What Is Super Top Up Health Insurance?

With every passing day, new diseases are getting known and inflation is rising rapidly too. Given the scenarios around, your existing health insurance plans might not suffice in case of a medical emergency. The simple reason for this is generally, health insurance cover ranges from Rs. 3 to 5 lakhs. You might need additional coverage to pay your total medical expenses.

Super Top Up Health Insurance

Super top up health insurance is an additional policy with your existing health insurance plans as a base policy where if your medical expenses exceed the sum insured in the base policy, you can claim an excess amount under super top up health insurance to the extent of the amount insured.

Who Needs a Super Top-Up Health Insurance Policy?

Super top-up health insurance plans offer enhanced coverage at an affordable cost. Here’s a breakdown of who should consider this option:

1. Senior Citizens and Parents

1. Health insurance premiums increase with age. A super top-up policy can significantly reduce premiums for those aged 60 and above.
2. However, note that you’ll need to pay the deductible from your existing health or corporate plan or out-of-pocket.

2. Employees Seeking to Upgrade Corporate Health Plans

If your employer-provided insurance has insufficient coverage, a super top-up plan can enhance the sum insured at a lower cost than a standard plan.

3. Individuals with Insufficient Existing Coverage

If your current health insurance sum insured is inadequate or lacks comprehensive benefits, a super top-up policy allows you to boost coverage without replacing your existing plan.

Features and Benefits of a Super Top-Up Health Plan

• Coverage for COVID-19 and Other Illnesses: Super top-up plans cover the cost of treatment for COVID-19, along with other medical conditions.
• One-Time Deductible Payment: Deductibles are paid once, and you can claim multiple times within the policy term.
• Customizable Deductibles: Choose a deductible limit based on your existing policy and desired coverage.
• Higher Sum Insured at Lower Premiums: Extend your corporate or existing plan’s coverage affordably.
• Additional Benefits: Many super top-up plans include benefits absent in corporate policies, such as AYUSH treatments and critical illness coverage.
• Tax Savings: Premium payments qualify for tax deductions under Section 80D of the Income Tax Act.7.
• Convenience: Enjoy cashless treatment at network hospitals and quick, hassle-free claims.

How Does it Differ From Other Top Up Plans?

1. Deductible: Under normal top up health insurance, the deductible is applicable on per claim basis. That is if every claim amount doesn’t exceed the deductible amount, you will not get the claim for that bill. But what is super top up health insurance; is making deductible applicable on total claims made during a policy year.
2. Number of claims: Other top up health insurance policies only admit one claim during the policy year. So what if there arises a need for subsequent claims? This is where a super top up health insurance policy acts as a savior.

Read More: What is Deductible in Super Top-Up Health Insurance?

Super Top-Up vs. Top-Up Health Insurance Plans

What Medical Expenses Are Covered in Health Insurance?

• Hospitalization: Covers costs like doctor’s fees, surgeries, diagnostic tests, anesthesia, medicines, and implants.
• Pre- and Post-Hospitalization: Expenses incurred before and after hospital stays are covered.
• Daycare Procedures: Includes treatments not requiring 24-hour hospitalization.
• ICU and Room Rent: Covers room rent, ICU charges, and nursing expenses.
• Ambulance Charges: Road ambulance expenses during emergencies are included.
• Annual Health Checkups: Complimentary checkups are often provided after a specific policy period.

What Super Top-Up Plans Do Not Cover

Super top-up plans do not cover:

1. Claims below the deductible limit
2. Newborn baby expenses
3. Cosmetic surgeries, dental treatments, or contact lenses
4. Experimental treatments or congenital conditions
5. Alcohol or drug abuse-related treatments
6. HIV/AIDS or venereal disease treatments

How to File a Health Insurance Claim

• Reimbursement Claims: Inform the insurer promptly. Submit bills and documents online to process the claim.
• Cashless Claims: Seek treatment at a network hospital. Use your e-health card for a seamless experience.

Eligibility Criteria for Super Top-Up Insurance

1. Minimum entry age: 18 years
2. Eldest insured member’s age is considered for premium calculation.
3. Residency location and the number of insured members influence eligibility.
4. Group medical coverage, if applicable, can extend to dependents.

By opting for a super top-up health plan, you can ensure financial preparedness for medical emergencies without the burden of hefty premiums.

Super Top-Up vs Top-Up Policy: What Should You Buy?

If you are someone who doesn’t have regular medical expenses coming up requiring claims to be made, a normal top up might suffice. If you are someone who is suffering from any severe disease or someone approaching their 50s or above, it is advisable to go for a super top up health insurance policy.

Why Choose a Super Top-Up Over Increasing Base Sum Insured?

If you are aware of the meaning of sum insured then you also know that as it rises so does the annual premium. On the other hand, if you choose a super top up policy as per your need then the premium to be paid for increased sum insured is comparatively lower.

Read More: What Is Top-Up Health Insurance and How Does It Work?

Tips to Select the Right Super Top-Up Insurance

1. Deductible

First and foremost, you need to decide on the deductible. It is advisable to keep the amount of deductible equal to or at least near to the sum insured of the base policy. You remain secure for any sum payable by you provided it is within the sum insured under super top up plan. Example: If you have a health insurance plan of Rs. 3 lakhs as a base policy with a co-payment clause of Rs. 50000, and you have a super top up policy with a deductible of Rs. 3 lakhs. Now if you incur a medical expense of Rs 1.5 lakhs. You will have to make a payment of Rs 50000 and the insurance company will pay Rs 1 lakh. Later, in the same policy year, you incur another medical expense of Rs. 4 lakh. Now you can claim Rs 1.5 lakhs under the base policy and Rs 2.5 lakhs under the super top up policy.

2. Net Coverage

Whenever one buys a top up health insurance policy, he must look for ‘Net Coverage’ which essentially means the sum insured less deductible payable by the policyholder. Example: Riya has a super top up health insurance policy with a sum insured of Rs 8 lakhs and a deductible of Rs 3 lakhs. This means her net coverage is Rs 5 lakhs.

3. Parameters considered in deciding the amount of claim

The amount of claim is decided based on various parameters. Pre-diagnosis checkups, ambulance or other transportation expenses, category of rooms, network or non-network hospitals, and various other factors are considered in deciding the claim amount. Now if the parameters are the same for both the policies then it’s better as the claims can be made without any recalculation. Example: If as per conditions under the base policy, the claim amount comes to Rs 4 lakh with a sum insured of Rs 3 lakh then you need to make an additional claim under super top up health insurance. However, the eligible claim amount calculated under the super top up policy as per its conditions is Rs 3.5 lakh and your super top up has a deductible of Rs 3 lakh then you will be paid additional Rs 50000 only.

Read More: Difference Between Top-up vs Super Top-up Health Plans

FAQs

1. Do I get a tax benefit if I take a super top up health insurance policy?

Yes, you do get income tax deduction under section 80D for super top up premium paid.

2. Are there any medical tests necessary before taking this policy?

Though it depends on the provider, these policies may require certain tests for pre existing diseases or if you are above a specific age say 45 or 50 years.

3. Is super top-up offered as the individual policy only or does it have a family floater variant also?

It has both the variants, individual policy and family floater policy. you have to choose it based on your needs.