Difference Between Top Up and Super Top Up Health Insurance

What is Top-up in Health Insurance?

A top-up insurance policy provides you with extra coverage above a predetermined "threshold limit". It means that if you exhaust the coverage of your base insurance policy, then the coverage of the top-up policy begins. One can best understand this concept with the help of an example. Let us assume that you have a top-up plan with a coverage of Rs. 10 lakhs sum insured. Let the threshold limit of the plan be Rs. 5 lakhs. That means that the top-up policy will provide a coverage of Rs. 5 lakhs only after you have exceeded your base insurance policy coverage of Rs. 5 lakhs. If you have a claim amount that is Rs. 7 lakhs, then you will be paid only Rs. 2 lakhs (7 - 5) from the top-up policy, and not the total Rs. 7 lakhs. It is the primary difference between normal health insurance and a top-up health insurance plan.

What is Super Top-up Health Insurance?

A super top up health insurance plan considers the entire amount of all the bills you have in a whole year, not just every individual case. Thus, even if you had two separate medical bills of Rs. 3.5 lakhs each, with your total coming to Rs. 7 lakhs, you will get the coverage of Rs. 2 lakhs (the amount that crossed the Rs. 5 lakh threshold) paid to you. You can use your base health policy to cover the remaining Rs 5 lakh; otherwise, you have to pay the amount from your pocket. Thus, we can say that a super top-up policy provides an additional safety cover for your finances to help you tackle any medical emergency.

Difference between Top-up and Super Top-up Health Insurance Plans

Super top-up health insurance plans are very similar to top-up health insurance . Both are valuable in keeping the total premium at a low cost while having high coverage at the same time. Top-up policies will reimburse you only if the claim amount (the amount for a single hospitalization) has crossed the threshold. If we consider the previous example, top-up medical insurance helps you only when your bill amount goes over Rs. 5 lakhs every time. So, in the Rs. 7 lakh bill amount case, you were eligible for coverage up to Rs. 2 lakhs. However, if you had two separate bills, each of Rs. 3.5 lakhs, then a regular top-up policy would not help because none of the bills has crossed the base-threshold amount of Rs. 5 lakhs individually. Here is where a super-top up plan would be beneficial as it will cover multiple claims made in a policy year.

What is a Deductible in Super Top-up?

Health insurance companies, like Care Health Insurance, set a limit on the claim. This limit is called a deductible. It represents the portion of the claim that the insurance company does not cover. The insured individual has to cover this himself before the policy covers the remaining amount. The insured must pay the medical expenses up to the deductible, and the insurer will bear the excess. So, the deductible acts like a safety valve for the insurance company. It safeguards them from trivial and frequent claims. To understand this better, let's use an example.

Let us assume you have a base insurance plan with a coverage of Rs. 2 lakhs, and you purchase a super top-up that provides Rs. 3 lakhs on top of the base amount. It means you now have a Rs. 5 lakh plan with a deductible of Rs. 2 lakhs. This amount of the deductible varies with each plan. Thus, it is advisable to read the policy documents carefully to understand the terms and conditions, thereby avoiding any confusion when filing claims.

Things to Remember

Base health policy: You can opt for a top-up or a super top-up policy even if you do not have a base health policy. However, it is highly advisable to have a regular health insurance policy, given the rising medical inflation.

Premium: The premium amount depends on various factors, including the deductible. Usually, a higher deductible implies a lower premium for the insured person. So, decide after you have assessed your needs.

Deductible: Every top-up or a super top-up health policy comes with a deductible. It is better to opt for the deductible carefully so that you can easily manage your medical expenses without any impact on your savings.

How to Choose Between Super Top-up and Top-up?

People often get confused when selecting between top-up and super top-up plan. Each plan has its benefits. A normal top-up plan is less expensive in the short term, but it usually has a smaller coverage in terms of the types of illnesses. It can become more expensive in the long run since it covers only a single claim, unlike super top-up policies. It is, therefore, better to go for this plan if you do not suffer from any chronic illness or do not run the risk of getting a terminal disease.

A super top-up plan, on the other hand, is quite economical in the long run. It also provides coverage for a broad spectrum of illnesses. It is ideal for senior citizens, who tend to face an increased risk of hospitalization and incur medical expenses very frequently. The cumulative coverage can be very beneficial here. It is also advantageous if you think you have higher chances of hospitalization more than once in a year. It is then necessary to consider your medical needs, budget, premium cost, and medical history before choosing any health insurance plan to make a well-thought-out decision.

Enhance a Super Top Up plan by Care Health Insurance works on the simple principle of policy deductible, which is the predefined amount that you will bear, through your finances or any other health insurance, during a medical event. We will settle the amount over and above policy deductible. Suppose you opt for a policy of Rs. 6 lakh sum insured with a deductible of Rs. 2 lakh. Then, the 2 lakh will be borne by you and 6 lakh over and above the deductible of 2 lakh will be borne by us during the policy period.