Super Top-up Health Insurance

A super top-up health plan covers hospital bills above the deductible, up to the policy limit. For example, with a ₹10 lakh plan and a ₹3 lakh deductible, expenses beyond ₹3 lakh are covered, while the deductible can be paid through your existing health plan.
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Super Top-up Health Insurance
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3 mins
21-March-2024

Super top-up health insurance is an excellent add-on to a standard health insurance plan that provides additional coverage without increasing the premium drastically. The policy covers all medical expenses like any other health insurance policy.

What is super top-up health insurance?

Super top-up health insurance is a type of health insurance plan that enhances your regular health insurance plan by giving extra financial protection. It provides extra coverage, like a regular top-up policy, but with a higher threshold limit. A super top-up covers all hospitalisations beyond the threshold limit for the policy year.

When purchasing a Super Top-up Plan, you are required to set a deductible, which is the amount you must pay before the insurance starts covering your approved medical expenses. At the time of making a claim, you will need to pay the hospital bill up to the deductible, after which the Super Top-up Plan will cover the remaining balance. There are three ways to pay the deductible: directly out of your pocket, through a group health cover, or using your existing health insurance policy.

Super Top-Up Plans - Example Table For Your Better Understanding

Super Top-up Plans

Deductible

Rs 4 lakh

Sum Insured

Rs 12 lakh

Claim Amount

Rs 8 Lakh

You Pay

Rs 4 lakh

Insurer Pays

Rs 4 lakh

 

Super Top-up Health Insurance: Key Highlights

Key Features

Highlights

Deductible

Need to be paid only once

Cashless Treatment

Provided

Online Purchase and Renewal

Available on Policybazaar

COVID-19 Treatment

Covered

 

Super Top-Up example

Here's an example to better understand how a Super Top-up Plan works. Suppose you have a Super Top-up policy with a deductible of Rs. 3 lakh and a sum insured of Rs. 10 lakh. If your total medical expenses in a year reach Rs. 5 lakh, you will first pay the Rs. 3 lakh deductible. Once that is covered, the Super Top-up plan will cover the remaining Rs. 2 lakh. If further expenses arise later in the same policy year, the Super Top-up will cover the entire amount up to Rs. 10 lakh without requiring additional payments from you.

Who should opt for Super Top-up health insurance?

Super Top-up health insurance is ideal for individuals looking to enhance their coverage without significantly increasing premiums. It’s particularly beneficial for those who already have a basic health insurance plan but want additional protection against large or unexpected medical expenses.

If you are worried about high hospital bills that may exceed the coverage limit of your existing policy or group health plan, a Super Top-up plan can help. This is especially useful for people with a history of chronic conditions or those approaching retirement, as medical costs tend to rise with age. Additionally, families or individuals with multiple dependents may find it valuable to have extra financial security for multiple claims during a policy year.

Eligibility criteria for Super Top-up Health Insurance plan

Here are the basic eligibility criteria for a Super Top-up Health Insurance plan:

  • Age limit: Most insurers offer plans to individuals aged 18 to 65 years, with some extending coverage to senior citizens.
  • Pre-existing conditions: A waiting period may apply for pre-existing medical conditions.
  • Medical check-up: Some insurers may require a health check-up for applicants over a certain age.

How does super top-up health insurance work?

Super top-up health insurance works in a simple way. A super top-up plan covers the expenses over and above a regular health insurance policy. For instance, you have a regular health insurance policy with a coverage limit of Rs. 5 lakh. If you incur medical expenses of Rs. 7 lakh in a year, the regular health insurance policy will pay for Rs. 5 lakh. The super top-up policy will cover the additional Rs. 2 lakh. The coverage depends on the policy terms and conditions.

Pro Tip

A comprehensive health plan not only covers hospitalization but also pre & post-treatment expenses, ensuring complete financial protection against rising medical costs.

