India's 1st Personal Finance Advice Marketplace (Currently in Mumbai only)
+91- 8828828181
Query Stat
  • Posted by: {{post.user.name}}
  • Date: {{post.created_at | date:'MMM dd, yyyy'}}
  • Category: {{post.category.name}}
  • Views: {{post.read_count || 0}}
{{post.user.name}} Connect {{post.user.detail.bio}} Posted this on {{post.created_at | date:'MMMM dd, yyyy'}}
{{post.headline}}

Considering the increase in the medical costs and the unhealthy lifestyle that we are living, the risk of health issues and related medical financial emergencies have only increased. One medical emergency can put a huge strain on our personal finances. Having a health insurance policy to cover these kinds of emergencies could provide the much needed buffer. A health insurance cover can be a regular standalone policy or a combination of a standalone cover with a top up plan or a super top up plan. The distinction between all three is the catch.  

What are Top Up & Super Top Up Health Insurance Plans?

In this post, we will understand what is the difference between the Regular Health Plan, Top Up Plan and Super Top Up Plan and more importantly, how do each of these plans work. 

Regular Health Insurance Plans : 

  • An independent health insurance policy or a standalone cover would be able to cover the cost of hospitalization / medical expenses incurred by the life insured. Based on the terms and conditions accepted by the insured, the reimbursements could be based on a co–pay clause (sharing of expenses based on a certain percentage) or a complete cashless treatment for injuries or illnesses covered under the policy at one of the network hospitals.

  • The premium amounts for regular standalone health plans are relatively higher and there may be cases where many people, just to save on the higher costs of premium,  opt for a lower health coverage amount. This lower coverage may not be able to fulfill the real motive of purchasing a health insurance cover. For instances where the claim amount is more than the coverage amount, the cost of remaining medical expenses has to be borne by you. The top up or a super top health cover option can be handy in these situations. 

What are Top Up Plans & Super Top Up Plans ? 

  • A Top Up as well as a Super Top Up plan has the unique feature to provide additional health coverage over and above your base cover or maximum limit as allowed under your existing regular health insurance plan.  

  • These plans give an option to the insured to enhance their medical coverage above their existing base cover at a low premium cost. 

  • The key difference between the two is their mode of reimbursement of claims. 

  • Top up plans work on ‘Per Hospitalization’ basis and would cover ‘A single claim’ above the threshold limit in the given year. 

  • Super Top-Up Plans work on ‘Multiple Hospitalization’ basis and covers the total of all hospitalization bills above the threshold limit.

Understanding How Top Up Plans work with case scenarios : 

Let's suppose you have a base cover (standalone health insurance policy) of Rs. 5 lakhs. You enhance the same cover up with a top up plan of Rs. 3 lakhs. Thus, you are now being covered for a total of Rs. 8 lakhs. In this case, the threshold limit (deductible) is Rs. 5 lakhs for the Top Up plan.

Case -1 : You have a single claim in a year to the tune of Rs. 5 lakhs

This claim will be reimbursed by your regular standalone health cover of Rs. 5 lakhs

Case – 2 : You have a single claim in a year to the tune of Rs. 7 lakhs

This claim will be reimbursed by the standalone health cover upto a sum of Rs. 5 lakhs and the remaining Rs. 2 lakhs will be covered by the top up plan.

Case – 3 : You have a single claim in a year to the tune of Rs. 8 lakhs

This claim will be reimbursed by the standalone health cover upto a sum of Rs. 5 lakhs and the remaining Rs. 3 lakhs will be covered by the top up policy.

Case – 4 : You have a single claim in a year to the tune of Rs. 10  lakhs

This claim will be reimbursed by the standalone health cover upto a sum of Rs. 5 lakhs. The additional sum of Rs. 3 lakhs will be covered by the top up policy. The remaining sum of Rs. 2 lakhs will have to be borne by you. 

Case – 5 : You have two claims in one year. One amounting to Rs. 3  lakhs and the other for Rs. 6 lakhs. 

Your first claim of Rs. 3 lakhs will be covered by your regular standalone policy. The second claim of Rs 6 lakhs will only be partly reimbursed by your standalone policy to the tune of Rs. 2 lakhs from remaining coverage amount  (5 lakhs – 3 lakhs). The top up policy will not reimburse you with any amount here. 

As discussed above, Top up plans cover hospitalization expenses on a per hospitalization or per claim basis, meaning they will only pay the claim amount for a single hospitalization over and above the threshold limit or deductible opted for. 

Understanding How Super Top Up Plans work with case scenarios : 

Let's suppose you have a base cover (standalone health insurance policy) of Rs. 5 lakhs. You enhance the same cover up with a super top up plan of 3 lakhs. Thus, you are now covered for a total of Rs. 8 lakhs. In this case, the threshold limit (deductible) is Rs. 5 lakhs for the Super Top Up Plan. 

Case -1 : You have a single claim in a year to the tune of Rs. 5 lakhs

This claim will be reimbursed by your standalone health cover of Rs. 5 lakhs

Case – 2 :  You have a single claim in a year to the tune of Rs. 7 lakhs

This claim will be reimbursed by the standalone health cover upto a sum of Rs. 5 lakhs and the remaining Rs. 2 lakhs will be covered by the super top up policy.

Case – 3 : You have a single claim in a year to the tune of Rs. 8 lakhs

This claim will be reimbursed by the standalone health cover upto a sum of Rs. 5 lakhs and the remaining Rs. 3 lakhs will be covered by the super top up policy.

Case – 4 : You have a single claim in a year to the tune of Rs. 10 lakhs

This claim will be reimbursed by the standalone health cover upto a sum of Rs. 5 lakhs. The additional sum of  Rs. 3 lakhs will be covered by the super top up policy. The remaining sum of Rs. 2 lakhs will have to be managed by you.

Case – 5 : You have two claims in a year. One amounting to Rs. 3  lakhs and the other for Rs.6 lakhs. 

Your first claim of Rs. 3 lakhs will be covered by your regular standalone policy. The second claim of Rs. 6 lakhs will only be partly reimbursed by your standalone policy to the tune of Rs. 2 lakhs (5 lakhs – 3 lakhs) and the balance of Rs. 4 lakhs (6lakhs – 2 lakhs) will be covered by the super top up policy.  

Super top up plans covers the aggregate of all the medical and hospitalization expenses over and above the deductible. It takes into consideration an aggregate of multiple hospital claims in a given year. 

Consult an Advisor

Let's get started. Call us at +91 - 8828828181 or share your contact details below for further details.

girl-image
Call Me

lock-imageYour number is secured with us. We dont promote spamming.

Subscribe to our newsletter

Don't miss any of our articles, both serious and fun, on life, investment, insurance & money matters!

envelope-image

lock-imageYour email address is secured. We dont promote spamming.