Key Differences Between Super Top-up and Top-up Health Insurance Plans
Synopsis:
In some situations, your health insurance may prove inadequate in covering the cost of hospitalisation, treatment etc. So, you may buy a top-up plan to pay for expenses surpassing your sum insured. You can choose between a top-up and a super top-up plan based on your needs and budget. Here's what you need to know about them.
You may have health insurance for yourself or a floater policy for your entire family. But if the policy coverage is low, you must get an additional sum insured (SI) to meet your expenses during an emergency. There are two types of health insurance plans and super top-up health policy. The two plans differ in terms of certain features such as:
Top-up health plan
With this policy, you can make a claim if the total amount of healthcare expenses exceeds the deductible amount and the sum assured of your existing policy during a single hospitalisation. Insurers will consider each claim separately in this cover and will not consider the sum of multiple claims in the same policy period. The deductible is the set amount that you have to pay every time you make a claim.
Super top-up health plan
A super top-up plan pays claims for the total medical expenses within a policy year. Use it if your expenses exceed the deductible amount, the sum insured of your existing policy and also the SI of your top-up plan.
Features of top-up plans
You can buy top-up plans from any insurer and not compulsorily from your existing insurer.
The top-up plans are applicable only after the claim amount exceeds the deductible and the sum insured of the base policy.
The premium of top-up plans is usually less than the premium of a regular healthcare policy.
The two types of top-up plans differ in terms of the claim process and coverage.
Taxation and other fee and charges do not differ much. You can choose a plan according to your budget and requirements. Before buying, make sure to go through the policy papers related to the inclusion, exclusion, and claims process.
The major difference between these two plans is that a super top-up plan offers coverage for complete hospitalisation bills, above the deductible amount. A top-up policy only covers a single hospitalisation claim above the deductible amount. Find the difference between top-up and super top-up
health insurance plans in the table below:
|
Top-up health insurance |
Super top-up health insurance |
|
Number of claims | Covers a single claim above the deductible amount | Covers multiple claims after the total amount exceeds the deductible amount |
|
Payment of deductibles | You have to pay the deductible on every claim | Pay the entire deductible amount only once during a policy term |
|
Example | SI = Rs 10 lakh
Deductible = Rs 2 lakh
1st claim = Rs 5 lakh Policyholder pays = Rs 2 lakh Insurer will pay claim minus deductible = Rs (5-2)= Rs 3 lakh
2nd claim = Rs 6 lakh Policyholder pays = Rs 2 lakh Insurer will pay claim minus deductible = Rs (6-2) = Rs 4 lakh | SI = Rs 10 lakh
Deductible = Rs 2 lakh 1st claim = Rs 5 lakh Policyholder pays = Rs 2 lakh Insurer will pay claim minus deductible = Rs (5-2) = Rs 3 lakh
2nd claim = Rs 6 lakh Policyholder pays = 0 Insurer will pay Rs 6 lakh |
|
Suitability | Suitable for short-term expenses, sudden medical emergencies etc. | Suitable for long-term treatment, chronic ailments, senior citizens requiring multiple hospitalisations. |
You would have noticed that the super top-up plan provides better benefits compared to a top-up health plan. Deductible in a top-up plan is a limit set by the insurer. It is a sort of security for them and prevents policyholders from filing frequent and minor claims. When you are the policyholder, you have to pay the deductible. The insurer will pay the amount over and above the deductibles and up to the sum insured limit. The deductible amount may vary for
different plans.
Which plan would you choose?
If you or any of the family members suffer from the risk of chronic ailments and require multiple hospitalisations in a year, then a super top-up plan would be suitable. It is suitable for senior citizens who may have to undergo medical treatments frequently. Super top-up plans with cumulative coverage can be beneficial for them. In case there is no pre-existing disease or medical problem among your family members, you can choose a top-up plan for situations related to medical emergencies.
Top-up plans provide the much-needed support when your medical bills exceed the sum insured of your existing policy. Also, the cost of the premium is low compared to the premium of an individual health plan with high coverage amount. However, you have to consider factors such as the premium, your budget and the medical history of your family members and yourself before opting for any of the plans. Get to Know about
Health Gain Plan here