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Super Top Up Health Insurance Plan

Rising health issues have resulted in unaffordable costs of medical treatment. The skyrocketing cost of medicines and healthcare treatments makes it inevitable to buy health insurance. However, the more important question is whether the existing health insurance plan is enough to cover the entire cost of medical treatments arising in an unforeseen situation.

What is a Super Top-Up Health Insurance Plan?

A Super Top Health Insurance Plan is a type of health insurance policy that offers an additional layer of coverage above a predetermined threshold called the deductible. It acts as a safety net to provide extra financial protection in case your medical expenses exceed the threshold set by the deductible. This type of plan becomes useful when your regular health insurance coverage is exhausted, ensuring that you are not burdened with high medical bills during times of unexpected medical emergencies.

How does a Super Top Up Health Insurance Plan work?

Let’s understand the workings of a Super Top Up Health Insurance Plan with an example:
Suppose you have a regular health insurance plan with a coverage limit of ₹5 lakh. You also have a Super Top Up plan with a coverage limit of ₹10 lakh and a deductible of ₹3 lakh. Now, if you face a medical emergency that incurs expenses of ₹4 lakh, your regular health insurance will cover ₹4 lakh. However, if you face another medical emergency in the same year costing ₹6 lakh, your regular health insurance will cover ₹5 lakh (up to its limit), and the Super Top Up plan will kick in. Since the expenses exceed the deductible of ₹3 lakh, the Super Top Up plan will cover the remaining ₹3 lakh, ensuring that you are protected without having to pay a significant amount out of pocket.

Super Top Up vs. Top Up Health Insurance Plans: Differences and Selection

Super Top Up Health Insurance Plans and Top Up Health Insurance Plans do sound similar and do have their own of share similarities, however, there are key differences that influence your choice. Let us understand the key difference between these health insurance plans that would help you in making a sound decision.

Example:
Suppose you have a regular health insurance plan with a coverage limit of ₹5 lakh and a top plan with a deductible of ₹5 lakh and a coverage limit of ₹10 lakh. If you incur medical expenses of ₹4 lakh, the regular health insurance will cover it.

However, if you face another medical emergency incurring expenses of ₹3 lakh, the regular health insurance will cover only ₹1 lakh (since it has already paid ₹4 lakhs before from the total limit of ₹5 lakhs), and the Top Up plan won’t trigger since the expenses don’t cross the ₹5 lakh deductible in THIS particular claim.
In contrast, a Super Top Up plan will cover the remaining ₹2 lakh in the above scenario, as it aggregates multiple claims within a policy year to reach the deductible threshold.
However, if any further claim arises when the claim amount is more than the deductible limit, then the excess amount for that claim would be paid by the top-up plan.

  Base PlanTop Up PlanSuper Top Up Plan
Coverage Limit ₹ 5 lakhs₹ 10 lakhs with a deductible of ₹5 lakhs₹ 10 lakhs with a deductible of ₹5 lakhs
1st Claim₹ 4 lakhs₹4 lakhs (since the base coverage is ₹5 lakhs)Not applicableNot applicable
2nd Claim₹ 3 lakhs₹1 lakh only (since ₹4 lakhs was already paid earlier from the total limit of ₹5 lakhs)Won’t trigger since the expenses don’t cross the ₹5 lakh deductible in THIS particular claim.Since the aggregate claim amount is ₹7 lakhs (i.e. >5 lakhs), the remaining ₹2 lakhs would be paid by the Super Top Up Plan
3rd Claim₹6 lakhsNot applicable as the entire amount has already been paid earlier₹1 lakh (i.e. amount> ₹5 lakhs would be paid)₹6 lakhs (as the entire amount would be >5 lakh threshold of aggregate claim already crossed in the earlier claims)

How do deductibles work in Super Top Up Plans?

A deductible is a pre-defined threshold above which the Super Top Up plan becomes effective. For instance, if you have a Super Top Up plan with a deductible of ₹3 lakh and you incur medical expenses of ₹2 lakh, the Super Top Up plan won’t cover it, and you would have to pay these expenses from your pocket. However, if your aggregate medical expenses exceed ₹3 lakh in the entire policy year, the Super Top Up plan will cover the excess amount.

Pro tip: Once triggered, the Super Top-Up Plan will pay for all future claims for that policy year. So, ideally, you should opt for a base health insurance plan and a super top-up plan on the same date, or at least close to each other.

Optimal Coverage in Super Top-Up Plans: Base Plan + Super Top-Up

The optimal coverage in a Super Top-Up plan is determined by considering your existing health insurance coverage (base plan) and the potential medical expenses you might face. To calculate the right coverage, add your base plan coverage to the deductible of the Super Top-Up plan. This ensures that you have comprehensive coverage for a range of medical scenarios.

