During the time of medical contingencies, your Health Insurance plan covers the treatment/hospitalisation expenses only up to the amount of Sum Insured you have opted for. One can never predict the magnitude of medical exigencies and the corresponding treatment expenses. In an unfortunate circumstance, if the hospital bills exceed the chosen Sum Insured amount, you will have to pay the additional costs out-of-pocket, which can deplete all your savings and earnings.
Here is where you need extended coverage to meet your additional health care expenses. For this purpose, Health Insurance providers offer Top-up plans that provide further financial protection for you and your family by covering the additional expenses incurred over and above your chosen Sum Insured in your regular Health Insurance plan.
What is a Top-up Health Insurance plan?
A Top-up Health Insurance plan offers additional coverage over and above your regular Health Insurance policy and enhances the coverage.
With soaring medical costs, you must definitely have 360-degree protection for all sorts of medical emergencies. In case heavy medical expenses are likely, you can consider buying a Top-up Health Insurance plan which is more economical than increasing the Sum Insured under your base plan.
How does a Top-up Health Insurance plan work?
Let us understand how a Top-up Health plan works with an example.
Assume that you have purchased a Health Insurance plan with a Sum Insured of Rs. 5 lakhs, and considering the rising medical costs and health risks, you have opted for a Top-up insurance plan with a Sum Insured of Rs. 8 lakhs with a set threshold limit of Rs. 5 lakhs. The total coverage will be Rs. 13 lakhs. For example, if you have incurred an expense of Rs.7 Lakhs towards a treatment, you can claim Rs. 5 Lakhs from your Base Health Plan and Rs. 2 Lakhs from your Top Up Plan.
You can utilise the Sum Insured under the Top-up plan only if the claim amount exceeds the chosen Deductible, which is also referred to as the Defined Limit. Hence, it is understood to keep the Sum Insured under the base Health Insurance plan and the threshold/Deductible/Defined limit under the Top-up Plan.
However, the threshold/Deductible/Defined Limit can also be set lower than the Sum Insured under the base plan, in case the policyholder wishes to utilise the Sum Insured under the Top-up plan, without completely exhausting the Sum Insured under the base plan. This may be with a view to conserve the base plan’s Sum Insured for future claims, in case the base plan does not provide reinstatement of Sum Insured or provides limited/restricted reinstatement of Sum Insured.
Why should you buy a Top-up Health Insurance policy?
Here are the advantages of buying a Top-up plan.
Increasing healthcare costs
The increasing inflation in healthcare costs is inevitable due to medical advancements. This warrants buying a comprehensive Health Insurance plan with a good amount of coverage and having it enhanced with a Top-up plan to make it adequate to meet the ever-increasing medical expenses.
Apart from providing additional coverage, it is a cost-effective way to enhance the Sum Insured of your regular Health Insurance cover, which is available at an affordable Premium compared to the other plans. For the same Sum Insured, the cost of a base plan will be much higher than that of a Top-up plan since the latter operates with a Deductible.
Top-up Health Insurance plans are a good option for policyholders with a family floater (base) plan, where the Sum Insured is shared among the family members as there are higher chances of the Sum Insured getting exhausted.
The Top-up plans are also ideal for those covered under their employer’s group policies to meet the medical expenditure incurred over and above the coverage under such group plans and at a much lower Premium.
Moreover, you can either buy the Top-up plan from the same insurer from whom you have purchased the regular Health Insurance plan or another insurer, depending on the availability and the choice of the Sum Insured and the Deductible that is suitable to meet your requirements.
Beneficial during Pandemic COVID-19
Top-up plans have come to the rescue of many policyholders during the pandemic to meet the unexpectedly high cost of treatment for COVID-19 infection.
Top-up plans come with tax-saving benefits under IT-Act Sec 80D, similar to other Health Insurance policies.
Top-up plans complement one’s base Health Insurance policy and shield the policyholder from financial strains caused due to additional expenses. Those who have opted for low Sum Insured can definitely stay worry-free by choosing a Top Up Health Insurance Plan.
Star Health offers Super Surplus Insurance Policy – a pocket-friendly Top-up Health Insurance Plan offering coverage for medical expenses above and beyond your base Health Insurance plan.
Features of Super Surplus Insurance Policy
Before you opt for the Super Surplus Insurance Policy, it is important to know the highlighting features and benefits of the policy. Read Now!
- The plan is available in Gold and Silver variants on both Individual and Floater basis.
- No pre-acceptance medical screening is required to avail the policy.
- Anyone aged between 18 and 65 is eligible to take this plan.
- The policy is available for terms of 1 or 2 years. If you have opted for a 2-year policy term, you can avail a long-term discount of 5%.
- The policy benefits can be availed after the completion of an initial waiting period of 30 days.
- Super Surplus Insurance Policy covers Pre-existing Diseases (PED) like Diabetes, Hypertension, Cancer, etc., after a waiting period of 36 months under the Silver plan and 12 months under the Gold plan.
- Specific diseases are covered with a waiting period of 24 months under the Silver plan and 12 months under the Gold plan.
Special Features in Gold Plan
- Delivery expenses up to the limits specified as per the policy terms and conditions.
- Coverage for Organ Donor Expenses.
- Recharge Benefit: If the Sum Insured under the policy is either exhausted or exceeded during the policy period, an additional indemnity coverage is provided up to the limits mentioned in the policy.
For more information, read the policy wordings and clauses.
- Any hospital admission primarily for investigation and diagnostic purpose
- Pregnancy and infertility (except to the extent provided under the policy)
- Domiciliary treatment and treatment outside India
- Circumcision, sex-change surgery, cosmetic surgery and plastic surgery
- Any substance abuse
- Self-inflicted injuries
- Hazardous sports, war, terrorism, civil war or breach of law
- Any kind of service charge, surcharge, admission fees or registration fees levied by the hospital.
These are some of the policy exclusions. For the complete list, you can refer to the policy clauses.