Life is an unpredictable journey. It can take sharp, fatal turn at moments, which are capable of leaving one physically, mentally, emotionally and financially bruised.
Many of us ignore buying a personal Health Insurance plan (Mediclaim). Many of us also think that the mediclaim coverage provided by the employer is sufficient enough to cover any unforeseen medical expenses.
In my experience, the average medical cover opted (personal health insurance) or provided by an employer (group mediclaim) is generally in the range of Rs 3 Lakh to Rs 5 Lakh. Do you really think that this coverage is sufficient? What if the claim amount is more than the coverage amount? Can you afford to pay for the medical expenses out of your pocket? Do you agree that medical expenses are increasing at a very fast rate every year?
But, we are also aware of the fact that the premiums of health insurance plans are increasing every year. For some of us, the premiums are unaffordable. Also, it is not practically possible for everyone to increase the premium of their existing plan, or buy another mediclaim policy.
So, what are the available options? How to get higher coverage at affordable premium rates? How to deal with the inflating costs of medical treatment?
Have you heard of Top up Health Insurance plans / Super Top up Medical Insurance plans?
In this post, let us understand – What are Top up Health Insurance plans? What are Super Top up Health Insurance Plans? How does Top Up medical insurance work? How does Super Top up plan work? Which one should you buy, a Top up plan (or) a Super top up plan? Frequently Asked Questions (FAQs) on Top up Health Insurance Plans / Super Top up Health Insurance Plans.
Top up health insurance plans are a unique type of health cover policies that offer you (insured) an additional coverage, which is beyond the “threshold limit” (or) the maximum limit of the existing health insurance policies.
For example – Let’s say you have an Employer’s Mediclaim policy for Rs 3 Lakh and also a Top up Health cover for Rs 10 Lakh with the threshold limit (deductible) of Rs 3 Lakh.
If there is a claim for Rs 5 Lakh, your mediclaim policy (employer’s) will pay Rs 3 Lakh and the remaining claim amount of Rs 2 Lakh will be covered by your Top up policy.
So, such Top up health insurance policies come handy when the threshold of the existing health cover is already used or exhausted and there are some medical costs left to deal with, which would otherwise exert pressure on your financial savings. (To buy a Top up plan, it is not mandatory to have an existing health insurance policy. The threshold limit is the mandatory deductible, which can be borne by you or by your existing health insurance policy i.e., your company’s or personal regular health insurance policy)
How does Top Up Health insurance plan work?
Top up plans work on ‘per hospitalization’ basis. A Top up plan will pay you, if your claim amount for a single hospitalization is above the threshold limit.
Example – Mr Kejriwal has a personal Health Insurance policy of Rs 3 Lakh and also has a Top up health cover of Rs 10 Lakh sum assured, with the threshold limit of Rs 3 Lakh.
Scenario 1 – If there is a single claim of Rs 2 Lakh in a year, his regular policy will pay Rs 2 Lakh.
Scenario 2 – If there is a single claim of Rs 5 Lakh in a year, his regular policy will pay RS 3 Lakh and top up plan will pay the remaining Rs 2 Lakh.
Scenario 3 – If there is a single claim of Rs 10 Lakh in a year, his regular policy will pay Rs 3 Lakh and the remaining claim amount of Rs 7 lakh will be paid by the Top up plan.
Scenario 4 – If there are two claims in a year, one for Rs 3 Lakh (Claim 1) & another for Rs 2.5 Lakhs (claim 2), regular policy will pay the claim 1 amount (Rs 3 Lakh) and the total coverage is exhausted, the claim 2 amount (Rs 2.5 Lakh) is not covered by regular as well as the top up plan. (Though he has Rs 10 lakh as a top up cover, it is not applicable for 2nd claim as the threshold limit is Rs 3 Lakh. Top up cover will pay only if the bill amount is more than Rs 3 Lakh)
We are now clear that the Top up plans work on ‘per claim’ or ‘per single hospitalization’ basis, they are beneficial as long as the single claim amount is above the threshold limit.
In the above scenario 4, though Mr Kejriwal has Rs 10 Lakh Top up cover, his claim amount (claim 2) will not be paid. Super Top plans will be useful in these types of scenarios (multiple claims).
Example – Mr Kejriwal has a personal Health Insurance policy of Rs 3 Lakh and also has a Super Top up health cover of Rs 10 Lakh sum assured (total coverage Rs 13 Lakh), with the threshold limit of Rs 3 Lakh.
Scenario 5 – If there is a single claim of Rs 2 Lakh in a year, his regular policy will pay Rs 2 Lakh.
Scenario 6 – If there is a single claim of Rs 5 Lakh in a year, his regular policy will pay RS 3 Lakh and super top up plan will pay the remaining Rs 2 Lakh.
