Super Top-up Health Insurance: Ticket to a Healthier Life

Mr.Verma was busy planning his daughter’s marriage. Everything went well until his wife had to be admitted immediately due to a cardiac arrest, leading to major bypass surgery.  As she was hospitalised in a renowned private hospital in Mumbai, the incurred medical expenses came in five digits. That was the first time when he realised the importance of health insurance, as the entire expense was on him!

Lifestyle diseases are taking a toll on individuals’ life. It can easily upset someone’s lifetime savings. However, with health insurance in place, the maximum affordable cover that one can avail is a maximum of Rs.3 lakh to 5 Lakh. Anything above this will again charge an exorbitant premium. Then what is the solution? How to get extensive coverage with an affordable premium?

Here comes the super top-up plan in the picture!

Decoding Super Top-up Health Insurance Plan

Super top-up plans are an excellent solution in case the policyholder exhausts the maximum sum insured of his/her health insurance policy. Under this policy, the insured can select a specific limit/deductible amount to bear, at the time of claim, before the insurance provider pays out the claim amount. This is termed as ‘aggregate deductible’, which should be based on the maximum coverage of the basic insurance policy.

Under this plan, the sum total of all the admissible medical expenses within the policy tenure is being considered and if it exhausts the chosen deductible, you can claim the insurance. Let’s understand this with an example-

Taking the above example again, Mr.Verma could have covered the treatment expenses with a floater health insurance of Rs.3 Lakh, clubbing with a super top-up plan, possibly with Rs. 10 Lakh and a deductible of Rs. 3 Lakh. Therefore, any expense incurred beyond Rs. 3 Lakh which he had to pay on his own, would now be covered by Super Top Up health insurance. In his case, the policy will work like this:

• Scenario 1: If there is a claim of Rs. 1 Lakh, his regular policy will pay the amount

• Scenario 2 – If there is a single claim of Rs. 4 Lakh in a year, Rs. 3 Lakh can be paid by claiming the regular policy and remaining Rs. 1 Lakh can be paid through Super top-up policy.

• Scenario 3: If there is a claim of Rs. 10 Lakh, his regular policy will pay up to Rs. 3 Lakh and for paying the remaining Rs. 7 Lakh; Mr Verma can claim super top-up policy.

• Scenario 4: In case of two claims one for Rs. 3 Lakh and another for Rs. 2.5 Lakh, the regular policy will pay the claim 1 and the actual sum insured will be exhausted. To pay claim 2, the super top-up plan will be activated and pay the amount, though it is less than the actual threshold amount (Rs. 3 Lakh).

From the above examples, it is understood that Super Top-up plans consider the total medical bills in a particular year. You can cover multiple hospitalisations with a single plan. Hence, the insurer put together several cases to decide the deductible limit under Super-top Plan.

Wrapping it up!

With medical expenses rising at a rapid pace, it is necessary to ensure that the health coverage owned by you is sufficient. Some illnesses may require immediate attention where the treatment cost can be skyrocketing. In such a situation, backing your regular health cover with a super top-up plan is an ideal way to plan your finances.