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Super Top Up Health Insurance plans benefits

Here are some benefits of health insurance for a super top-up plan:

  • Higher coverage at lower premiums: Super Top-up plans offer substantial coverage beyond a certain deductible, allowing you to enhance your health insurance benefits without paying high premiums.
  • Covers multiple claims: Unlike basic top-up plans, Super Top-up policies provide coverage for multiple claims during the policy year, once the total expenses exceed the deductible.
  • Acts as a backup for existing policies: If your regular health insurance or group cover is insufficient, a Super Top-up plan can fill the gap by covering expenses after the deductible is met.
  • Flexibility with deductibles: You can choose your deductible amount, giving you control over how much you pay before the coverage kicks in.
  • Affordable way to boost benefits of health insurance: Super Top-up plans are a cost-effective way to increase your overall coverage without replacing your existing health insurance policy.
  • Cost-effective: By having a deductible, the insurance company risk is lowered, thus the premiums are also lowered. This makes it very cost effective for the consumer.
  • Customization: As mentioned above, the deductible is customizable, also the sum insured is customizable. Thus allowing the consumer to build a plan that fits their needs.
  • Pay a single deductible: With a super top up plan, you only have to meet the deductible once per year, and then all other claims will be covered.

Key features of super top-up health insurance

Here’s a quick look at the key features of the super top-up health insurance plan.

Features

Description

Sum insured

Up to Rs. 50 lakh

Room rent

Covered up to the sum insured by the policy.

Pre-hospitalisation expenses

Covered up to 60 days, depending on the policy chosen.

Post-hospitalisation expenses

Covered up to 90 days, depending on the policy chosen.

ICU charges

Covered up to sum insured on the policy.

Cashless services

Available at networks hospitals

 

Difference between super top-up health insurance and top-up health insurance

Here’s a quick look at the common difference between super top-up health insurance and top-up health insurance.

Parameters

Super top-up health insurance

Top-up health insurance

Definition

An add-on policy that provides extra coverage with a higher threshold limit.

An add-on policy that provides additional coverage over and above the base health insurance policy for a single incident.

Policy trigger

Triggered at a predetermined threshold limit for a year.

Triggered at a predetermined deductible limit for a single incident.

Claim

Covers all hospitalisations beyond the threshold limit for a year.

Covers a single hospitalisation beyond the deductible limit.

Premium

Relatively higher

Relatively lower

Suitability

Ideal for individuals with chronic medical conditions with recurring healthcare expenses.

Ideal for individuals who want to protect themselves financially from unexpected hospitalisations without paying a hefty premium.

Advantages of super top-up health insurance

Know the benefits of having the best super top-up health insurance plan.

1. High coverage:

Super top-up health insurance provides coverage beyond the limit of the base health insurance policy.

2. Cost-effective

Super top-up health insurance comes at an affordable premium, offering additional coverage.

3. Customisation

You can customise the policy as per your medical needs.

4. Pay a single deductible

You need to pay the deductible amount only once. After which, you can claim benefits multiple times in a year.

Key inclusions of super top-up health insurance

Here are some of the key inclusions of super top-up health insurance.

Pre-and post-hospitalisation expenses:

Super top-up health insurance covers all medical expenses incurred before and after hospitalisation. This includes the cost of doctor consultations, medical tests, and medications. You get coverage for up to 60 days before and 90 days after hospitalisation. The duration may depend on the policy chosen and the insurer’s terms and conditions.

In-patient hospitalisation expenses:

The policy covers the cost of hospital room rent, surgical expenses, and ICU charges, among others.

Daycare medical procedures:

Super top-up health insurance policy covers minor surgeries that require hospitalisation for less than 24 hours. Examples include cataract surgeries, dental surgeries, chemotherapy, and tonsillectomies.

Ambulance charges:

Super top-up health insurance covers ambulance charges that include transportation to the hospital during an emergency. This is particularly important in case of life-threatening emergencies where time is of the essence. The policy covers both air and road ambulance charges.

Read more: Pre- and post-hospitalisation expenses

Key exclusions of super top-up health insurance

Here are some key exclusions under super top-up health insurance.

  • Does not cover medical expenses related to pre-existing conditions for a particular period.
  • Does not cover treatment of an illness or injury caused by alcohol or drug abuse.
  • Does not cover cosmetic surgery or any other non-medical treatment.

Why should I buy a super top-up health insurance plan?

Here are some reasons why buying a super top-up health insurance plan makes sense:

Affordable: Super top-up health insurance plans have lower premiums compared to traditional health insurance policies.

Additional coverage: Super top-up health insurance plans provide additional coverage when the sum insured in your primary health insurance policy is exhausted.

Comprehensive coverage: Super top-up health insurance plans provide comprehensive coverage for hospitalisation expenses, treatments, and other medical expenses.

Customisable: Super top-up health insurance plans are flexible and allow policyholders to customise them as per their needs and budget.

