A top-up health insurance plan is a type of supplemental health insurance plan that helps cover the cost of medical expenses not covered by an individual's primary health insurance plan. The top-up health insurance plan is often purchased to help cover the cost of co-pays, deductibles, and other out-of-pocket costs that are not covered by an individual's primary health insurance.
The top-up health insurance plan is a popular option for people who are self-employed or who work for companies that don't offer coverage. It's also a good idea for people who have pre-existing conditions and need more coverage than what their employer provides. Several health insurance companies in the Indian market offer top-up health insurance plans at affordable premiums. You can buy a top-up cover if you are aged between 18 years and 80 years. In this article, we will talk about top-up health insurance coverage in detail.
What is Top-up Health Insurance Cover in Health Insurance?
Top-up health insurance is similar to a rider or add-on for your health insurance which means it enhances your existing health insurance policy’s sum insured amount. When the primary health insurance sum insured amount is exhausted, it acts as an additional layer of financial protection and backup to your primary health insurance. You can use it to pay for things that are not covered by your hospital plan or basic health insurance.
Having a top-up policy without a base health insurance policy is like having a bike without an engine. However, a top-up plan comes with a mandatory deductible and provides coverage only after the insured has paid the deductible amount. A top-up policy has a deductible amount which would be almost 20% of the top-up policy sum insured. For example let us take a base policy with Rs.2 Lacs and Top up a policy with Rs.5 Lacs, in case of hospitalization first the base policy sum insured will be utilized, and then the top-up policy kicks in.
How Does Top-Up Health Insurance Work?
A top-up plan is like a regular health insurance plan where the hospitalization and other allied expenses are covered but only after a threshold limit, known as the deductible. Every top-up policy comes with a certain deductible, which is the amount of claim to be borne by the policyholder. A top-up policy is normally taken in addition to the base policy where the requirement of the sum insured is high but the severity or occurrence of claims is rare. The premium charged for the top-up policies is quite less compared to that of the base health insurance policies. This is due to the high deductible in the top-up policies when compared to the normal health insurance policies.
Top-up Health Insurance Cover Working Model
The top-up plans offered by the insurers are cheap the reason that insurance companies don’t offer the top-up plans without having a base health insurance plan. The higher deductible ensures that the insurance companies have little liability and the chance of occurrence of huge claims is generally low.
For example, Mr. Daniel aged 30 years has taken a base health insurance policy for a sum assured of Rs.5 Lacs and purchased a top-up plan for Rs. 15Lacs with a deductible of Rs.5 Lacs. In total his coverage is Rs.20 Lacs including the base policy and the top-up policy. Now let us understand how the reimbursement claims work in this scenario:
- If there is a single claim of Rs.3 Lacs in a year, then the base policy will pay the claim amount of Rs.3 Lacs and the top-up cover remains intact.
- If there is a single claim of Rs.20 Lacs in a year, then the base policy will pay the claim amount of Rs.5 Lacs and the remaining Rs.10 Lacs will be paid from the top-up policy (as the deductible in the top-up policy is Rs.5Lacs, the top-up policy will trigger only if the claim amount is above the deductible amount).
- If there are multiple claims in a year of Rs. 3Lacs, Rs. 5 Lacs and Rs.15 Lacs. In the case of the first claim, the base policy will settle the amount, in the case of the second claim base policy will settle Rs. 2Lacs (remaining S.I after settling the first claim) and the remaining claim amount of Rs.3Lacs have to be borne by the insured. In the third claim (total base sum insured exhausted) the top-up policy pays only Rs.10 Lacs (deductible is Rs.5 Lacs) and the remaining claim amount has to be borne by the policyholder.
A top-up policy is ideal for those people who have a regular health insurance policy but do not have sufficient coverage to deal with a huge medical emergency. The top-up policy can be understood as beneficial for claims arising out of a single illness in a single event. For instance, in the above example of base policy and top-up sum insured the total premium would come around Rs.10k but if the total sum insured of Rs.20 Lacs is to be taken under the regular health insurance it would cost the policyholder around Rs.30k.
You can opt for a higher sum insured health insurance plan, but that will increase your premium. Or else you can opt for a regular health insurance plan with an adequate sum insured and purchase a top-up plan with a deductible amount less than or the same as that of regular health insurance.
The top-up plans sum insured is in general reimbursed when all the medical bills are submitted to the insurance company within the specified time frame. The top-up policy’s deductible amount must be paid by the policyholder to the hospital before the insurance company settles the remaining claim amount.
