What is Top Up Health Insurance & How Does it Work?
Mar 4, 2021

What is Top Up Health Insurance?

During a medical emergency, a health insurance plan covers your needs. But there is a time when the hospital bills exceed the health insurance amount, forcing you to bear the extra amount, which might sometimes be out-of-pocket. However, there is an option to avoid such crises with a top-up health insurance plan.

What is top up health insurance?

Top up health insurance is an additional coverage offered by health insurance companies to aid the policyholders when they exceed the maximum limit of their health insurance plans. For example, Mr. A has a health insurance policy of INR 3 lakhs. He pays a premium amount of INR 6000 annually. But he feels that the coverage won’t be enough. Accordingly, if he increases the existing health insurance policy coverage from INR 3 lakhs to INR 5 lakhs, the premium amount would be INR 10,000. But instead, he opts for a top-up health insurance plan, which has a premium of INR 1000 for every 1 lakhs top-up. Therefore for an extra 2 lakhs cover, he pays INR 2000 additional that it is INR 8,000 annually.

What is top up in health insurance?

If the policyholder's medical emergency claims are more than the health insurance policy plan covered, then the policyholder can claim the extra amount from the top-up plan. There are two types of plans — top-up and super top-up.
  1. Top-up plan: Applicable per year per claim basis and works when the claim amount is more than the current health insurance policy's coverage amount.
  2. Super top-up plan: Applicable when due to the repeated claims in a year, the policyholder exhausts the cover of the health insurance plans.
   
CLAIM MR. A — HEALTH INSURANCE OF INR 3 LAKHS + TOP-UP PLAN OF INR 5 LAKHS MR. B—– HEALTH INSURANCE OF INR 3 LAKHS + SUPER TOP-UP PLAN OF INR 5 LAKHS
Claim 1 — INR 3 Lakhs Covered by the health insurance Covered by the health insurance
Claim 2 — INR 1 Lakh Policyholders need to pay the entire amount because the top-up plan will only cover the claim if they exceed the health insurance coverage plan. The super-top up plan will cover the claim. In case of multiple claims within a year, the super top-up plan pays the extra amount if the policyholder exhausts the health insurance coverage amount.
Claim 3 — INR 4 Lakhs Only INR 1 Lakh will be covered by the to-up plan, which is the extra amount over the policyholder’s health insurance coverage plan. The policyholder will bear INR 3 Lakh since he already exhausts his health insurance coverage amount in his 1st claim. The super top-up plan will cover the entire amount.  

How does top up health insurance work?

A top-up health insurance plan gets activated only after the current health insurance policy amount gets exhausted. The difference between top-up and super top-up plans is — the top-up plan only covers a single claim above the current health insurance policy. In contrast, the super top-up plan claims for collective medical expenses within a year.

FAQ’s

  1. What is top up health insurance? Why does one need to avail the plan?

At the time the policyholder thinks that their current health insurance plan won’t be enough to cover medical or health care needs, the policyholder can buy a top-up health insurance plan to increase the coverage amount. Top-up health insurance is a cost-effective plan to ensure the policyholder is covered for life’s uncertainties.
  1. What is top up in health insurance? Who should buy the plan?

Top-ups in health insurance often confuse the extra benefits provider such as — hospital cash, personal accident insurance, etc. But, the top-up is actually a policy that provides the same benefits as a regular health insurance plan. Every policyholder should buy the top-up health insurance plans besides their current health insurance base plan. It has more generous senior citizens' coverage because the older the person gets, the health insurance premium also gets higher. Buying top-up health insurance can significantly reduce the premium.
  1. How does top up health insurance work?

Both the health insurance policy and top-up health insurance can be claimed together at the same time for a single hospitalization bill. Each insurer is liable to pay the part of the claims.

Conclusion:

A top-up health insurance plan acts as a bridge-whist between healthcare policy and the medical emergency expenses. It is enhancing the health insurance limit at a reduced cost. Top-up health insurance is a good option for policyholders who have a family floater plan or have a history of medical ailments.

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