Health is one of the most important aspects of our lives, influencing everything from our daily activities to our long-term well-being. However, despite our best efforts, unexpected illnesses and accidents can still occur, often without warning. A single hospital visit can lead to exorbitant medical bills, sometimes so high that even a comprehensive health insurance policy can’t cover all the costs. This is where top up and super top up plans come to the rescue. These plans act as an extension to your existing health insurance, providing additional coverage once the initial sum insured is exhausted. Understanding super top up vs top up plans can help you decide which is the best fit for your healthcare needs.
What Is Top Up Health Insurance?
A top up health insurance plan is designed to boost the sum insured of your existing health insurance policy. It kicks in once you’ve utilised the maximum claim amount on your base policy, providing an extra layer of financial protection.
In today’s world, with healthcare costs constantly rising due to advancements in medical technology and infrastructure, having comprehensive health coverage is more important than ever. A top up plan ensures that when your medical expenses go beyond the limits of your primary health insurance, you have a safety net to fall back on, covering those additional costs and giving you peace of mind.
How Does Top Up Health Insurance Work?
Let’s consider a practical example to better understand how a top up health insurance plan works.
- Base Plan Sum Insured: Rs. 5 Lakhs
- top up Plan Sum Insured: Rs. 10 Lakhs (with a deductible of Rs. 5 Lakhs)
Now, let’s look at the hospitalizations over a year:
Hospitalization Scenarios
- Hospitalization 1: Claim amount = Rs. 3 Lakhs
- Base Plan Coverage: Rs. 3 Lakhs
- top up Plan Coverage: Rs. 0
- You Pay: Rs. 0
- Covered By: Base Plan
- Hospitalization 2: Claim amount = Rs. 4 Lakhs
- Base Plan Coverage: Rs. 2 Lakhs (remaining coverage)
- top up Plan Coverage: Rs. 0 (claim amount not exceeding the deductible)
- You Pay: Rs. 2 Lakhs
- Covered By: Base Plan and Out-of-Pocket
- Hospitalization 3: Claim amount = Rs. 6 Lakhs
- Base Plan Coverage: Rs. 0 (exhausted)
- top up Plan Coverage: Rs. 1 Lakh (after meeting the deductible)
- You Pay: Rs. 5 Lakhs
- Covered By: top up Plan and Out-of-Pocket
Summary Table
| Claim Amount | Insurance Pays | You Pay | Coverage Plan |
| Hospitalisation 1 | Rs 3 Lakhs | 0 | Base plan |
| Hospitalisation 2 | Rs 4 Lakhs | Rs 2 Lakhs | Base plan and out-of-pocket |
| Hospitalisation 3 | Rs 6 Lakhs | Rs 1 Lakh | Top up plan and out-of-pocket |
- Total Claims Made in the Year: Rs. 13 Lakhs
- Total Paid by You: Rs. 7 Lakhs
This example illustrates how a top up plan primarily helps in cases of large hospitalizations, providing additional coverage after your base plan is exhausted and the deductible is met. However, there might still be significant out-of-pocket expenses, especially for claims that do not exceed the deductible.
What Is Super Top Up Health Insurance?
Super top up plans are similar to top up plans in that they enhance your health insurance sum insured. However, the key difference is that super top up plans consider the total medical expenses incurred during the policy year, rather than evaluating each claim individually.
With a regular top up plan, coverage kicks in only when a single claim surpasses the threshold limit. In contrast, a super top up plan provides coverage once your overall medical expenses during the policy period exceed the threshold limit.
How Does Super Top Up Health Insurance Work?
A Super Top Up plan’s deductible is calculated based on the sum total of all hospitalization expenses incurred during the entire policy year. Once the total costs across all admissions exceed the deductible, your super top up plan starts paying.
Let’s revisit the example with a super top up plan:
- Base Plan Sum Insured: Rs. 5 Lakhs
- Super top up Plan Sum Insured: Rs. 12 Lakhs (with a deductible of Rs. 5 Lakhs)
Here are the hospitalisations over the period of a year:
Hospitalisation Scenarios
- Hospitalisation 1: Claim amount = Rs. 4 Lakhs
- Base Plan Coverage: Rs. 4 Lakhs
- Super Top Up Plan Coverage: Rs. 0
- You Pay: Rs. 0
- Covered By: Base Plan
- Hospitalisation 2: Claim amount = Rs. 5 Lakhs
- Base Plan Coverage: Rs. 1 Lakhs (remaining coverage)
- Super Top Up Plan Coverage: Rs. 4 Lakhs (after the deductible is met)
- You Pay: Rs. 0
- Covered By: Base Plan and Super top up
- Hospitalisation 3: Claim amount = Rs. 8 Lakhs
- Base Plan Coverage: Rs. 0 (exhausted)
- Super Top Up Plan Coverage: Rs. 8 Lakhs (deductible already met)
- You Pay: Rs. 0
- Covered By: Super top up Plan
Summary Table
| Hospitalisation | Insurance Pays | You Pay | Coverage Plan |
| 1 | Rs 4 Lakhs | 0 | Base plan |
| 2 | Rs 5 Lakhs | 0 | Base plan(Rs 1 Lakh) + super top up(Rs 4 Lakhs) |
| 3 | Rs 8 Lakhs | 0 | Super top up plan |
- Total Claims Made in the Year: Rs. 17 Lakhs
- Total Paid by You: Rs. 0
This example illustrates how a super top up plan provides extensive coverage by considering the cumulative medical expenses throughout the policy year.
Super Top Up Vs Top Up Plans
Below is a comparison table highlighting the key differences between super top up vs top up health insurance plans –
| Feature | Top Up Plan | Super Top Up Plan |
| Purpose | Provides additional coverage when a single claim exceeds the deductible. | Provides additional coverage when the total expenses in a year exceed the deductible. |
| Claim Basis | Applies to individual claims exceeding the deductible. | Considers cumulative medical expenses over the policy year. |
| Deductible | Applied per individual claim. | Applied once across all claims made in a policy year. |
| Best Suited For | Large single hospitalizations that exceed base coverage. | Multiple hospitalizations over the year that collectively exceed the deductible. |
| Out-of-Pocket Risk | Higher for multiple smaller claims as each must surpass the deductible individually. | Lower overall since coverage is based on cumulative expenses across all claims. |
Wrapping Up!
Both top up and super top up health insurance plans are vital tools for enhancing your financial protection against medical expenses. The key difference in super top up vs top up lies in how they handle claims. While a top up plan kicks in when a single claim exceeds the deductible, a super top up plan offers more comprehensive coverage by considering the total medical expenses over the policy year. By understanding super top up vs top up plans, you can make an informed decision to ensure you are adequately covered during unforeseen medical emergencies, ultimately safeguarding your savings and providing peace of mind.
