Simran is an insurance expert with more than 4 years of experience in the industry. An expert with previous experience in BFSI, Ed-tech, and insurance, she proactively helps her readers stay on par with all the latest Insurance industry developments.
Naval Goel, the founder of PolicyX is a well-recognised name in the Indian insurance and finance industry. His global overview has revolutionised the way insurance is perceived and bought by commoners in India.
Updated on Apr 08, 2025 4 min read
Top-up Health Insurance Plan in India 2025
A top-up health insurance will act as a supplement to your main health insurance plan. Top-up health insurance plans offer you medical care coverage in case your base medical policy is exhausted. It is one of the best insurance solutions for those who think their base medical insurance policy is insufficient and need extra coverage at minimal premium charges. Top-up health insurance plans provide health cover on an individual and family floater basis offering a sum insured value as high as 1 Crore depending on your needs and requirements.
This article covers all your queries about a health insurance top-up plan, read further to know more.
What Is A Top-Up Health Insurance?
Top-up health insurance plans are a vital insurance product that provides you with additional protection while saving you from increasing healthcare costs. A top-up health insurance plan is activated once your base health insurance plan is exhausted. However, investing in top-up health insurance comes with a condition of mandatory deductibles.
Let's understand a top-up health plan with an example:-
Mr Ashish has a base health insurance with a sum insured value of INR 5 Lakhs from his employer. He needed a recharge of the additional sum insured with a top-up plan of INR 5 Lakhs because his base policy's sum insured was insufficient.
Unfortunately, he met with an accident which cost him a medical bill of INR 8 Lakhs. If he did not have a top-up health policy, his cost of treatment would have not been covered by the base policy. In such a condition, he needed to pay the total bill on his own.
The good news? Since he bought the top-up insurance plan, his treatment cost was paid by the insurer of his top-up plan.
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Listed below are top-up health plans provided by various health insurance providers
Sum insured is the maximum monetary coverage that a health insurance policy provides you. You should decide your sum insured based on the cost of medical treatments, your health, income, and lifestyle habits.
What is Eligibility
Eligibility is the pre-set criteria that you must fit into to buy an insurance policy. Eligibility includes age, the status of your health, income, pre-existing diseases, nationality, salaried or self-employed, etc.
What is Deductibles Available
Unique Feature: Unique features are the benefits offered by an insurance policy that differentiate it from the other ones available in the market.
What Are Deductibles In Top-Up Health Insurance?
Deductibles are a mandatory element when you purchase top-up medical insurance. Health insurance deductibles refer to the amount of money a policyholder has to pay medical insurance. Health insurance deductibles refer to the amount of money a policyholder has to pay
Example: Let us say that someone has a base health insurance policy of INR 5 lakhs and a top-up health plan of INR 3 Lakhs with 1 Lakh as deductible amount. If the hospitalization bill is INR 6 lakhs, then the insurance company will pay 5 lakhs from your base policy and INR 1 lakh from your top-up health plan. In case there is a second hospitalization during the policy period and the hospital bill is INR 2 lakhs, then the policyholder will have to pay 1 Lakh as deductible and the other 1 lakh will be paid from the top-up health plan.
Let's learn about different kinds of deductibles that come with health insurance plans:-
Voluntary Deductibles Some health insurance top-up plans offer voluntary deductibles which means that the insurance holder is free to opt for the amount of deductibles they want to pay. Opting for a higher value of deductible means that the premium value will be reduced accordingly.
Compulsory Deductibles As the name suggests compulsory deductibles are governed by the insurance providers. For example, if you have a compulsory deductible of INR 10,000 and the hospital bill is INR 50,000. The insured individual has to pay the deductible amount i.e. INR 10,000 before the insurance providers pay the rest of the amount.
Cumulative Deductibles These deductibles are applicable for family floater plans wherein the insurance company will apply deductibles for all family members. In this case, when any family member files a claim the insurance company will apply a deductible.
Benefits of Top-Up Health Insurance
Many individuals think that purchasing an additional top-up health insurance will only add up to their premium expenses. But let me tell you that a plethora of benefits come along with health top-up insurance which are listed below:
Avail Additional Coverage With health expenses on the rise and medical care inflation, it is necessary to invest in a top-up health insurance plan as it provides you with enhanced medical care coverage. Top-up and health plans offer coverage to you and your entire family.
