Top up and Super Top-Up Policy

Top up and Super Top-Up Policy
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Super Top Up policy is a Policy which offers you coverage of Mediclaim above your chosen deductible limit along with extra ordinary features. It is a type of product that offers you cover over and above your standard health insurance plans. They secure you from surging medical costs and unexpected health issues. You can avail of all the added coverage and related benefits at affordable premiums by choosing such plans. 

These policies provide health cover over and above a threshold limit set in the policy. This threshold limit is known as ‘deductible limit’. The hospitalization expenses within the deductible limit can be paid by your pocket or an existing primary health insurance.

Often, the Top up and Super Top up policies are confused with health insurance riders like Hospital cash or critical illness. It is important to know that these policies are regular indemnity policies and are similar to health insurance policies in every way except for the deductible limit. Riders or add on covers are add on to your existing policy in turn of some more premium. You cannot purchase a rider without a base plan.  

For example: If your super top up health insurance policy only covers for you after 5 lakhs…this means if your bill is 8 lakhs, it will only cover for the 3 lakhs after you’ve spent 5 lakhs from your pocket or from your standard health insurance policy.

You can buy a super top-up plan from any insurer. It is not mandatory to buy it from the same insurer from where you brought your base policy. 

Similarity between top-up and Super top-up health insurance:-

Both top-up and super top-up health insurance plans can be used only when the claim amount exceeds the threshold.

Difference between top-up and Super top-up health insurance:-

A top-up health insurance will only cover for costs when a single claim goes beyond the deductible limit.

However, a super-top up health insurance will cover for costs even when more than one claim during the year put together go beyond the deductible limit.

Let us understand this with an example

If Mr. X has a basic health cover of Rs. 4 lakhs and a Top Up policy of 10 lakhs with a deductible limit of 4 lakhs.

If Mr. X has a basic health cover of Rs. 4 lakhs and a  Super Top Up policy of 10 lakhs with a deductible limit of 4 lakhs.

ScenariosTop Up PolicySuper Top Up
Mr. X is hospitalized once and the total bill is Rs. 8 lakhsPrimary health cover will pay Rs. 4 lakhs and Top up policy will reimburse Rs. 4 lakhsPrimary health cover will pay Rs. 4 lakhs and Super Top up policy will reimburse Rs. 4 lakhs
Mr. X gets hospitalized twice in a year. The total hospitalization costs for the first and second instances are Rs. 4 lakhs and Rs. 3 lakhs respectively.In the first instance of hospitalization, the health cover will pay Rs. 4 lakhs. For second instance, neither health cover nor Top up policy will pay anything as the regular health cover has been exhausted during the first instance and the hospitalization cost in the second instance does not exceed the deductible limit of the Top up plan.In the first instance of hospitalization, the health cover will pay Rs. 4 lakhs. For second instance, the Super Top up plan pays Rs. 3 lakhs.
Mr. X gets hospitalized twice in a year. The total hospitalization costs for the first and second instances are Rs. 5 lakhs and Rs. 7 lakhs respectively.For the first instance, the health cover pays Rs 4 lakhs and the Top up plan pays Rs 1 lakh. In the second instance, the health cover doesn’t pay anything as it is already exhausted. The Top Up plan pays only Rs. 3 lakhs which is above the deductible limit.For the first instance, the health cover pays Rs 4 lakhs and the Super Top up plan pays Rs 1 lakh. In the second instance, the health cover doesn’t pay anything as it is already exhausted. The Super Top Up plan pays Rs. 7 lakhs.

How is the premium calculated for super top policy?

The factors that will affect your super top-up health insurance premium include, your age, geographical location, and the deductible and sum insured you’ve chosen as part of your super top-up health insurance plan. 

Benefits of Super Top-up Health Insurance

  • Extremely useful with a family floater insurance plan

The super top plans can be of immense use with a standard family floater health insurance plan. Under a family floater plan, the base sum insured is applicable for all the members of the family. So, if you purchase a super top with a deductible equal to the sum insured of you base family floater plan, the super top up policy will come to your rescue even if aggregate of the claims of all the family members, covered under the plan, exceeds the deductible.

  • Higher Sum Insured

According to Money Control, healthcare costs in India rise at a much higher rate than the inflation rate. A super top-up plan helps you to get coverage over and above your standard health plan at a much lower premium, so you never fall short even for higher sum assured.

  • Greater coverage for seniors & parents

Since healthcare costs for seniors are higher, health insurance premiums too are usually very high. A super top-up plan can help you get extensive coverage at a comparatively lower cost!

  • Additional Tax Saving

Just like any other health insurance policy, a super top-up health insurance too comes with tax saving benefits.

Most people buy top-up health insurance plans to ease financial uncertainties. While both a top-up and super top-up help manage expenses when they go above the decided deductible, super top-up plans are applicable when total expenses in the year go above and beyond the deductible whereas top-up plans are applicable to single claims only.

So, from a financial perspective, super top-up plans help you save and benefit a lot more! 

Vaishnavi Rastogi

Actuarial Student

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