Ideally, your total health insurance coverage should be about 50% of your annual income + the last 3 years of your hospitalisation expenses. This coverage should be taken care of by your base health plan + your Super Top Up Health Insurance Plan.

Highlights of Super Top-up Health Insurance Plans

1. Affordability:
Super Top Up plans offer extensive coverage at a reasonable premium. The premium for a Super Top Up Plan is always lesser than the base coverage because there is a deductible beyond which the plan gets triggered.

2. Covers Cumulative Expenses:
It accumulates expenses over a policy year, providing coverage when individual claims don’t surpass the deductible but the cumulative claims do.

3. Comprehensive Coverage:
These plans cover a wide range of medical expenses, including hospitalisation, surgeries, diagnostics, and more.

4. Flexible Deductibles:
You can choose a deductible that aligns with your financial capabilities and risk tolerance and your base coverage.

5. Enhanced Financial Security:
Super top-up plans prevent unexpected high medical costs from depleting your savings.

6. Tax Benefits:
The premium payable for super top-up plans also qualifies for an 80D Income Tax deduction

Basically opting for Super Top Up Health Plans is a smart way of opting for higher health insurance coverage without a large pinch in your wallet!

Who Should Buy a Super Top-up Health Plan?

A super top-up health plan is the need of the hour due to the rising cost of medical expenses. Additionally, the premium of the super top-up health insurance plan is not very heavy on the pocket. Therefore, a super top-up plan is suitable for individuals and families who want to enhance their health coverage without a substantial increase in premiums.

The super top-up plans are particularly beneficial for those individuals and families who are at a higher risk of medical emergencies due to lifestyle factors, pre-existing conditions, or age as they would typically have higher hospitalisation expenses.

Key Features of a Super Top-up Health Insurance Plan

1. Deductible Options:
Whoever wishes to opt for a super top-up health insurance plan can choose deductible amounts based on their specific healthcare needs. Ideally, the deductible should be equal to your base plan.

2. Coverage Limit:
This is the USP of a super top-up health insurance plan as it offers an additional coverage limit beyond the deductible to the policyholder thereby offering an additional insurance security net.

3. Cumulative Claims:
The super top-up health insurance plans accumulate claims throughout the policy year thereby offering comprehensive coverage to the policyholder and their families.

4. Enhanced Financial Protection:
A super top-up health insurance plan is an additional insurance coverage over and above the base health insurance plan. Thus, it offers additional protection to your savings from unexpected medical expenses.

5. Affordable Premiums:
Super top-up health insurance plans are designed to provide high insurance coverage at a fraction of the cost of a regular health insurance plan.

Benefits of a Super Top-up Health Insurance Plan

A Super top-up health insurance plan is one of the best insurance tools to safeguard yourself and your family from the rising cost of medical expenses. This is because a super top-up health insurance plan is the best way to increase your insurance coverage and safeguard yourself and your family financially in times of uncertain events. Apart from the mentioned, the following are additional benefits offered by a super top-up health insurance plan:

1. Cost-effective:
A super top-up health insurance plan can be availed at low premiums. So, you can increase the insurance coverage without a significant increase in premium.

2. Comprehensive:
A super top-up health insurance plan offers a wide range of medical expenses, including hospitalisation, surgeries, and more.

3. Financial Security:
They protect your savings and ensure financial stability during medical emergencies. Additionally, one can buy a super top-up health insurance plan as a family floater thereby making it easier to cover the entire family.

4. Flexible Deductibles:
A super top-up health insurance plan is designed to allow you to customise your plan as per your insurance needs. You can customise the plan based on your risk tolerance and financial capabilities.

5. Tax Deduction:
The premiums paid towards buying the coverage under a super top-up health insurance plan qualify for a tax deduction of up to Rs 25000 under section 80D of the Income Tax Act. For senior citizens, the limit is enhanced to Rs 50000. An individual buying a super top-up health insurance plan for parents can avail of a tax deduction of up to Rs 50000.

What’s covered in Super Top-up Health Insurance?

Super Top Up health insurance plan is designed to offer coverage in the event of a medical emergency. This insurance covers takes care of medical expenses, including but not limited to:

○ In-patient hospitalisation
○ Pre and post-hospitalisation expenses
○ Day-care treatments
○ Surgeries
○ Organ transplants
○ Critical illnesses, etc.

What’s not covered?

While above are the inclusions of the super top-up health insurance there are certain exclusions under these plans. However, these exclusions vary between insurance providers, but common exclusions in Super Top Up plans include:

○ Pre-existing diseases for a specified waiting period
○ Cosmetic treatments
○ Non-allopathic treatments
○ Self-inflicted injuries
○ Pregnancy-related expenses, etc.

However, check the specific exclusions in your plan and then choose according to your needs.

