When availing of a health insurance plan, you opt for one that caters to your current financial status and stability. However, once you think of the inflation across the healthcare services industry, you cannot help but wonder if your current insurance coverage would suffice your future medical requirements.

In such cases, you have 2 options -

  1. You purchase another healthcare insurance plan.
  2. You request your insurer to increase your coverage amount.

The problem here is that you are looking at a huge spike in your premium and hence putting a significant financial burden on yourself. So, what do you do?

Well, there is a 3rd option - opt for a top-up or super top-up policy on your existing insurance plan. Top-ups and super top-ups are an extension on the sum insured that come into effect as soon as your claim amount is exhausted.

What are Top-Up and Super Top-Up Plans?

Top-ups and super top-ups are the most affordable options that cushion your existing financial coverage.

However, since these plans offer a significant extension on the coverage amount, it is only obvious that they take on additional precautions to risk the chances of payouts over minimal invoices of hospitalization.

Deductibles are this safeguard measure - a threshold amount that needs to be paid off by the policyholder (via their base health insurance if they have availed it or from their own pocket) prior to having access to the additional fund offered by top-ups and super top-ups.

While both top-ups and super top-ups offer policyholders financial cushioning over and above their existing mediclaim fund, these plans differ in functioning.

What is Top-Up in a health insurance plan?

Top-up plans across the health insurance sector are additional funds that help meet your medical expenses. These plans are standalone policies that come with a threshold deductible amount. You can avail of a top-up plan singularly or with a base health insurance coverage. What would be the difference? Here, take a look -

Let’s say you have availed of a top-up plan of INR 50 lakhs that demands a deductible of INR 10 lakhs. And upon your hospitalization, you are charged a bill of INR 25 lakhs.

CASE 1: You have an existing base health insurance plan that offers coverage of INR 10 lakhs.

  • Your base insurance plan pays towards the Deductible of INR 10 lakhs, activating your Top-Up plan.
  • Now the Top-Up plan pays off the residual bill amount of INR 15 lakhs.
  • Thus, you need not pay anything off your own pocket.

CASE 2: You have no existing health insurance plan

  • To pay off the Deductible amount of INR 10 lakhs, you dig into your savings that activate your Top-Up plan.
  • The Top-Up plan now pays off the balance hospital bill of INR 15 lakhs.

Hence, it is always recommended that you avail of a base health insurance plan before purchasing a top-up one. This would safeguard your savings while offering you financial cushioning for your medical expenses.

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How do Top-Up plans work in health insurance?

To explain the functioning of a Top-Up plan in health insurance, we need to take up a simple example -

Arun avails of a health insurance policy of INR 10 lakhs and tops off the coverage with a Top-Up plan of INR 40 lakhs. And, he is made aware that this top-up plan demands a deductible of INR 10 lakhs.

After a certain period (that ensures completion of the waiting period on both his base plan and his top-up policy), he, unfortunately, meets with an accident that requires immediate hospitalization and a series of surgeries over multiple hospitalizations -

CLAIMS (IN 1 YEAR) HOSPITAL BILL DEDUCTIBLE TOP-UP Remaining Base Amount & Super Top-Up Plan Amount
1st Claim INR 30 lakhs BASE: INR 10 lakhs INR 20 lakhs BASE: INR 0
TOP-UP: INR 20 lakhs
2nd Claim INR 12 lakhs POLICYHOLDER: INR 10 lakhs (since the base policy is exhausted for the year) INR 2 lakhs BASE: INR 0
TOP-UP: INR 18 lakhs
3rd Claim INR 7 lakhs NA NA (since it is below the deductible and the base policy is already exhausted for the year,
the policyholder has to pay it out of his pocket)

Well, here is the catch - Top-Up plans demand that the deductible threshold be passed before the plan gets activated for each hospitalization.

Why are Top-Up Plans so rare in the Health Insurance Market?

While on the one hand, it is true that Top-Up plans offer an additional financial layer to safeguard you against spiraling medical expenses, on the other hand, this policy is on its way out of the market due to its long queue of downsides -

  • The medical expenses have to surpass the deductibles for each hospitalization. Since the deductible threshold is set high, availing of the additional top-up fund becomes cumbersome.
  • There are multiple restrictions for the Top-Up plan funds that include disease-wise sub-limits, room rent restrictions, pre- and post-hospitalization expenses, and more (varies based on the availed plan)
  • Top-Up plans may have copayment features (the downsides of which you can read in our blog)
  • Loading charges may be added to the premium of the policy (based on the availed plan)
  • Premiums for top-ups can shoot north if you opt for higher coverage or a lower deductible.

