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Top Up Vs Super Top Up

When you wish to enhance your health insurance coverage without increasing your premiums, you could opt for additional coverage by using Top-Up or Super Top-Up Plans. Both of these plans provide additional coverage on top of what is already offered by your primary health insurance plan. However, what makes the top-up and super top-up health insurance plans different? Continue reading to discover.

What are Top-Up and Super Top-Up Plans?

The most cost-effective ways to supplement your financial protection are extensions known as top-ups and super top-ups. However, in both these cases, the claim is only paid after the threshold limit has been crossed. However, the threshold limit calculation differs for top-ups and super top-up plans.

Given that these plans substantially increase the coverage amount, it is only natural that they make further efforts to reduce the likelihood that they would have to pay out for hospitalisation expenses below the bare minimum.

So, before you can access the extra funds provided by top-ups and super top-ups, the deductible, i.e.the threshold amount, must first be paid. This security mechanism is known as a deductible.

Although top-ups and super top-ups provide policyholders additional financial protection on top of their current Mediclaim fund, they work distinctively.

Difference Between Top-Up Plans and Super Top-Up Plans with Example

If you are curious about what super top-up health insurance is, it is a kind of health insurance coverage that offers you coverage over deductibles or threshold limitations.
The supplemental medical insurance policies accomplish the same goal as well. As you can see, there is no difference in the sense that each phrase is intended to convey. On the other hand, the top-up plans will pay only when your claim amount crosses the deductible limit in one single claim.

But a super top-up plan would pay for all claims incurred throughout the policy term as long as the aggregate amount of the claims is more than the deductible limit. It is the primary distinction between the two types of plans.

If you have a top-up plan, you must pay the deductible whenever you make a claim. On the other hand, if you have a super top-up plan, you will only be required to pay the deductible once every policy year.
One way the ideas behind super top-up and top-up health plans might be clarified is by using an illustration. For this example, suppose that the total covered on your policy is 10 lakh rupees, and the deductible is 2 lakh rupees. You now submit the first claim for the insurance, which is for five lakh rupees.

You would be responsible for making the deductible payment in this scenario, while the insurance company would cover the balance of the cost. Let’s assume you make a second claim in the same year for six lakh rupees.

	Claim Amount	Deductible	Top-Up Plan Payout	Super Top-Up Plan Payout
1st Claim	Rs 5 lakhs	Rs 2 lakhs	Rs (5-2)= Rs 3 lakhs	Rs (5-2)= Rs 3 lakhs
2nd Claim	Rs 6 lakhs	Rs 2 lakhs	Rs (6-2)= Rs 4 lakhs	The entire amount of Rs 6 lakhs would be payable since the deductible has been crossed in the previous claim itself

Now, by the terms and circumstances of your insurance policy, you would be required to pay two lakh rupees, and the insurer would be responsible for paying the remaining four lakh rupees. If you had a backup plan, everything would play out like this in the end.

If you had a super top-up plan, the insurer would take care of the total payment on their end, so you wouldn’t have to worry about shelling out any money. The super top-up plans offer a significant benefit over the top-up plans in this respect, which is one of those areas.

Table of differences between Top-Up and Super Top-Up Plans

The following table compares Top-up insurance with Super Top-up insurance and explains the differences.

	TOP-UP PLAN	SUPER TOP-UP PLAN
Meaning	Plans that fall under the top-up health insurance category cover policies that go above and beyond the coverage thresholds of an individual’s primary health insurance plan.	A top-up plan covers a single claim that exceeds the threshold limit for every claim, but a super top-up plan pays the sum of all hospitalisation costs that exceed the threshold limit.

Situation: A basic health insurance policy of Rs. 2 lakhs, and a top-up or super top-up plan of Rs. 10 lakhs, with a deductible of Rs 2 lakhs.

