Health Insurance is a safety net to protect you from the financial hardships imposed by expensive medical bills. However, the sum insured either by a personal health insurance policy or group health insurance policy is often not enough to meet the insured person’s medical expenses, necessitating spending from his/her own pockets to cover the balance amount. This is where super top-up health insurance comes into play.
The rising costs of medical expenses frequently make conventional health insurance plans insufficient. This is why an adjunct to the main policy known as super top-up health insurance is a suitable choice.
How does super top-up health insurance work?
Super top-up health insurance provides coverage for cumulative medical expenses over a deductible limit. The reimbursement covers the cost of medical treatment after the sum insured by the regular health insurance policy has been exhausted. The cumulative claim amount in the policy period which exceeds the threshold amount is paid by the super top-up plan.
For example, Rakesh has a regular health insurance policy with a sum insured of Rs. 5 lakhs. He also has a super top-up health insurance policy of Rs. 10 lakhs with a deductible limit of Rs 5 lakhs. Suppose Rakesh gets hospitalized and his medical bill is Rs. 7 lakhs. In such a scenario, his regular health insurance policy will pay Rs. 5 lakhs. Since the deductible limit has been breached, his super top-up health insurance plan will pay the remaining 2 lakhs.
Unlike a top-up plan, a super top-up plan does not consider the threshold limit on a single claim but total hospitalization bills during the policy period. This means super top-up insurance plans cover multiple claims.
Inclusions and Exclusions of Super Top-Up Health Insurance
The inclusions of super top-up health insurance in India include hospitalization expenses, pre, and post-hospitalization expenses, in-patient expenses, daycare procedures, and annual health check-ups.
Exclusions of super top-up health insurance include claim amounts below deductible limits, pre-existing diseases, self-inflicted injuries, cosmetic surgeries, infertility treatments, pre and postnatal expenses without hospitalization, and claim amounts during waiting periods.
Depending upon the insurer, there may be specific inclusions and exclusions in the super top-up plan.
Benefits of Super Top-Up Health Insurance
The super top-up health insurance premium amount depends upon the deductible limit. Greater is the deductible limit; lesser is the premium amount. However, the premiums of super top-up health insurance policies are much lower as compared to regular health insurance policies providing similar sum insured. Many insurance providers have super top-up plan calculators on their websites to give people a clear idea about the premium amount to pay for purchasing their super top-up plans.
One Time Deductible and Multiple Claims
Super top-up health insurance requires you to pay the deductible amount only once during a policy term and make multiple claims during the same term. Unlike a top-up plan active for a single hospitalization per policy term, a super top-up plan entertains multiple claims in the policy period.
The best super top-up health insurance plans provide coverage for treatment expenses for COVID-19 apart from other illnesses. The pandemic is still raging worldwide, with everyone at risk of getting infected. To this end, the best super top-up plans covering it are highly beneficial for the customers.
The deductible limit is customizable. This implies that the customers can choose between a plethora of deductible limits as per the sum insured, premium amount, and other features. The deductible limit can be as low as Rs 1 lakh or exceed Rs 5 lakhs. The sum insured ranges between Rs. 10-20 lakhs.
Tax savings are possible by purchasing super top-up health insurance. This is because premiums paid for super top-up insurance plans are eligible for tax deductions under Section 80D of the Income Tax Act.
No Room Rent Restriction
The best super top-up health insurance plans do not impose room rent restrictions. This means the policy reimburses the room rent regardless of the type of room the insured may have chosen in the hospital. There is no threshold amount for the room rent.
Enhanced Sum Insured
The sum insured by the individual, family, or group health insurance plan is often not enough to meet the medical expenses. A super top-up plan increases the sum insured, thereby enhancing the coverage. For instance, a person having a sum insured of Rs. 5 lakhs under his/her regular health insurance policy can purchase a super top-up policy having a sum insured of Rs. 10 lakhs to get total coverage of Rs. 15 lakhs.
Cashless Claim and Reimbursement Facility
Like regular health insurance, super top-up health insurance also provides either cashless treatment in-network hospitals of the insurer or reimburses the amount in the case of non-network hospitals.
Why opt for super top-up plan?
Insufficient Base Health Insurance
Super top-up health insurance is a suitable option for anyone who considers that the coverage provided by his/her current health insurance policy is insufficient. Getting a top-up plan is a cost-effective option instead of porting to a new and more expensive health insurance plan.
Extensive Coverage to Senior Citizens
Senior citizens are at increased risk of hospitalization. This is why premium rates of health insurance policies for senior citizens are very high. Super top-up insurance plans provide extensive coverage to senior citizens at lower premium rates. Once the deductibles have been paid once, senior citizens can enjoy multiple claims without paying anything extra.
Lower Sum Insured by a Group Health Insurance Policy
The group or employee health insurance policy can be upgraded by opting for super top-up health insurance. The sum insured by a group health insurance policy is often not enough to meet the needs of many individual employees. By opting for super top-up health insurance, such employees can increase their coverage amount by paying lower premiums than standard health plans.
Extra Coverage in Medical Emergencies
Super top-up plans provide extra coverage to meet the costs of medical emergencies, which exhaust the coverages provided by conventional health insurance plans.
Super top-up health insurance plans should be purchased as an adjunct to a base health insurance plan. The super top-up plan provider can either be the same company providing the base health insurance policy or different.
If you are looking for a health cover, which provides all these benefits, then make sure that you check out Vital.