How top-up health insurance plans give you more coverage at a lesser premium? Find out

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Updated: May 13, 2021 6:53 PM

Top-up plans are generally considered a safety net that helps if one exceeds the limit of their normal health insurance plan.

Health insurance, super top-up health insurance plan, Rs 5 lakh deductible, super top up, Covid-19 pandemic, premium cost, hospitalisation costs, coverage limits, Liberty General - Health Connect Supra, Future Generali - Advantage Top Up, Star Health - Super Surplus, Tata-AIG - MediCare PlusNote that, the deductible should be equal to your base health insurance plan – so the super top-up kicks in once your base sum insured are exhausted.

Top-Ups and Super Top-Ups are two different concepts that address the requirement of enhancing sum-insured of your health policy.

To start with, for existing customers with health insurance cover looking to increase their sum insured, it can be done in two ways – either by requesting the existing insurer to increase the sum insured or by separately opting for a top-up or super top-up plan.

Roopam Asthana, CEO and Whole-time Director, Liberty General Insurance, says “It goes without saying, that the latter is more beneficial as it provides higher Insurance cover at a lower cost.”

Any type of top-up health plan provides additional coverage over the available limit of one’s base health insurance policy. Subramanyam Brahmajosyula, Head – Reinsurance and Product Development, SBI General Insurance says, “Apart from a base health plan, it is wiser to have top-up health insurance that comes at minimal premiums.”

Top-up plans are generally considered a safety net that helps if one exceeds the limit of their normal health insurance plan.

Shanai Ghosh, CEO and Executive Director, Edelweiss General Insurance, says “When you opt for a top-up/super top-up policy along with a base insurance policy you will have to maintain two separate policies. You can buy these either from the same insurer or separate insurer depending on the availability and the choice of the sum insured and the deductible matching your need.”

How one can use top-up or super-top to get adequate coverage?

When an insured exceeds its base insurance limit, the top-up plan helps cover the additional expense but is beneficial in case of a single catastrophic event of hospitalization.

A super top-up plan covers claims for cumulative medical expenses within a policy year once you’ve exceeded the deductible versus a regular top-up only covers claims when a single claim goes above the deductible. So in a top-up, the deductible is charged for every claim whereas in a super top-up it is charged on a cumulative basis in one year.

Rakesh Jain, ED and CEO, Reliance General Insurance says, “In a view of rising medical conditions, changing disease patterns and the cost burden chances of exhausting your base policy sum insured are higher and, in such cases, super top-up works best, as the deductible is applied to the extent of exhaustion of deductible in a cumulative manner and then the Super Top Up cover is triggered.”

Note that, the deductible should be equal to your base health insurance plan – so the super top-up kicks in once your base sum insured are exhausted.

Having said so, Asthana of Liberty General says, “For customers with no insurance cover, it is advisable to opt for both base and top-up/super top-up product at one go, instead of going for a single base plan as it will help in saving money.”

Source: Edelweiss General Insurance

How top-up health insurance plans give you more coverage at a lesser premium?

Top-up and super top-up insurance plans are triggered only when the hospitalisation bills exceed the sum insured under your base medical insurance policy, they are cheaper since they will come into play only when the sum insured under the base policy is exhausted.

Hence, Brahmajosyula, of SBI General Insurance says, “top-up and super top-ups are a very cost-effective way of enhancing the coverage available under medical insurance and can be very useful especially in cases of prolonged and/or expensive hospitalisation stay.”

Since top-up coverages start after a certain sum insured it feels that they are cheaper. However, experts say, a policyholder needs to keep in mind the grounds up claim cost.

Jain, of Reliance General, says “Many times top-ups and super top-ups are insurance cover in addition to the existing base cover and as the name suggests tops up the value of the existing cover. If the insurer has a base cover of Rs 10 lakh and feels that is not enough, he can opt for top-ups or super top-ups to increase this coverage to Rs 25 lakhs by adding the premium value for the difference amount only.”

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