
    • Lower premium – One can get a top-up health insurance policy at lower premiums, with the premium amount depending on the deductible. A higher deductible results in a lower premium and vice-versa.

    Top-up Vs Super Top-up Health Insurance Policies:

    While similar in concept, there are a few key differences between a top-up and super top-up health policy, as highlighted in the table below.

    Parameter

    Top-up policy

    Super top-up policy

    Working basis

    Works on the principle of “per claim” or “per hospitalisation”

    Multiple claims are permitted

    Lapse on claim

    Policy lapses after 1 claim for the cover provided

    Policy lapses when the entire cover is exhausted (multiple claims entertained)

    Settlement

    Settles claim only if single bill amount is over and above the deductible

    Settles claim if total bill amount exceeds the deductible limit

    Example:

    Rakesh has a Top-up and Super Top-up health policy with Rs 10 lakh cover and a regular policy with a cover of Rs 5 lakh. He undergoes treatment for hospitalisation, consider the following scenarios.

    1. Single bill comes to Rs 7 lakh
    2. Two bills amounting to Rs 4.5 lakh each
    3. Two bills, one for Rs 7 lakh and another for Rs 2 lakh
    1. Rs 5 lakhs paid by normal policy and Rs 2 lakhs paid by top-up policy cover
    2. Rs 5 lakh paid by normal policy and no amount paid by top-up plan (since deductible is Rs 5 lakh)
    3. Rs 5 lakh paid by normal/regular policy and Rs 2 lakh paid by top-up plan
    1. Rs 5 lakhs paid by normal policy and Rs 2 lakhs paid by super top-up policy cover
    2. Rs 5 lakh paid by normal policy and Rs 4 lakh paid by super-top up plan
    3. Rs 5 lakh paid by normal/regular policy and Rs 4 lakh paid by top-up plan

    When to opt for a Top-up Health Insurance Policy:

    Individuals can opt for a top-up or super top-up policy under the following circumstances.

    • When their regular health insurance policy doesn’t offer adequate protection. In such cases they can choose one of these plans to enhance their protection.
    • When they want to increase their cover without having to pay higher premiums. The premium for a top-up or super top-up plan is cheaper than the premium for a normal plan with the same cover, helping them save money.

    Popular Top-up and Super Top-up Health Insurance Policies in India:

    Some of the popular top-up and super top-up health insurance policies in India are mentioned below.

    • Bajaj Allianz Extra Care – This policy offers cover ranging from Rs 10 lakh to Rs 15 lakh with deductibles ranging between Rs 3 lakh and 5 lakh. Working on a per claim basis, it comes with a family floater option.
    • ICICI Lombard Healthcare Plus – This policy offers flexible sum assured and deductibles to suit the financial requirements of different individuals, covering multiple scenarios.
    • Star Health Super Surplus – This plan comes with a cover ranging between Rs 7 lakh and Rs 10 lakh, with the deductible starting at Rs 3 lakhs.
    • Religare Enhance - This custom designed scheme comes without any sub limits, ensuring that the entire family is protected, with the option to choose a cover between Rs 1 lakh and Rs 30 lakh, depending on their requirement.
    • Apollo Munich Optima Plus – This plan covers multiple scenarios, offering cashless benefits and an option to convert the scheme into a zero deduction health insurance policy upon retirement.

    • United India Insurance Super Top Up – This plan can be used to protect both an individual and his/her family, coming with a floater option and offering cashless treatment across multiple locations in India.
    • HDFC Health Suraksha Top-up Plus – This plan comes with a family floater option, with deductible starting from Rs 1 lakh and sum assured ranging between Rs 2 lakh and Rs 10 lakh.
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