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.

What is 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.

How does it differ from other top up plans?

• 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.
• 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.

Whether to buy a regular top up policy or a super top up health insurance policy?

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 should one opt for super top up and not increase the sum insured in your base policy?

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.

How can you choose an appropriate super top up policy for yourself?

• 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.  

• 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.  

• 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.

FAQs:

1. 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.