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Essential features of a super top-up health insurance policy you must know

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NEW DELHI: Suppose your existing health insurance plan does not offer sufficient coverage, then a super top-up plan can help increase your coverage without having to opt for a fresh, expensive policy.

A super top-up health insurance policy provides reimbursement for cumulative medical expenses over and above a deductible. It is usually different from a regular health policy. It covers all hospitalisation expenses only after the sum insured of the standard health policy gets exhausted or you have paid the costs, up to the deductible, from your pocket.

Features of the top-up policy:

Cover for COVID-19 treatment: A super top-up policy covers the insured for hospitalisation required due to COVID-19. It also covers for other critical illnesses.

Only one-time payment of deductible: Under a super top-up policy, the insured is required to pay the deductible only once and can make a claim several times during the policy term.

For example, suppose an insured undergoes hospitalisation due to a specific illness, and the treatment expenses go up to Rs12 lakh. Here, the individual has a base health insurance plan of Rs7 lakh and a super top-up plan of Rs10 lakh. Under this case, the initial Rs7 lakh would be covered by the base health insurance plan, and the super top-up plan would cover the remaining Rs5 lakh of the total treatment expenses.

Flexibility to choose deductible: When buying a super top-up plan, the policy buyer gets the flexibility to select the deductible option as per the sum insured.

High sum insured: With a super top-up policy, the insured gets a chance to increase sum insured as per requirement.

Additional coverage: Considering rising health expenses, having just an employer’s insurance policy is not enough. With a super top-up policy, you can avail of cover that you might not get under an employer’s health coverage policy—for instance, critical illnesses, AYUSH treatment, etc.

Additional tax saving: On the premium paid for the super top-up health insurance policy, the insured can take tax benefits under Section 80D of the income tax act.

Who should opt?

The super top-up plan is highly recommended for senior citizens since, in their case, the risk of getting hospitalised is higher. The super top-up plan can reduce the higher premium rates that come due to increased age, said Rakesh Goyal, Director, Probus Insurance. “Moreover, you can also use super top-up plans to upgrade your group health insurance plan, as in many cases, the sum insured offered by group health plans is comparatively lower and insufficient due to the increased medical treatment expenses.”

One should confuse a basic top-up plan and super top-up plan as they are different when it comes to making claims. In the case of basic top-up plan, the deductible is normally kept equal to the existing regular health policy sum insured. Unlike super top-up plan, you need to have a regular health policy with a basic top-up plan.

This is because the deductible is applied on single hospitalisation or per claim basis in a year, that is, a basic top-up plan kicks in only if a single claim is made over and above the deductible.

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