How Top-Up Insurance Works: A Simple Guide

With the increase in lifestyle diseases and medical costs, basic health plans often fail to provide the required coverage. This is where top-up health insurance comes as a savior.

It offers extra coverage in addition to your current policy, thus helping you lessen the extra costs you might face in case your medical expenses go beyond the limits of that plan. Now, regardless of whether you pick a health insurance top-up plan or a super top-up health insurance plan, knowing how these products work is crucial to making an informed decision.

What is a Top-Up Health Insurance Plan?

Health Insurance

A top-up health insurance policy offers you extra coverage that activates once you cross a specific limit known as the deductible. This kind of plan helps improve your existing health insurance by providing additional financial support.

For example, suppose your health insurance policy has a ₹5 Lakhs limit, and you spend ₹7 Lakhs on medical treatment. The extra ₹2 Lakhs will be covered by the top-up policy after you have paid the deductible from your primary policy.

It is a relatively inexpensive way to enhance your health insurance coverage without too much of an increase in your premium.

How Does Top-up Insurance Work?

Top-up insurance is only active when your standard health policy has been completely utilized. The plan comprises a deductible amount decided by the policyholder at the time of availing the policy.

You can either pay this deductible out-of-pocket or use another health policy to pay it. It should also be noted that a member can only make a claim on the top-up insurance after an amount has been incurred that exceeds the chosen deductible on one hospital bill. In addition, only one claim can be made on top-up insurance in a policy year.

Types of Top-Up Health Insurance Plans

These are the regular types of top-up health insurance plans that can be found in India:

  • Deductible-based Top-Up Plans: These plans become activated when medical expenses surpass the coverage limit of the primary health insurance policy. In case the healthcare costs exceed these expenses, the top-up plan comes into play.
  • Aggregate-based Top-Up Plans: These plans take into consideration the total medical expenses incurred in a policy year and provide coverage after the aggregate medical expenses have surpassed the chosen aggregate limit.
  • Super Top-Up Plans: These cover several claims during a policy year. The deductible applies to the cumulative total rather than individual claims.
  • Disease-specific Top-Up Plans: These top-up plans offer additional coverage for specific diseases or medical conditions such as cancer or heart ailments.

Advantages of Top-Up Health Insurance

Mentioned below are the common advantages that encourage people to avail top-up health insurance plans:

●    Increased Coverage at Lower Premiums

Health insurance top-up plans allow you to increase your coverage without affecting your current health policy. In addition, it provides the added benefit of lower premium payments than are normally required for increased coverage in the main plan.

●    Extend Coverage for Major Medical Expenses

Top-up plans can cover costs beyond your deductible, providing extensive protection against high medical costs.

●    Lower Costs

Compared to the expense of increasing coverage in your main health insurance policy, top-up plans have much lower premium requirements.

●    Customizable Options

Depending on your financial capability, you will be able to select from a variety of deductible options, which will allow you to manage your health insurance costs efficiently.

●    Tax Benefits

The premiums of a top-up health insurance plan are eligible for a maximum deduction of ₹25,000 (₹50,000 for senior citizens) per financial year under Section 80D. Also, you can avail yourself of an extra ₹5,000 deduction for preventive medical checkups.

What is Covered in a Top-up Health Insurance Plan?

Most top-up insurance plans cover these medical expenses:

  • Charges for in-patient hospitalization, including nursing and room charges, doctors' fees, costs of operating theatres, cost of oxygen, prosthetic appliances, surgical implants, blood, diagnostic tests, and similar expenses.
  • Expenses for donors of organs
  • Pre-hospitalization
  • Post-hospitalization
  • Day-care procedures that do not require hospitalization for more than 24 hours.
  • Home treatment charges
  • Emergency ambulance charges

Top-up health insurance plans provide additional bandwidth to the existing health insurance coverage. Thus, even if your medical expenses are extremely high, a top-up plan can ensure that you get the required coverage without affecting your finances.

However, when choosing the best super top-up health insurance, opting for a reliable insurer like Star Health is necessary. Their Super Surplus Insurance Policy is available on an individual or floater basis, making it an excellent choice for those seeking family health insurance. This policy covers a wide range of medical expenses and comes with lifelong renewal facilities, ensuring comprehensive protection for you and your loved ones.

Call us now and make handling medical costs a breeze!

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