Benefits of Top-up Health Insurance Plans
- Cashless Claims
- Tax Benefits
- Cumulative Bonuses
- Consumable Benefits
- High Health Insurance Coverage
- Flexibility in Premium Payment Mode
Best Top-up Health Insurance Plans in India
| Plan Name |
Age limit |
Policy Tenure |
Sum Assured |
| Star Surplus Top-up Plan |
18 to 65 years |
1 or 2 years |
5 lakhs to 1 Crore |
| SBI Arogya Top-up Plan |
18 to 65 years |
1 or 2 or 3 years |
1 Lakh to 10 Lakhs(Based on Plan Type) |
| Universal Sompo Super HealthCare Top-up Plan |
Up to 80 years |
1 or 2 or 3 years |
1 Lakh to 20 Lakhs(Based on Plan Type) |
| Future Generali Advantage Top-up Plans |
1 day to 99 years |
1 or 2 or 3 years |
Rs. 50k to 1 Crore |
| New India Assurance Top Up Mediclaim Policy |
18 to 65 years |
1 year |
5 lakhs to 22 Lakhs |
What is covered under Top-up Health Insurance?
- Inpatient Hospitalization: Top-up health insurance plans cover you for in-patient hospitalization expenses up to the sum insured limit.
- Pre-Hospitalization Expenses: Top-up health insurance plans cover pre-hospitalization expenses incurred up to the date of 60 days before hospitalization (number of days which may differ from insurer to insurer).
- Post-Hospitalization Expenses: Top-up health insurance plans cover post-hospitalization expenses incurred up to the date of 90 days after hospitalization (number of days which may differ from insurer to insurer).
- Organ Donor Expenses: Top-up health insurance plans provide you the coverage for medical expenses incurred for organ transplantation are payable.
- Room Rent Expenses: top-up health insurance plan covers you for room rent expenses incurred during hospitalization.
What is not covered under Top-up Health Insurance?
- Self-inflicted injury
- Infertility treatment
- Cosmetic or plastic surgeries
- Pre-existing diseases
- Sexually Transmitted Diseases
- Medical expenses during the waiting period
- No claim until you have exhausted the deductible
- Hospitalization without a doctor’s recommendation
Who Should Opt For Top-Up Health Insurance?
There are many reasons why someone might want to purchase top-up health insurance. Some people may want to protect their assets from high out-of-pocket medical costs in case of catastrophic injury or illness. Others may want more comprehensive coverage than what's offered by their primary plan provider so they can access better care and services from providers who aren't covered by their plan. Below are the following categories, must opt for the top-up or super top-up health insurance plans.
- Senior Citizens: The medical expenses for senior citizens are higher. So, this coverage increases the sum assured value and is relatively affordable compared to a regular health insurance plan.
- Corporate employees: If you take a life insurance policy from your employer. However, the sum insured may not be enough. You can increase your sum insured by including add-ons to the primary health insurance plan.
How to Buy Top-up Health Insurance Plan Online
The process of buying a top-up health insurance policy online has become simple with PolicyBachat. For buying a health insurance plan online please visit our website Policybachat.com Following are steps to purchase the health insurance policy online in our portal.
- Visit the Policybachat Website and Select the ‘Health’ tab.
- Select your ‘Gender’.
- Select ‘Whom do you want to insure’ and their ‘Age’.
- Enter your ‘Pin code’.
- Enter your ‘Name’.
- Enter your ‘Email Address’.
- Then click on ‘Start Saving Money’.
- Premium Quotes of top health insurance plans will be displayed as per data entered by you and which suits your requirement.
- You can edit policy details, sum insured value, and policy term and you can choose your preferred company
- Purchase the best health insurance policy using online payment
How to Select the Best Health Insurance Plan?
There is no best health insurance plan which fits all. Each person has different requirements and the health insurance plan has to be chosen as per the requirements. In that case below factors are to be considered before deciding on the best top-up health insurance plan online
- Coverage/Premium
- Network Hospitals
- Individual/ Floater
- Deductibility
- No Claim Bonus
Conclusion
If you are looking for an affordable plan, then you can opt for higher deductibles. Choosing the best top-up health insurance plan online is not an easy task. There are many plans available in the market. It is important to know what you want before you buy a plan.
The best way to choose a top-up health insurance plan online is by understanding your requirements and choosing a plan that meets them. You can also compare different plans, their features and prices to find out which one suits your needs the most.