Scenario 7 – If there is a single claim of Rs 10 Lakh in a year, his regular policy will pay Rs 3 Lakh and the remaining claim amount of Rs 7 lakh will be paid by the Super Top up medical insurance plan.
Scenario 8 – If there are two claims in a year, one for Rs 3 Lakh (Claim 1) & another for Rs 2.5 Lakhs (claim 2), regular policy will pay the claim 1 amount (Rs 3 Lakh) and the total coverage is exhausted, the claim 2 amount (Rs 2.5 Lakh) will be paid by his super top up plan (though the claim 2 amount is less than the threshold limit)
Scenario 9 – If there are two claims in a year, one for Rs 5 Lakh (claim 1) & another for Rs 6 Lakh (claim 2), regular policy will pay upto Rs 3 Lakh (claim 1) & super top up plain will pay the remaining Rs 2 Lakh amount (a portion of claim 1). The entire claim 2 amount (Rs 6 Lakh) will be paid by Super top up plan, as the regular policy coverage is exhausted.
So, it is now clear that Super Top up plans consider ‘the total of all the bills’ in a given year. Super Top up plans cover ‘multiple’ hospitalizations and they look at the aggregate claim. This means they put together several cases of hospitalization to calculate the deductible limit (threshold limit).
FAQs & Important points about Top up / Super Top up Health Insurance plans ;
Below are some of the popular & best Top up Health Insurance Plans
Latest Update : Kindly note that Apollo Munich Health Insurance is now HDFC ERGO. The holders of Apollo Munich Health Insurance policies now become part of HDFC ERGO Health Insurance.
Below are some of the popular & best Super Top up Health Insurance Plans
Super Top up plans are offered by a few very health insurance companies;
Should you top up your health cover?
As health expenses increase, you may find that your base health insurance is no longer sufficient for your needs. A serious illness or accident can require long term care and complicated treatment, that can quickly become expensive and exhaust your health cover.
If you think that the sum assured of your existing health insurance plan (personal or employer’s group mediclaim) does not suffice for expenses due to illness or accidents, you may definitely consider buying a top up or super top up health insurance plan.
Before choosing an additional cover, compare the premiums of additional regular policies, top up plans and super top up plans. Do not buy Top up health insurance plans just because they are cheap, they may not serve the purpose (as mentioned above). Super Top up Plans can be the best way to enhance your total Sum Assured. Always, keep in mind about the medical inflation before finalizing the required sum assured.
In case your basic policy and the top-up policy are from two different companies, informing two insurers and getting the claim settled may be cumbersome. So, you may consider taking a top up or super top up plan from the same company (not mandatory).
To summarize;
Secure yourself with Super top up cover and never worry about your medical expenses again.
Did you like this post? Kindly share your views & comments. Cheers!
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(Image courtesy of Mister GC at FreeDigitalPhotos.net)
This post was last modified on July 10, 2023 6:32 pm
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View Comments
Hi Sreekanth,
Can you please help in confirming if Religare enhance is super top up or a top up plan?
I have health insurance from religare so thought of super top up from same company. Please advise on decision.
Dear Bhupendra..I believe that its a super top up plan. You may also check with the company itself.
Dear Sir,
I am 43 years old (businessmen) with a Mediclaim policy of 7 Lacs from National Insurance Co.
Now I wish to take Mediclaim policy for My wife-43 years, Son-18.5 years and Daughter-17.6years.
should I buy a Family Floater for all of 6Lacs and then take a Super Top up plan. Or shall I take a Super Top up plan for 15Lacs, with some threshold limit (say 50 thousand)?
Kindly suggest that what shall I do, please.
Dear Amit,
You may consider taking stand-alone mediclaim policies for all three. Most of the family floater plans offer health cover to kids till they attain 18/21 years only.
If you can afford the premiums, you can also buy a Super top up family floater plan with deductible (based on the regular policies Sum Assured).
Read:
Best portals to compare health insurance plans.
Best Family Floater health insurance plans.
As per my understanding, Max Bupa Health Companion is one of the best Super Top-up policy available currently. It sounds strange. But surprisingly, this plan from Max Bupa is unique since it can be taken both as a base plan or Super top-up plan. The added advantage here is that the deductible can be removed in future to covert the plan to a base policy. Also, unlike normal Top-up or Super Top-up plans, this policy provides No Claim Bonus.
Do you have any feedback about this?
Dear Mr. Mishra,
Can you please let me know what premium you paid for Max Bupa Health Companion?
Thanks
Vik
Dear Mr.Mishra..Thank you for sharing the information.
Dear Sreekanth,
Please can you let me know which of the super top up plans can be converted to a regular policy without any threshold limits? Is Religare enhance also super top up or only a top up plan?
If one has an insurance policy from employer, then will it be beneficial taking only super top ups? What will happen post retirement?