Protect Your Savings Investing in an additional top-up health insurance plan will ensure that you do not have to drain your hard-earned savings on the ever-rising hospital bills and treatments. With top-up health insurance, you can focus on your recovery rather than worrying about your finances
Higher Coverage Top-up health insurance provides you with higher coverage at affordable premiums. The sum insured offered by top-up health insurance plans can go as high as INR 1 crore offering an array a plethora of features.
Tax Benefits Just like your regular health insurance plan, You can claim tax benefits on your top-up health insurance premiums under section 80D of the Income Tax Act.
No Pre-policy Medical Check-up Top-up health insurance plans do not require you to undergo any pre-policy medical check-up up to a certain age. However, some top-up plans may have an age condition that will vary from insurer to insurer.
What Is Covered Under A Top-Up Health Insurance
Let us take a look at all the inclusions under a top-up health insurance plan that will assist you in making a better purchase decision
Top-Up Health Insurance Coverage
Description
In-Patient Hospitalization
Insured individuals are covered for in-patient expenses including room rent, doctor's fees, diagnostic procedures, and more.
Pre and Post Hospitalization Expenses
These expenses include diagnostic tests, medication, and more. These charges are incurred up to 30 days before hospitalization and 60 days after hospitalization.
Day Care Procedures
Procedures that do not require hospitalization for more than 24 hours are covered by top-up health insurance plans.
Organ Donor Expenses
Expenses incurred during surgery and medical procedures required for organ transplants are covered by top-up health insurance plans.
Emergency Ambulance
Top-up health insurance plans offer emergency ambulance cover to insured individuals for any emergency hospitalizations or medical emergencies
Domiciliary Treatments
Expenses incurred during domiciliary hospitalization on the recommendation of a doctor are covered by a top-up health insurance plan
AYUSH Treatments
All expenses incurred while availing of any treatments that fall under Ayurveda, Unani, Siddha, or Homeopathy are covered by a top-up health insurance
Top-Up Health Insurance Exclusions
The exclusions of top-up health insurance are mentioned below, take a quick look:
Any injuries and hospitalizations due to acts of war, terrorism, or unlawful activity
Obesity and weight-related surgeries
Cosmetic procedures
Injuries and Hospitalizations due to adventure sports or activities
Injuries or Hospitalization due to drug abuse, overconsumption of alcohol, etc.
To get more details about them, please speak (1800-4200-269) with the experts of PolicyX.com.
When it comes to purchasing a top-up health insurance plan, many people do not deem it to be necessary. However, If you fall under one of these below-mentioned categories then you should consider purchasing a top-up health insurance plan.
Corporate Health Insurance Policyholder If you are covered under a group health insurance plan, it might not be adequate for the long term. It also is not a reliable source of health insurance as it will terminate as you move from one company to another. A top-up health plan will boost your base health insurance plan and offer an additional sum insured at a low cost of premiums.
Elderly Individuals It is a well-known fact that a health insurance policy premium increases with age. If you are someone who wants to buy a health insurance plan for your parents , you can purchase a base health cover along with a top-up health insurance plan increasing their overall coverage
People Who Have Basic Coverage Individuals who have purchased a basic health insurance plan that covers hospitalization expenses but want enhanced coverage should invest in a good top-up health insurance plan.
5 Things To Consider Before Buying A Top-Up Health Insurance
We have mentioned the 5 most important things you must consider before purchasing a top-up health insurance.
Waiting Periods You must consider waiting periods for various top-up plans as each has different conditions for the illnesses they cover. It is important to read the terms and conditions for waiting periods for different pre-existing conditions.
Deductibles Deductibles are a mandatory element of top-up health insurance. So it is important to read the terms carefully before purchasing a top-up plan with deductibles. Some top-up plans have compulsory deductibles and others may have flexible deductibles resulting in reduced premium amounts.
Co-payment Clause Similar to a regular health insurance plan, top-up health insurance also has a co-payment clause. Before purchasing a top-up health plan it is essential that you understand the co-payment clause as it varies from insurer to insurer.
