Top-up Health Insurance

Top-up health insurance plans are add-on covers that provide additional protection to you and your family at the time of a medical emergency. These plans come to your rescue in case your existing health insurance is not enough to meet the medical bills. In other words, they prove to be useful when the basic threshold limit of your existing health plan is breached. However, they apply to a single hospitalization.

For example- you have a health cover of Rs. 5 lakhs. With your growing age and the soaring cost of healthcare facilities, you know that it won't be enough to cover a medical emergency in the future. Rather than buying a separate health policy or upgrading your existing health plan, you can simply buy a top-up plan that would enhance your cover and won't burden your pocket.

What Are The Features Of A Top-up Health Plan?

A top-up health plan is a must-have in your arsenal due to the following reasons-

• It offers additional financial coverage in case your base policy is exhausted.
• Such plans are available at affordable premiums, which is a blessing to our wallets.
• By paying regular premiums for this plan, you can avail of tax benefits, thanks to Section 80D of the Income Tax Act, 1961.

What Is A Super Top-up Health Plan?

Just like a top-up health plan, a super top-up health plan is also an extension of your basic health plan. But these plans are eligible to cover multiple claims for cumulative medical expenses (over the threshold limit) within a policy year (once your base cover is exhausted). These plans ensure that the policyholder gets the treatment without any restrictions or limitations.

For example- you have regular health insurance of Rs. 5 lakhs and you decide to buy a super top-up health policy of Rs. 10 lakhs, which comes with a deductible of Rs. 5 lakhs. During the year, you are hospitalized 3 times, where the bill was Rs. 3 lakhs during the first time, Rs. 4 lakhs during the second time, and Rs. 5 lakhs during the third time.

You will get coverage under your regular health policy for your first hospitalization, but it will not cover your second hospitalization in full, as you've already claimed Rs. 3 lakhs against your first hospitalization. In such a case, your regular health policy will cover Rs. 2 lakhs, and the remaining Rs. 2 lakhs claim will be settled by the super top-up health policy.

In your third hospitalization, a super top-up plan will settle the entire bill amount.

What Are The Features Of Super Top-up Health Plans?

• You can claim multiple times in a year by paying the deductible amount only once.
• You can choose your deductible and sum insured amount as per our needs and requirements.
• A policyholder can avail of tax benefits for the premiums paid for a super top-up health plan under Section 80D of the Income Tax Act, 1961.

Top-up Plans Vs Super Top-up Plans

With so many plan types available in the market, people often get confused between Top up Health Insurance & Super Top up Health Insurance. In the below mentioned table, we have differentiate both the plans on some parameters that will give you a clear idea of Top up Health Insurance plan & Super Top up Health Insurance plan. Take a look

How Top-up and Super Top-Up Works?

Let's understand the functioning of both the plans with an example:

Amar and Vinay are good friends working together in the same company. Both have standard health insurance of Rs. 5 lakhs each. After considering his family's history of Cancer, Vinay purchases a super top-up health plan of Rs. 10 lakhs, with a deductible of Rs. 5 lakhs. Considering the idea of additional protection, Amar purchases a top-up plan of Rs. 10 lakhs, with a deductible of Rs. 5 lakhs. After 6 months, both were travelling together, met with an accident, and hospitalized for multiple surgeries.

Now let's check how both plans function at the time of claims-

What Is Not Covered Under Top-up and Super Top-up Plans?

The following are a few conditions, which aren't covered under such plans-

• Pre-existing diseases before the waiting period is over.
• Pre-natal and post-natal medical expenses, unless hospitalization is required.
• Any condition you get hospitalized for that doesn't match with the doctor's prescription.
• No claim until the standard health insurance coverage is exhausted or the listed deductible is spent.

To get more details about them, please speak (1800-4200-269) with the experts of PolicyX.com.

Who Should Buy Top-up and Super Top-up Health Plans?

As you already know that both Top up Health Insurance & Super Top up Health Insurance are designed to enhance your standard health insurance. But then the question arises, do you really need it? Well, to answer your question, read the below section.

Individuals falling into the below categories should consider buying these plans. Let's learn about them.

1. Corporate Employees

   Working in an organization, your company may have provided you with health insurance, but the sum insured may not be enough. In such a case, you should buy an additional cover that would protect you and your family at the time of medical emergencies.

2. Senior Citizens

   With growing age, you get vulnerable to health-related issues. And to treat those issues, you may be stuck in a situation where your base coverage is not enough and you are required to pay from your wallet. To avoid such a possibility, consider buying these add-on plans.

3. Low Coverage Holders

   Many people go for low coverage plans as they don't have the budget to pay higher premiums. But in their hearts, they know that such coverage is not enough to meet future medical needs. If you are one of them, consider going for top/super-top plans. They will give you additional coverage at cheaper rates.

Key Factors to Consider Before Buying Top up Health Insurance Plan/Super Top-up Policy

Before buying a Top-up/ Super Top up policy, knowing some of the factors that you should consider can help you in making a wise decision. Below mentioned are some of those factors :

1. Check the premium

   Before buying a Mediclaim Top up policy, one of the most important factors is to evaluate the premium in comparison to the coverage benefits offered.In order to make the best choice, you must compare the premiums of various top-up health insurance policies. Not only will it help you in choosing the most cost-effective policy, but will also provide the coverage you want.

2. Go through your Base Policy

   Before buying a Super Top up policy, it is important for you to go through your base policy completely. Check what benefits you already have, and evaluate if you would require anything else. Evaluate your and your family's healthcare needs, and then choose an ideal plan.

3. Opt for a Single Insurer

   Purchasing a Mediclaim Top up policy from the same insurance company where you currently have a basic health insurance policy is a good idea. This not only helps you create trust with your insurance provider, but it also makes things easier for you because you're already familiar with the terms and conditions of numerous operations. You may also be eligible for extra advantages, such as the elimination of a pre-existing waiting period.

How To Buy With PolicyX.com?

Buying a policy online helps to save your precious time and money. Though there is a risk of fraud, it can be avoided if you buy from a trusted buyer- PolicyX.com. Here are the steps-

Here are the steps-

Note: You can also buy the top-up/super top-up policy from the respective insurance provider.

Documents required:

If you buy these health plan from your existing provider of standard health insurance, then you won't have to submit the documents. But if you decide to buy it from another provider, you need to submit the following documents-

• Age Proof- 10th or 12th mark sheet, Driving License, Birth Certificate, Passport, Voter ID, etc.
• Identity Proof- Passport, Voter ID, Driving License, PAN Card, or Aadhar Card, which proves one's citizenship.
• Address Proof- Electricity Bill, Telephone Bill, Ration Card, Driving License or Passport should mention the permanent address.

• Passport-size photographs.
• Others requested by the insurance company.

How To File A Claim For Top-up/Super Top-up Health Insurance?

Generally, there are two ways of filing claims for such plans. Let's learn about them.

For cashless claim (can be opted only at the network hospitals):

• Intimate your insurance company about hospitalization.
• Provide your health card and ID proof and fill the pre-authorization form.
• The hospital will send your form with your medical records, which will be verified by your insurance company.
• Once approved, the company will directly pay all the bills at the network hospital.

For reimbursement claim:

• Intimate your insurance company about the hospitalization as soon as possible.
• Get treated, pay all the expenses and file for reimbursement.
• At the time of getting discharged, collect all the necessary documents and bills, and submit them to your insurance company.
• After assessing and verifying the documents, the amount will be transferred to your registered bank account, provided the claim is approved.

Note- The above steps may vary from one insurance company to another. Please take note of it before filing a claim.