Difference Between Super Top-Up And Top-Up Plans

Over the past few years, the inflation in the health sector which includes the cost of medical expenditure has increased rapidly, thus draining the entire financial savings of the individual. Modern treatments, surgeries, transplants, expenses for critical illnesses, etc. are some of the common medical expenses that are incurred these days at the time of hospitalisation. Sometimes the sum assured or the coverage of a health insurance plan can be insufficient at the time of the treatment and the customers have to clear the medical dues from their pockets which can result in a huge financial strain. To help people overcome such conditions, the health insurance providers have rolled out top-up and super top-up health insurance covers. 

Top-up and super top-up covers help the individuals to compensate for their medical dues which exceed the limit of the base health insurance plan, and ensure enough financial backup at the time of an emergency. These health insurance covers are additional and optional covers which can be bought to add extra value to the existing health insurance policies. Though these covers serve a similar purpose, they differ in certain features and are affordable than the standard health insurance policies. 

About Top-Up Plans 

Top-up health insurance plans provide compensation to the policyholders for medical expenses that have exceeded the deductible value of the basic health insurance policy of the customer for a single illness. It claims for only single hospitalization and the deductible limit can be customized by the policyholder based on their financial budget. The premium rate of the cover depends on the deductible limit and the sum assured under this policy. It works on “per hospitalization” or the “per claim” basis, that is it looks after only a single bill of the policyholder. 

About Super Top-Up Health Insurance Covers 

Super top-up health insurance plan provides a claim for the medical dues of the policyholder that exceeds the threshold limit of the standard health insurance policy. It looks after the multiple illnesses of the individual under a single cover and offers multiple claims to the customers. Under this health insurance cover, you can claim all your medical bills arising out of single or multiple illnesses. The claim for this cover can be offered by any insurer and is not confined with the insurer of your basic health insurance plan. 

How To Know If A Top-Up Cover Or A Super Top-Up Cover Is Better? 

Both top-up cover and the super top-up cover can be claimed only after the threshold limit of the base health insurance plan exceeds. But these covers have a different working basis and usually it is better to buy a super top-up cover as it covers multiple hospitalization expenses. An individual who has to go for regular checkups and have risks of multiple hospitalizations due to their critical disorders must invest in a super top-up plan else a top-up cover is sufficient in adding extra value to your policy cover. To help you make a choice, let us understand the working of both the types of medical covers considering the following situations: 

In case a person has a base health insurance plan of Rs. 5 Lakhs, then following are the possible cases: 

1. Considering that the person has a top-up cover of Rs. 10 Lakhs with Rs. 5 Lakhs as deductibles, he will get the claim for the following medical expenses as: 

• Single medical bill of Rs. 12 Lakhs - Rs. 5 Lakhs will be claimed from the base cover and Rs. 7 Lakhs from the top-up plan as it exceeds the deductible limit. 
• A bill of Rs. 7 Lakhs and another one of Rs. 4 Lakhs - Rs. 5 Lakhs for the first bill be paid from the base cover  and rest Rs. 2 Lakhs from top-up plan and for the second bill no claim will be applicable as it does not exceed the threshold limit. 

2. Considering that the person has a super top-up cover of Rs. 10 Lakhs with Rs. 5 Lakhs as deductibles, he will get the claim for the following medical expenses as: 

• Single medical bill of Rs. 12 Lakhs - Rs. 5 Lakhs will be claimed from the base cover and Rs. 7 Lakhs from the super  top-up plan as it  exceeds the deductible limit. 
• A bill of Rs. 7 Lakhs and another one of Rs. 4 Lakhs - Rs. 5 Lakhs for the first bill be paid from the base cover  and rest Rs. 2 Lakhs from super top-up plan and for the second bill, another Rs. 4 Lakhs will be claimed. 

Conclusion 

You can choose any one among the top-up or the super top-up health insurance cover based on your financial budget and other requirements. However, you must thoroughly go through the terms and conditions of the plan to get a fair idea of the inclusion. 

Must Read: Why Should I Buy A Super Top-Up Health Insurance Policy?

What Are Top-Up And Super Top-Up Plans In Health Insurance?

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.