Sum Insured An essential factor to consider when purchasing a top-up health insurance plan is the sum insured you want. Since people buy top-up health insurance as an additional form of protection in case their base health plan is exhausted it is important to select the sum insured wisely.
Family Cover Top-up health insurance plans offer you to cover family members. However, it is necessary to read the terms and conditions to understand how many family members can be covered under the plan you choose for yourself and your family and the relations that are covered.
Buying Process of Top-Up Health Insurance with PolicyX
Follow the steps mentioned below to avail of the best top-up health insurance plans with quotes that will help you make the best purchase decision.
1
Step 1
Visit the official website of PolicyX
2
Step 2
Click on the "Health Insurance" tab which will open up a digital form for you to fill.
3
Step 3
Fill in all the necessary details such as the number of family members you want health insurance cover for and your age and click on "View Plans"
4
Step 4
Select your city and click on "Proceed"
5
Step 5
Further, fill in your name and mobile number and click on "Get Free Quotes"
6
Step 6
You will be directed toward a list of health insurance plans wherein you can compare the plans of your choice and pay for the one you want as per your needs
Documents Required When Purchasing Top-Up Health Plans
When purchasing top-up health plans you will need a few fundamental documents such as:
Proof of Identity
In order to purchase a health insurance plan it is essential to submit your proof of like
Adhaar Card
Passport
Voter ID Card
Driving License
Proof of Address
You will have to offer the insurance providers a proof of address like
Rent Agreement
Utility Bills
Telephone Bills
Adhar Card
Proof of Age
One of the most essential documents is the proof of age which can be provided by giving the following documents
Aadhar Card
Birth Certificate
Voter ID Card
Driving License
Wrapping It Up
Top-Up health insurance comes with a deductible and may seem like an extra expense to your overall financial planning. However, it is one of the smartest decisions one can make to enhance the overall medical care coverage at a minimal premium. A top-up plan is ideal for those individuals looking for additional sum insured if they feel that their base health insurance is not adequate.
Wanna know more about a top-up health cover? Reach out to our experts at PolicyX who will guide you to make an informed decision before purchasing a top-up health plan.
Top Up Health Insurance: FAQs
1. Top 5 top-up health insurance plans in India based on claim settlement ratio.
The following are the top 5 top-up health insurance plans in India based on the latest claim settlement ratio (CSR) for the year 2021-22:
Star Health Super Surplus
Niva Bupa Health Recharge
Bajaj Allianz Extra Care Plus
SBI General Arogya Top Up Health Insurance
New India Top-Up Mediclaim Policy
2. What Is a Top-Up Health Insurance?
A top-up health insurance is activated when your base health plan is exhausted. It offers additional protection for you and your family when the main health plan is not able to. Top-up plans offer a high range of sum insured options going as high as 1 crore and have a mandatory deductible clause which varies from insurer to insurer.
3. Are waiting periods applicable for top-up health plans?
Yes, like regular health insurance plans, top-up health plans also have waiting periods applicable for different ailments and conditions.
4. Should you buy top-up health insurance?
Having top-up insurance is useful in many ways as it not only increases your overall sum insured capacity but also provides you with additional medical care features.
5. What are deductibles in a top-up health plan?
Deductibles are a mandatory element when you purchase a top-up medical insurance. Depending on the insurance company deductibles can be fixed or flexible as per your affordability.
6. Do I need to undergo a medical test to buy top-up health insurance?
Some insurance companies may ask you to undergo medical screening after a certain age. It's better to check this with your chosen insurer before buying the policy or call our insurance advisors at PolicyX.
7. Can I buy a top-up health plan for my family?
Yes, top-up health policies come as individual and floater plans.
8. Does a Top-up health insurance plan offer coverage for AYUSH Treatments?
Yes, you will get the coverage for AYUSH Treatments under a top-up policy.
9. Am I eligible to avail of any tax benefits under the health insurance top-up policy?
Yes, like any other health policy, you can avail of tax-saving benefits with top-up health insurance under Section 80D of the Income Tax Act of India.
Simran is an insurance expert with more than 4 years of experience in the industry. An expert with previous experience in BFSI, Ed-tech, and insurance, she proactively helps her readers stay on par with all the latest Insurance industry developments.
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