Health Insurance 116 views May 11, 2021

If you have a comprehensive health insurance plan and want to extend your coverage amount, buy a top-up plan. Under a top-up plan, you’ll get coverage beyond the base policy sum insured. The top-up plan comes with a deductible option, which means the claim under the plan is admission only if the medical expenses cross the deductible limit. There are two types of top-up plans – Basic Top-up & Super Top-up. Continue reading this post below to know the difference between top-up and super-top health insurance plans, and the better of the two.

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Basic Top-up Plan

A basic top-up plan is admissible per hospitalization in a policy year if the medical expenses are more than the deductible limit. If your first, second, third or any subsequent claims do not exceed the deductible limit in a policy year, the top-up plan will not be admissible for the claim.

Illustration 

Suppose you purchase a basic top-up plan with a sum assured of INR 5 Lakh and a deductible of INR 2 Lakh. Now, if you get hospitalized due to any covered illness or injury and the total hospital bill is INR 1.5 lakh, the basic top-up plan won’t cover the medical expenses as it is under the deductible limit. Later that year, if you have been hospitalized again and the hospital bill goes up to INR 3 Lakh, the top-up plan will cover INR 1 Lakh (3-2) from the hospital bill while you have to pay the remaining on your own.

Super Top-up Plan

Super top-up plan is admissible for total admissible claims where the deductible limit is crossed. This plan becomes active for subsequent claims taking account of your previous claims in that policy year.

Illustration 

Suppose you have a super top-up plan with a maximum sum insured of INR 5 Lakh and a deductible of INR 3 Lakh. Now, if a claim arises within the policy year, and the claim amount is INR 1.5 lakh, it means the super top-up won’t cover the medical expense as the claim amount doesn’t exceed the deductible limit. Later that year if the second claim of INR 2.5 lakh arises, the super top-up plan covers INR 1 Lakh of the medical expenses, as the total number of admissible claims in a year exceeds the INR 3 lakh limit.

Things to Know Before Buying Top-up Plans

  1. Under both basic top-up plan and super top-up plan, the admissible claim is based upon the terms and conditions, waiting period, sum insured, room rent limit, sub-limit, etc. But in some cases, base policy and top-up plans may have different terms and conditions that would impact the claim amount.
  2. If you already have a base health insurance plan, you should purchase a super top-up plan instead of a basic top-up plan. Because a super top-up plan takes into account the total claim amount in a year and makes claim settlement easier. Whereas in a basic top-up plan, the deductible limit applies afresh to each claim admissible in a policy year.
  3. If the incurred medical expenses are less than the mentioned deductible limit, no claims shall be admissible under basic top-up and super top-up plans.

List of Popular Top-up Plans

Check out the below top-up plans and choose the one that suits you the best –

Policy NameSum Assured (In INR)Deductible (In INR)
HDFC ERGO Health Suraksha Top Up Plus3-10 Lakh2-4 Lakh
Bajaj Allianz Extra Care Plan10-15 Lakh3-5 Lakh
Star Health Super Surplus10 Lakh for Silver Plan
5 Lakh to 1 Crore for Gold Plan
5 and 10 Lakh for Silver Plan
3-25 Lakh for Gold Plan
United India Super Top-up Plan3-15 Lakh2-5 Lakh
Care Health Enhance Plan1-30 Lakh for Enhance 1
45/55 Lakh, 40/50 Lakh, 35/45 Lakh, 30/40 Lakh for Enhance 2
1-10 Lakh for Enhance 1
5, 10, 15, 20 Lakh for Enhance 2
HDFC ERGO Optima Plus Plan5 Lakh1-5 Lakh
Oriental Super Health Top-up Policy3-30 Lakh3-20 Lakh

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