A. What are the repercussions of receiving a single invoice for Rs 8 lacs?	The minimum payment for health insurance is Rs. 2 lakhs.The top-up plan will pay the remaining Rs 6 lakhs debt.	The top-up plan and the super top-up plan will remain the same since the single amount of the bill is less than the value of the top-up.The situation is different if the spending is divided into individual hospitalisation charges.
B. What takes happen if more than one bill is produced –1) Rs. 6 lakhs2) Rs. 2 lakhs3) Rs. 1 lakh	Because this is the least amount covered, basic insurance will pay out Rs. 2 lakhs.Because the total cost of the first bill is more than the threshold limit of Rs. 5 lakhs, the top-up insurance will pay out Rs. 4 lakhs.The patient is responsible for paying all the additional costs of his care since each individual claim is less than the deductible limit of Rs 2 lakhs.	The minimum coverage of Rs. 2 lakhs will be paid from the base plan.The super top-up would pay out the remaining Rs. 4 lakhs.Since the entire cost of hospitalisation is expected to exceed the aggregate deductible limit of Rs. 2 lakhs for that particular year, super top-up will also cover the following two bills, which are expected to total Rs. 2 lakhs and Rs. 1 lakh, respectively.
Which one to prefer?	A top-up plan would be appropriate for your circumstances if you do not already suffer from a chronic condition or face the possibility of a life-threatening disease.After all, you’d have to be exceptionally unlucky to put yourself in a scenario where your life was in danger more often than once a year. Top Up plans are slightly cheaper than Super Top-Up Plans.	Investing in a super top-up plan is in your best interest if you have a history of chronic conditions that put you at risk of being hospitalised more than once a year.The higher premium paid for super top-up plans covers the potentially financially extreme hospitalisation costs to avoid out-of-pocket expenses.

How Do Top-Up Plans Work in Health Insurance?

A primary health insurance plan will cover medical expenses up to the amount covered. In contrast, a top-up plan will pay for expenses after the primary plan’s coverage has been depleted per the policy. The insurance terms and conditions stipulate that you are responsible for paying the required deductible.

For instance, let’s say you choose a health insurance plan that offers an amount insured of 5 lakhs Indian rupees and then add a top-up insurance plan that offers Rs 10 lakhs to your current plan. Therefore, the entire sum insured would be Rs. 15 lakhs, and there is a restriction of Rs. 5 lakhs that has been predetermined.

Ideally, you should claim Rs. 5 lakhs from your base plan and Rs. 3 lakhs from your top-up plan if your medical expenses total Rs. 8 lakhs.

Why are Top-Up Plans So Rare in the Health Insurance Market?

Although Top-Up plans indeed provide an extra financial layer to protect you from skyrocketing medical bills, it is also true that this kind of insurance is on its way out of the market due to its lengthy queue of drawbacks, which include the following:

The patient’s medical bills must be higher than the deductible amount for each hospitalisation. Because the deductible barrier is set so high, using the extra top-up money available isn’t easy.
Many limitations are placed on using the Top-Up plan funds, including disease-specific sub-limits, room rent restrictions, limits set on pre- and post-hospitalisation expenditures, and other limitations (these limitations vary depending on the plan used).
Top-up plans may contain co-payment options.
There is a possibility that loading fees will be added to the cost of the policy’s premium (depending on the plan that is selected).
The cost of your top-up insurance premiums may rise if you choose a greater level of coverage or a lower deductible.

What are Super Top-up Plans?

Plans known as Super Top-Ups provide a function that is similar to that of traditional Top-Ups. Both options may serve as extra financial assistance to help pay medical costs not covered by your primary health insurance policy.

On the other hand, policyholders with super top-up plans have access to alternatives that are both more reasonably priced and more readily accessible. It is due to the fact that insured persons only need to pay the deductible once each year on top of their hospitalisation costs.

How Does Super Top-Up Plan Work in Health Insurance?