Medical Expenses Covered under Super Top-up Health Insurance Plans

Here is a common list of medical expenses that are covered by the Super Top Up health insurance plans. The plan covers a wide array of medical expenses, including:

○ Room and boarding charges during hospitalisation
○ Doctor’s fees and surgeon’s fees
○ Medical tests and diagnostics
○ Medication and pharmacy expenses
○ Intensive care unit charges
○ Ambulance charges, etc.

Eligibility criteria for Super Top-up Medical Insurance plan

Eligibility criteria to avail of a super top-up health insurance plan can vary among insurance providers, but generally, individuals aged between 18 and 65 can avail of Super top-up plans. Additionally, the insurance providers may ask for certain medical tests depending on the pre-existing conditions of an individual.

Additionally, if an individual has any pre-existing medical conditions then he/she is expected to offer declarations in this regard depending upon the nature of the medical condition, age, and health status.

Role of Super Top-up Plans in Health Insurance Plans

We all know a super top-up health insurance plan is designed to offer additional insurance coverage to protect an individual and their family in times of medical emergency. Super Top Up plans play a crucial role in enhancing your overall health insurance coverage. These plans are especially beneficial in the case of senior citizens as their health insurance plans are expensive Also the medical expenses are usually higher due to age-related conditions. Thus, buying a Super Top Up plan provides an extra layer of protection, preventing financial strain during emergencies.

How to File a Claim for a Super Top-up Health Plan?

Filing a claim for a Super Top Up Health Plan is very simple. The claim procedure of a super top-up health insurance plan is similar to the regular health insurance:

1. Notification: Inform your insurance provider about the hospitalisation or treatment within the specified time frame.
2. Claim Form: Fill out the claim form with accurate details of the treatment, be it cashless or reimbursement.
3. Submission of Documents: Provide all necessary documents, including medical bills, discharge summaries, doctor’s prescriptions, and diagnostic reports.
4. Review and Approval: The insurance provider reviews the documents and verifies the claim.
5. Claim Settlement: Once approved, the insurance provider settles the claim based on the terms of your policy.

Documents needed to file a claim

Following are the common documents required for filing a Super Top Up claim:

○ Duly filled claim form
○ Original medical bills and receipts
○ Discharge summary
○ Doctor’s prescription and treatment details
○ Diagnostic reports
○ Any other documents specified by the insurance provider.

The process of a claim depends on whether it is a cashless or a reimbursement claim and it works like a regular indemnity health insurance plan. However for multiple insurers to be claimed at the same time, you need to opt for a certified true copy of the original documents that are submitted for the initial claim, in order to file the subsequent claims.

List of Top 7 Popular Super Top-up Health Insurance Plans in India

Following are the top 7 popular super top-up health insurance plans in India that individuals can opt for additional coverage.

Sr. NoName of the CompanyName of the Plan
1Aditya Birla Health InsuranceActiv Assure Diamond + Super Health Plus Top up
2Care Health InsuranceEnhance – Super top-up health insurance plan
3Bajaj Allianz Health InsuranceExtra Care Plus
4Manipal Cigna Health InsuranceSuper top-up plan
5Reliance Health InsuranceSuper top up Insurance
6Digit Health InsuranceDigit Healthcare Plus
7Oriental Health InsuranceSuper Health Policy

You need to choose the plan that best suits your needs.

To Sum up!

a Super Top Up Health Insurance Plan is a prudent way to enhance your healthcare coverage and safeguard your financial well-being during unforeseen medical emergencies. By offering a higher coverage limit beyond a deductible, these plans provide a safety net that ensures you are adequately protected without significantly increasing your premium costs. The choice between a Super Top Up plan and a Top Up plan depends on your individual needs and risk tolerance, and it’s important to consider these factors before making a decision.

Frequently Asked Questions

Yes, many insurance providers offer the flexibility to choose different deductible amounts for each family member covered under the plan.

Yes, some Super Top-Up plans might have waiting periods for specific illnesses or conditions. Review the policy terms to understand the waiting period details.

Yes, you can buy a Super Top Up plan to enhance your existing health coverage.

If your expenses don't cross the deductible in a policy year, the Super Top-Up plan won't provide coverage for those expenses. However, the deductible is cumulative, so if you incur medical expenses that exceed the deductible in subsequent years, the plan will kick in.

Maternity coverage is generally not included in Super Top-Up plans. It's recommended to check with the insurance provider for specific coverage details.

Yes, premium payments for Super Top Up plans are eligible for tax deductions under Section 80D of the Income Tax Act, subject to the specified limits.

Yes, it is beneficial to buy a super top-up health insurance plan as it is similar to having two health insurance policies as it increases insurance coverage that can be availed in case of unforeseen emergency situations.

Leading Health Insurance Companies

Manipal cigna health insurance
Aditya birla capital
STAR health insurance
NIVA HEALTH INSURANCE
care health insurance

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