However, while Top-Up is on its way out of the health insurance market, Super Top-Ups are out to capture the industry. Why? Here is a look into it -

What is Super Top-Up in a health insurance plan?

Super Top-Up plans are similar in their purpose to that of Top-Ups. Both act as additional financial aids to meet healthcare expenses that exceed your current health insurance coverage.

However, with super top-up plans, policyholders have access to more affordable choices that are conveniently accessible, considering that insured individuals only need to pay the deductible once annually over their hospitalization charges.

To understand this better, let’s take a look at how super top-up plans work -

How do Super Top-Up plans work in Health Insurance?

Over time, super top-up plans have gained ground among policyholders seeking affordable options to extend their current medical financial coverage. The most crucial reason why such plans are getting popular is that while super top-up plans do charge a significant deductible -

  1. The deductible is only charged once a year, irrespective of the frequency of hospitalization.
  2. The deductible amount can be collected cumulatively. (case 2 in the table)

Take a look at the table below for a better reflection of the working of Super Top-Up plans -

Health Insurance Base Policy: INR 10 lakhs
Super Top-Up: INR 40 lakhs
Deductible: INR 10 lakhs
CLAIMS (IN 1 YEAR) HOSPITAL BILL DEDUCTIBLE SUPER TOP-UP Remaining Base Amount & Super Top-Up Plan Amount
CASE 1
1st Claim INR 30 lakhs BASE: INR 10 lakhs INR 20 lakhs BASE: INR 0
SUPER TOP-UP: INR 20 lakhs
2nd Claim INR 12 lakhs INR 0
(Super Top-Up deductible needs to be paid off only once a year)
INR 12 lakhs BASE: INR 0
SUPER TOP-UP: INR 8 lakhs
3rd Claim INR 7 lakhs INR 0 INR 7 lakhs BASE: INR 0
SUPER TOP-UP: INR 1 lakh
CASE 2
1st Claim INR 6 lakhs BASE: INR 6 lakhs NA BASE: INR 4 lakhs
SUPER TOP-UP: Not yet activated
2nd Claim INR 4 lakhs BASE: INR 4 lakhs NA BASE: INR 0
SUPER TOP-UP: Not yet activated
3rd Claim INR 4 lakhs (Deductible has already been collected over the last 2 cases of hospitalization: INR 6 lakhs + INR 4 lakhs = INR 10 lakhs) INR 4 lakhs BASE: INR 0
SUPER TOP-UP: INR 36 lakhs

With more convenient access to additional cushion funding, super top-ups are truly a great financial tool. However, much like any other financial aid, this doesn’t come without finer prints.

You will now need to weigh out the pros and cons of the plan to make the informed decision of whether you should buy super top-up health insurance or not.

What are the advantages and disadvantages of a Super Top-Up plan?

Pros

  • Higher coverage: With Super Top-Up plans, policyholders can access increased coverage which is typically essential considering the chances of a spiked medical bill over premium treatment channels.
  • Affordable option: Compared to the hikes in premium to extend the existing insurance coverage via the purchase of another policy or request to extend the current insurance coverage, the premium for super top-ups is low.
  • Cumulative and annual deductible payment: Super top-up plans require you to pay off the deductible only once (either in one go or cumulatively) a year. This makes the funds readily accessible to the policyholder.

Cons

  • Extensive exclusions & restrictions: Super top-ups, much like top-ups, have a list of extensive sub-limits when it comes to room rents, pre- and post-hospitalization expenses, etc.
  • No Restoration benefit: The super top-up plans do not have the restoration feature. Hence, once exhausted over the year, you will have to wait for the renewal of the policy.
  • No-Claim Bonus excluded(mostly): Depending on the plan availed, the chances are high that you won’t have access to the No-Claim bonus on your Top-Up plan. And in case you have read our Blog on the No-Claim Bonus in Health Insurance, you know that you will be missing out on a huge perk.
  • Higher premiums in case of lower deductibles: With higher deductibles, the chances of payout are comparatively low. Hence, the insurers offer lower premiums. However, if a potential policyholder opts for higher coverage and a lower deductible, the premium on the Super Top-Up plan shoots north. This is one of the most commonly talked about disadvantages of super top-up health insurance.
  • Strict underwritings: Since the insurers are offering you a substantial fund over a relatively low premium, it is only obvious that the underwriting team will be strict in their consideration of who gets access to these plans.

What are the best super top-up health insurance plans in India?