The sum insured amount is the maximum the basic health insurance policy will pay for in terms of medical bills. On the other hand, the super top-up health insurance plan continues to provide financial protection even after the total covered amount has been depleted. The super top-up plan is quite similar to the top-up plan, paying any costs with a cumulative claim amount exceeding the threshold limit.

It is essential to remember that the threshold limit is not evaluated for every claim made under the super top-up plans; instead, it is assessed on the total amount spent on hospitalisation over the policy term (cumulative claims).

On the other hand, if you have a top-up plan, the plan will kick in once the patient’s medical expenses reach a certain maximum for each claim before it becomes active.

Importance of Buying Super Top-Up and Top-Up Health Insurance

Here are some reasons to consider purchasing a health insurance plan that is either a Super Top-up or a Top-up.

Costs of Healthcare Are Continuing to Rise:
There is no way to get around the fact that the expense of medical treatment is always going up. This indicates that you need a comprehensive indemnity health insurance plan with a greater total insured amount than a standard one. When the total covered amount has been depleted, you should have the choice of purchasing either a Top-up plan or a Super Top-up plan via the insurance provider.
Greater Coverage:
If there were no demand for a greater sum insured, companies would not need to provide either standard or super top-up policies. These plans offer coverage in addition to the primary or business health insurance plan at a premium far less expensive than individual health policies would be for you to purchase.
More Comprehensive Protection for Older Adults:
With a Top-up plan, you may have full coverage while paying a lot more affordable premium for your health insurance. Top-up and Super Top-up plans, as well as other forms of health insurance, also allow members to reduce their taxable income.
An Added Advantage to the Existing Plan:
Unlike standard health insurance policies, Top-up and Super Top-up plans provide more comprehensive protection for sudden and unanticipated medical complications. Also, a top-up plan or super top-up plan is a cost-effective way to guarantee that you are protected during times of uncertainty.

What is a Deductible in Top-up/Super Top-up Plans?

The term deductible refers to the limit one’s health insurance provider establishes. People are less likely to file frequent and frivolous medical claims due to this provision, which benefits the insurance provider.

The individual who owns the insurance is the one who is responsible for paying this sum. The cost of deductibles is only sometimes paid by health insurance companies.

They are solely responsible for paying the amount that is over the deductibles. But, you are responsible for paying the deductibles, and the insurer is responsible for paying the remaining amount, also known as the excess, up to the total insured limit.

However, if you have a base plan, it pays from the 1st rupee spent on hospitalisation. Hence a base Comprehensive Health Insurance Plan + Super Top-Up Plan with the same deductible as the base plan is considered to be a complete health solution for an individual.

Pros and Cons of Between Top-Up and Super Top-Up Plans in India

Here is a list of the pros and cons of the super top-up and top-up plans.

Pros:

More extensive coverage:
Policyholders can access expanded coverage via Super Top-Up plans, which is often essential when considering the likelihood of a rise in medical expenses incurred through premium treatment channels.
Affordable Choices:
The cost for super top-ups is relatively inexpensive compared to the premium increases required to prolong the present insurance coverage by purchasing another policy or submitting a request to extend the coverage already in place.
Cumulative and annual deductible payment:
Only once (either all at once or cumulatively) throughout the year are you expected to pay off the deductible if you have a super top-up plan. The policyholder will now have easy access to the cash as a result of this.

Cons:

Exclusions and limits on a massive scale:
Regarding room rentals, pre- and post-hospitalisation fees, and other related costs, super top-ups, like regular top-ups, include a list of wide sub-limits.
No advantage to restoration:
The restoration option is unavailable on any super top-up plans. As a result, after the policy’s yearly limit has been reached, you will need to wait for the policy’s renewal.
No-Claim Bonus excluded (mostly):
You will likely need access to the No-Claim incentive on your Top-Up plan. However, this is dependent on the plan that you have opted for.
Higher premiums when deductibles are lower:
When the deductible amount is large, the likelihood of receiving a payment is relatively low. As a result, the insurance companies have reduced their rates.
However, the monthly price for the Super Top-Up plan will increase significantly if the prospective policyholder chooses a greater level of coverage and a lower level of deductible. This is one of the downsides of super top-up health insurance plans.
Strict underwritings:
Because the insurers are providing you with a sizable fund for a premium on the lower end of the spectrum, it stands to reason that the underwriting staff would be picky about who they let into these plans.