Role of Super Top-up Plans in senior citizen health insurance plans

Super Top-up plans play a crucial role in senior citizen health insurance by offering additional coverage at affordable premiums. As healthcare costs increase with age, especially for seniors with chronic conditions, these plans provide extra financial security. Once the deductible is met, the Super Top-up plan covers subsequent medical expenses, reducing out-of-pocket costs. It serves as a cost-effective way for seniors to enhance their existing health insurance without paying significantly higher premiums.

How to file a claim for super top-up health plan?

You can file claims in two ways, either cashless or reimbursement claim settlement. For both types of claim settlements, you need to inform the insurance company about the hospitalisation or medical treatment in time. In case of emergency, inform within 48 hours, and if planned, then three days before the admission.

Cashless claim settlement

  • Choose a network hospital and inform the insurer.
  • The insurer will then provide you with a pre-authorisation letter that you need to submit at the network hospital. The insurance admin at the hospital can also get the pre-authorisation done.
  • Following this, the network hospital will submit the required documents and the claim form.
  • Upon reviewing the claim request, the insurer will approve and directly settle the bills with the hospital.

Read more: Cashless Health Insurance

Reimbursement claim settlement

  • If you visit any other hospital not empanelled with the insurer, you can raise a reimbursement claim.
  • Download the claim form online and fill in the details.
  • Provide necessary documents such as hospital discharge summary, medical bills, and investigation reports within 15 days of discharge. Also, provide health insurance policy copy, and duly filled claim form for reimbursement claim settlement.
  • The insurance provider will review all the documents and notify you regarding the approval within a few days. If approved, the insurer will reimburse the amount as per the policy terms and conditions.
  • You will receive the amount in your registered bank account.

You can buy a super top-up health insurance policy with a comprehensive health insurance policy. Super top-up health insurance policy offers comprehensive coverage, ensuring you do not face any financial constraints while availing medical treatment. It helps you focus on your recovery without worrying about the funds.

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Frequently asked questions

What is the difference between a regular health insurance plan and super top-up health insurance?

A regular health insurance plan covers medical expenses up to a certain limit. A super top-up health insurance policy provides additional coverage when your regular health insurance policy limit gets exhausted. 

How does a super top-up health insurance benefit my parents?

As parents age, medical expenses tend to increase, and a super top-up health insurance policy can provide much-needed financial assistance. You can get a super top-up health insurance plan along with the parents health insurance plan. With a super top-up health insurance policy, your parents can avail of additional coverage at a relatively low cost. It ensures access to quality medical care without having to worry about the cost implications.

What are the major factors that affect the premium of super top-up health insurance?

Age, pre-existing medical conditions, coverage limit, and deductible amount mainly affect the premium of super top-up health insurance. The older an individual is, the higher the premium. Pre-existing medical conditions, if any, can also increase the premium. Higher coverage limit and lower deductible amount come at a higher price, and vice versa.

How to claim super top-up?

To claim a Super Top-up, you must first pay the deductible amount through your existing policy or out-of-pocket. Once medical expenses exceed the deductible, the Super Top-up covers the remaining costs within the policy limits.

What is super top-up in health insurance?

A Super Top-up in health insurance is an additional plan that provides coverage once your total medical expenses exceed a specified deductible, offering extended protection beyond your base policy for multiple claims in a policy year.

Can I take super top-up without any plan?

Yes, you can take a Super Top-up without having a base health insurance plan. However, you'll need to pay the deductible out-of-pocket before the Super Top-up policy starts covering any medical expenses.

What do you mean by deductible in a super top-up health insurance?

A deductible in Super Top-up health insurance is the threshold amount you must pay before the plan kicks in. Once your medical expenses exceed this deductible, the Super Top-up covers the remaining costs.

Why is a super top-up health insurance plan cheaper?

A Super Top-up plan is cheaper because it only comes into effect after you’ve paid the deductible amount. This reduces the insurer’s risk, allowing them to offer higher coverage at lower premiums than traditional health insurance policies.

What is the super top up policy of National Insurance?

National Insurance offers a Super Top-Up policy called the National Parivar Mediclaim Plus Policy. It's designed to provide additional coverage beyond your existing health insurance or employer-provided coverage. It helps cover expenses once your base policy's sum insured is exhausted, offering a higher overall coverage at a lower premium.

Can we port super top up health insurance?

Yes, you can port your super top-up health insurance to another insurer. The Insurance Regulatory and Development Authority of India (IRDAI) allows portability of health insurance policies, including super top-up plans, provided you follow the necessary procedures and timelines.

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