As more and more among the crowd get aware of the financial downfalls that come with ailments, cushioning policies like Super Top-Ups gain popularity. The additional coverage bandwidth it provides and the affordable premium that it seeks, make this policy appealing to potential policyholders.

Taking a cue from this high-end demand for Super Top-Up plans, multiple insurers across the market now offer this perk-like policy. Among these, our top choices are -

  1. HDFC Ergo myHealth Medisure Super Top-up
  2. NIVA BUPA (MAX BUPA) Health Recharge Super Top-up
  3. ICICI Lombard Health Booster Super Top-up
  4. Care Enhance Super Top-up
  5. BAJAJ ALLIANZ Extra Care Plus Super Top-up

What is the difference between Top-Up and Super Top-Up Plans in Health Insurance?

The main difference between top-up and Super Top-up is that the deductible amount is cumulative in case of super top-up, but they act as threshold in case of top-up policies for each claim.

  1. Deductibles: To activate the Top-Up funds, a policyholder must pay off the deductible in each hospitalization. On the other hand, the Super Top-Up policy demands that the deductible be paid off only once a year (all at one go in hospitalization or cumulatively over multiple hospitalizations across a  year)

2.  Others: As for the other differences between these two plans, the example below will be instrumental in explaining them -

Health Insurance Plan: INR 10 lakhs
TOP-UP PLAN: 40 lakhs
DEDUCTIBLE INR 10 lakhs
SUPER TOP-UP PLAN: 40 lakhs
DEDUCTIBLE INR 10 lakhs
CASE 1
1st Claim:
INR 7 lakhs
Base: INR 7 lakhs Base: INR 7 lakhs
Remaining base amount:
3 lakhs
Remaining base amount:
3 lakhs
2nd Claim:
INR 7 lakhs
Base: INR 3 lakhs Base: INR 3 lakhs
Policyholder: INR 4 lakhs Super Top-Up: INR 4 lakhs
Top Up: Not Activated Yet
CASE 2
1st Claim:
INR 12 lakhs
Base: INR 10 lakhs Base: INR 10 lakhs
Top-Up: INR 2 lakhs Super Top-Up: INR 2 lakhs
Remaining base amount: 0 Remaining base amount: 0
2nd Claim:
INR 6 lakhs
Policyholder: INR 6 lakhs Super Top-Up: INR 6 lakhs
Top Up: Not Activated Yet

Frequently Asked Questions:

What are the best Super Top-Up Plans in Health Insurance?

Among the plans available in the market, there are two that offer premium features without demanding exorbitant premiums -

  1. HDFC Ergo myHealth Medisure Super Top-up
  2. MaxBupa Recharge

When should I avail of a Top-Up or Super Top-Up Policy?

Insurers say that you can avail of a Top-Up or Super Top-Up policy anytime you want after your base plan. However, in case you talk to the insurance advisors at Ditto, you will know to purchase these plans at the earliest (as soon as you buy your base plan) since the Top-Up and Super Top-Up plans come with a significant waiting period.

To access the additional funds when you need them in your emergency, your waiting period for the super top-up should coincide with that of your base insurance coverage.

What should I consider when purchasing a Super Top-Up Plan?

  • Purchase a Super Top-Up/Top-Up plan whose deductible is less than or equal to the coverage offered by your base health insurance policy.
  • Read into your plan's finer print to know the policy's limitations and exclusions.
  • Compare the top 3 plans before choosing and finalizing one.
  • Consider the claim thresholds of the policy.

Can I purchase both the Top-Up and Super Top-Up Policy?

Yes, you can avail of both top-up and super top-up policies. However, please consider the collective premium (Base Policy + Top-Up + Super Top-Up) to be paid, which can considerably strain your financial stability.

Can I buy the base plan from one insurer and the Top-Up/Super Top-Up Plan from another? Should I?

While you can purchase the base policy and the Super Top-Up/Top-Up Plan from different insurers, you are advised to avail of both from one insurance provider. Here’s why -

  • HASSLE-FREE PROCESS

The top-Up or Super Top-Up activation requires proof that the deductible has been covered already. This means you need your base insurer to provide the required documentation and clearance. This, unfortunately, is inconvenient for a policyholder and lengthens the process unnecessarily.

  • DOCUMENTATION

To avail of a Top-Up/Super Top-Up from another insurer, you will need to provide them with the required medical and financial clearance documents. On the other hand, if both of your policies are from the same insurance provider, the underwriting team is already aware of your pre-existing conditions and claim history, thus eradicating the need for documentation.