Thanks,
RV
Dear RV,
Super top up plan can be taken without having any regular plan.
After retirement, if opne deos not have a regular plan then up to the deductible amount he/she has to bear the expenses from his own pocket.
Dear , my parents have a claim free family policy of Rs 5 lacs from NICL named BOI SWASTHYA BIMA since last 7 yrs .
My father is aug 1952 born and my mother is aug 1956 born . Now i wamt to buy a top up or super top up plan of Rs 10 lacs .Kindly suggest me the best plan which could adjust with my basic policy .
Dear Avtar,
It is very tough to advise best health insurance plan.
Suggest you to kindly visit 'Best portals to compare health insurance plans' and shortlist as per your requirements.
You may also go through;
Health insurance plans for Parents.
Hi Sreekanth,
Thanks for providing so much useful information. Hope you are doing great. I have a Mediclaim of Rs. 5L with Apollo Munich and now looking for a Super top-up of Rs 20L, I have shortlisted L&T Super topup .. is it a good option? Any other option you can suggest.
Dear Ashish,
It is a good option.
Kindly read this: 'Best portals to compare health insurance plans'. This can be useful to you.
my mother age 55 have star health insurance 2 lakhs for 8 yrs i need super top up plan 10 lakhs Sum assured with best company without medical test my mother B.P so i try to top up plan
Dear feroz,
Suggest you to kindly go through the above product links and decide.
Super top up can be more beneficial.
You may also visit health insurance comparison websites.
Hi Sreekanth,
Last year I bought star health insurance policy for my parents aged 67 and 66 respectively with a cover of 2 lakh each. I need to renew the policy now but I have read very bad reviews about their claim settlement.
Please suggest if I should renew the policy or buy new policy from some other vendor.
Also please suggest if I should buy super top up policy or increase the coverage amount as 2 lakh seems to be really less in today's time.
Dear Vibhuti,
As long as you have disclosed all the details in proposal form honestly, the company has to honor claims (if any).
However, if you are not happy with them, you may PORT the existing policy to another non-life insurance company (do not let it lapse).
Super top-up is very much beneficial, do consider it.
Thanks sreekanth for the prompt reply. Please suggest any other company which provides good insurance for senior citizens.
Also please suggest whether I should increase the sum assured or get a super top up plan in addition to the current policy of 2 lakhs.
A
Dear Vibhuti..Yes, you can surely consider opting for a super top up plan.
You may read : Best Portals to compare Health Insurance Plans.
31.10.2015
Dear Sreekanth
A very good afternoon to you and all our blog readers!
As I said earlier, I have purchased
1) Online term insurance, "HDFC Click2 Protect Plus" for 55 lacs,
2) Stand alone Personal accident policy for 50 lacs from "Apollo Munich"
3) Super top up mediclaim policy for 10 lacs with 1 lac deductible from "Apollo Munich" beside my company's group medicliam policy for 2 lacs.
I would like to share my experience with the Companies while purchasing the policies, so that it will be useful for other readers.
1) Apollo Munich's services are very very good, with one single personal meet at my home, just within 7 working days, I have received Policy document in hand both soft copy by email and hard copy by post. and
2) HDFC Life Insurance company, for my term life insurance, they have taken 45 days to issue a policy though it was purchased "ONLINE". For each and every email communication, they took 3-5 working days to respond, acknowledge or confirmation whatever the communication is.
As I am 41 years old, as I mentioned "Hypothyroid and heavy snoring" in my proposal form, they have advised me to undergo medical checkup at their prescribed diagnostic centre, I have under gone. Further, they have loaded me with 90% extra premium.
Even, they have reduced my sum assured amount from 75 lacs to 55 lacs.
My over all experience with HDFC is "Very good" though it is delayed and loaded with extra premium, but they have taken all required steps, so that, I believe, when ever claim is required, my family members may not face any difficulty in claiming process.
Dear Sreekanth, Thank you for your advises through your blog, which were helpful for so many lakhs of people like me while taking such big decisions.
I would like to post the same info in your 2 - 3 relevant articles, which will be helpful for all other readers.
It is good to see that you have relocated to Proddatur, so when I visit my native place Kadapa, with your prior confirmation I would like to see you.
Thank you
Krishna KP
Dear Krishna,
I am very happy to know that ReLakhs.com helped you in making financial decisions :)
Thank you so much for sharing your real-life experiences with the financial service companies.
Which option under HDFC Click2protect plus did you take?
By the by, we can surely plan to meet :)
Are there any health policies which offer policy or top up for existing diseases .( cancer). They say that pre existing conditions are covered after a specified period (4 years or less) .but will they offer policy even for extra premium.If so please inform
Dear Satyanarayana,
Do you have any existing health insurance plan ?