Top-Up Vs Super Top-Up Health Insurance - Know the Difference
Sep 26, 2024
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Health insurance is a crucial component of planning and securing coverage against unforeseen medical expenses. With rising healthcare costs, a basic Health Insurance Policy is often not sufficient to cover all your medical costs. In such cases, a person can opt for a Top-Up or a Super Top-Up Health Insurance Policy for additional coverage.
Purchasing a Top-Up or Super Top-Up Health Insurance Policy is a more affordable option than increasing the Sum Insured of a comprehensive Health Insurance Policy. This article explores the differences between a Top-Up and Super Top-Up Health Insurance Plan and also helps you understand which Health Insurance Plan is better suited for you.
What is a Top-Up Health Insurance Plan?
A Top-Up Health Insurance Policy provides coverage once the medical expenses exceed a specific threshold limit, called a Deductible. A Deductible is the amount of expenses that the Insured must bear from his own pocket before the Insurance Company starts paying out the claim. Each time a Claim is made that exceeds the deductible amount, the Top-Up Insurance Plan is triggered and provides coverage for the same.
Let us understand with an example. A Policyholder has a base Health Insurance Plan with a Sum Insured of Rs10 Lakhs and a Top-Up Insurance Plan of Rs25 Lakhs with a deductible of Rs10 lakhs.
Claim 1: The Policyholder files for a claim of Rs8 Lakhs which is covered by the base Health Insurance Plan and the Top-Up Plan is not triggered as it does not exceed the threshold limit.
Claim 2: The Policyholder files for a second claim of Rs15 Lakhs within the same Policy Period. In this case, the base Health Insurance Plan pays Rs2 lakhs and the Top-Up Plan is also triggered as the medical expenses have breached the deductible limit of Rs10 lakhs. The Top-Up Plan pays the amount over and above the deductible limit of Rs10 lakhs, which is Rs5 lakhs in this case.
An important Point to note is that a Top-Up Health Insurance Plan provides coverage only if the Claim amount exceeds the deductible amount each and every time.
What is a Super Top-Up Health Insurance Plan?
A Super Top-Up Health Insurance Policy reimburses the Insured once the aggregate of all Hospitalisation Expenses during the Policy Year exceed the Deductible Amount.
However, there is one major difference between a Top-Up Plan and a Super Top-Up Plan. A Top-Up Health Insurance Plan requires that each and every claim exceed the deductible amount while a Super Top-Up Health Insurance Policy requires that aggregate of all claims exceed the deductible amount during the Policy Year. This means that once the total of all medical expenses in a Policy Year exceed the deductible amount, the Super Top-Up Health Insurance Policy starts paying out the Claim.
Let’s understand better with an example: A Policyholder has a base Health Insurance Policy with a Sum Insured of Rs10 Lakhs and a Top-Up Insurance Plan of Rs25 Lakhs with a deductible of Rs10 lakhs. The Super Top-Up Health Insurance Policy starts providing coverage as soon as the aggregate of medical expenses during the Policy Year exceeds the deductible limit of Rs10 Lakhs.
Claim 1: The Policyholder files for a claim of Rs8 Lakhs which is covered by the base Health Insurance Plan and the Super Top-Up Plan is not triggered as it does not exceed the threshold limit. Claim 2: The Policyholder files for a second claim of Rs15 Lakhs within the same Policy Year. In this case, the base Health Insurance Plan pays Rs2 lakhs and the Super Top-Up Health Insurance Policy is also triggered as the aggregate of medical expenses have breached the deductible limit of Rs10 lakhs (including Rs8 lakhs of 1st Claim amount). The Super Top-Up Plan pays the amount over and above the deductible limit of Rs10 lakhs, which is Rs13 lakhs (Rs15 lakhs Claim Amount – Rs2 lakhs paid by the base Health Insurance Policy).
As you can see, a Super Top-Up Health Insurance Policy considers the aggregate of medical expenses across all claims in a Policy Year while considering the Deductible Limit while a Top-Up Health Insurance Policy requires that the Claim Amount exceed the Deductible for each and every Claim.
Top-Up Vs Super Top-Up Health Insurance: Key Differences
| Top-Up Health Insurance Policy | Super Top-Up Health Insurance Policy | |
|---|---|---|
| Definition | An Insurance Policy which provides coverage once the medical expenses exceed a the Deductible Amount | An Insurance Policy which reimburses the Insured once the aggregate of all Medical Expenses during the Policy Year exceed the Deductible Amount |
| Deductible | Deductible is applied to each and every Claim | Deductible is applied only once and the Claim is payable once the aggregate of all Medical Expenses during the Policy Year exceed the Deductible |
| Cost | Cheaper than a Super Top-Up Health Insurance | More expensive than a Top-Up Health Insurance |
Deductible in Top-Up/Super Top-up Health Insurance Plans?
The Deductible Amount is crucial for Top-Up and Super Top-Up Health Insurance Plans. Policyholders should ensure that the Deductible aligns with their base Health Insurance Coverage. For example, if the Base Policy provides coverage up to Rs10 Lakhs, Policyholders should opt for a Top-Up or a Super Top-Up Plan with a Rs10 Lakhs Deductible and not a higher deductible.
Get Best Health Insurance Quotes with Qian!
In today’s times, where medical expenses are continuously increasing, adequate Health Insurance Cover is more important than ever. A Top-Up or a Super Top-Up Health Insurance Policy is an excellent option to increase Health Insurance Coverage in an affordable manner. Qian is a licensed Insurance Broker for Health Insurance Policies. Our team will provide you with quotes for multiple Health Insurance Plans as well as assist you with the complete claims process. If you wish to learn more, please reach out to us via email at insurance@qian.co.in or call us on 022-35134695. We would be glad to assist you.