Which One to Choose for Whom and Why?

Since you are already familiar with the distinction between a top-up and a super top-up, deciding in this respect will be less complicated. Suppose you have a chronic condition that requires frequent hospitalisation.

In that case, it is recommended by most medical professionals that you get one of the insurance policies that come with a super top-up. The fact that the premiums for these plans are far lower than those you’d have to pay for another health insurance plan with a more extensive coverage quantity is another benefit of purchasing these policies.

A significant distinction between top-up plans and super top-up plans is that the latter is better suited for older adults who need to be admitted to hospitals and other similar facilities regularly to undergo medical operations. This is one of the key areas of difference between the two types of plans.

The super top-up plans, which provide cumulative coverage, are much more advantageous than elsewhere. In the same vein, a top-up plan should be enough for you if you do not have any terminal or chronic ailment.

This is especially true if you do not smoke. Before deciding on insurance, it is essential to investigate its terms and conditions since this is the most significant step in this scenario.

How to Decide Your Coverage for Top-Up/Super Top-Up Plans?

Suppose you want to protect yourself against the possibility of having chronic conditions that need more than one hospitalisation per year. In that case, the specialists recommend a Super top-up plan.

Additionally, the premium cost is relatively modest compared to the cost of purchasing a separate health plan that provides a greater quantity of coverage. In addition, it is appropriate for older individuals who regularly have to undergo various medical treatments. In this context, super top-up plans that provide cumulative coverage might greatly assist.

How to Claim Between Top-Up and Super Top-Up Plans

You may file a claim on your top-up Mediclaim coverage using two methods:

Reimbursement Claims:
If you are taken to the hospital, the first thing that you are required to do is contact your insurance as quickly as you can. In order to file a claim, it is optional for you to go to any office. You also have the option of sending an email.
Since the claims have been made digitally available, all that is required of you to start the process of being reimbursed is to submit your medical bills along with any other necessary paperwork to your insurance carrier.
Cashless Claims:
You need to be admitted to a hospital or part of a network to be eligible for cashless treatment. Presenting your e-health card at the hospital’s information desk will allow you to get the cashless request form. If everything is in order, the processing of your claim will begin immediately.

Frequently Asked Questions

When it comes to health insurance, the idea behind a super top-up plan is that you may use it for extra coverage if you have reached the point throughout the year when your health-related claims have reached the maximum amount your deductible allows.

This indicates that if you have a corporate health insurance policy with a sum insured of up to 3 lakhs and a super top-up health insurance policy with a sum insured of 10 lakhs, you would have a total of 13 lakhs sum insured, with the super top-up providing the principal boost to your coverage.

After you have purchased a basic plan, many insurers will tell you that you can buy a Top-Up or Super Top-Up insurance whenever you choose. Your waiting time for the super top-up should be the same as the waiting period for your standard insurance coverage so that you can have access to the extra money when you need it in an emergency.

You must consider the following factors while purchasing a super top-up plan.
You should invest in a Super Top-Up or Top-Up plan with a deductible that is either lower than or on par with the coverage provided by your primary health insurance policy.
You should familiarise yourself with the restrictions and exclusions of your policy by reading the fine print on your plan.
Comparing the top three options before deciding on one and moving forward with it.
Take into consideration the limits placed on claims by the insurance policy.

If your top-up or super top-up insurance policy lapses before its term is up, you cannot submit any insurance claims once the coverage provided by your primary plan has been depleted. The plan needs to be renewed to avail of continuity benefits.