What is Super Top Up health plan?

With the rise in inflation, it is important that we increase our medical cover to ensure adequate protection. But this can be a costly affair for many as the premiums would be high with a new plan. That’s where a Super Top Up plan comes as a saviour by providing additional coverage to your existing health plan at a lower price.

Components of a Super Top Up plan:

  • Deductible: The initial fixed threshold amount of the claim that is borne by the customer and then the remaining amount is paid by the company.
  • Basic Sum Insured: The total cover amount for which the company has agreed to take the risk.

You have opted for a Sum Insured of ₹10,00,000 and aggregate deductible of ₹2,00,000. If you make 3 claims in a policy year and the total claim amount is ₹7,60,000, then after the initial ₹2 lacs (aggregate deductible) is paid by you/your existing health insurance policy, the additional ₹5,60,000 will be paid by Super Top Up plan.

Situation Deductible Amount Sum Insured Amount Claim Amount Deductible Exhausted Balance Deductible Claim Paid by Existing Health Plan/Out of Pocket Claim Paid by Super Top Up Plan
At Inception ₹2,00,000 ₹10,00,000 0 0 ₹2,00,000 0 0
1st Claim ₹1,45,000 ₹1,45,000 ₹55,000 ₹1,45,000 0
2nd Claim ₹4,00,000 ₹55,000 0 ₹55,000 ₹3,45,000
3rd Claim ₹2,15,000 0 0 0 ₹2,15,000

With the increasing medical cost, it’s always wise to add a top up plan to the existing policy for that extra cover, rather than buying a new one. Super Top Up is also useful for PSU policyholders who can’t port their policy due to medicals at a higher age. It will even work great for people with group health policy, where the base cover is low. Super Top Up policy claims might not be cashless if base policy and top up policy are from different companies.

 



A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Super Top Up Plan Vs Top Up Plan

Unlike a regular Top-up plan which will cover medical expenses only when a single claim goes above the deductible, a Super Top-up plan covers claims for cumulative medical expenses within a policy year once you’ve exceeded the deductible.

Super Top Up Plan Top Up Plan
  • It allows multiple claims in a policy year above the deductible limit.
  • It allows single claims above the deductible limit per year.
  • Deductible is applicable on claims till the entire deductible amount is exhausted.
  • Deductible is applicable on every claim for the policy year.
  • For eg.,
    Sum Insured = ₹10 lacs
    Deductible = ₹2 lacs

    Scenario 1:
    1st Claim = ₹5 lacs
    Customer pays = ₹2 lacs
    Company pays = ₹3 lacs

    Scenario 2:
    2nd Claim = ₹5 lacs
    Customer pays = 0
    Company pays = ₹5 lacs
  • For eg.,
    Sum Insured = ₹10 lacs
    Deductible = ₹2 lacs

    Scenario 1:
    1st Claim = ₹5 lacs
    Customer pays = ₹2 lacs
    Company pays = ₹3 lacs

    Scenario 2:
    2nd Claim = ₹5 lacs
    Customer pays = ₹2 lacs
    Company pays = ₹3 lacs

 

Who should buy Super Top Up plan?

  • Whose existing health insurance cover is low: Sometimes budget constraint is the reason for people to choose a lower coverage plan. However, they would eventually realise that the coverage is not enough for future medical expenses, especially in such pandemic times. You can increase your coverage and benefits with a Super Top Up plan which comes cheaper than a regular health plan.
  • All Senior Citizens: With increased age, health insurance premiums tend to increase due to increased risk factors. A Super top Up plan will help to get enhanced coverage at a significantly lower price. Ofcourse, deductibles have to be paid first from out of pocket or from the existing health plan.
  • If you are a Corporate Employee: The coverage provided by your employer is never enough as it is a group policy and is not customised as per your requirements. You can enhance that coverage with a Super Top Up plan and secure your finances during medical emergencies.

Coverage Offered By Super Top Up Plan

All Hospitalization

This covers fees charged by the Doctor, Surgeon, Medical Practitioner, Anesthetist, and Nurses. Diagnostic tests, anesthesia, surgical appliances, blood, oxygen, medicines, and OT charges Cost of artificial body parts and internal implantations like a pacemaker, if required as a part of the surgery.

Pre/Post Hospitalization

It includes all expenses incurred before and after hospitalization.

Day Care Procedures

Day-care treatment expenses during the treatment that do not require a 24-hour of hospital stay shall be covered.

ICU Room Rent

Room Rent, Nursing and ICU Expenses are covered.

Road Ambulance Charges

It is one of the most basic facilities that are required during a medical emergency. The cost of the same is included in a super top-up plan.

Complimentary Annual Health Checkup

Expenses towards annual health check-ups are complimentary up to a certain amount and are reimbursed after completion of the policy tenure.

You cannot file a claim until your policy deductible limit is exhausted
Medical expenses of the newborn baby
Organ donor pre and post hospitalization expenses
Dental surgeries unless requires hospitalization
Any loss of damage due to war, rebellion, acts of foreign enemies, invasion, hostilities, civil war etc.
Plastic surgeries
Cost of contact lenses, spectacles or hearing aids
Congenital diseases and stem cell implantation surgery
Drug or alcohol abuse
Treatment of venereal diseases HIV/AIDS treatment
Vaccination or inoculation unless required for an animal bite or as part of the treatment
Experimental treatments

Save Up to 20%* on Health Insurance Premium

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*Standard Terms & Condition Apply. Premium discount is provided by insurer for a 3-year policy and 4 or above insured family members. CIBPL/Health/WebBanner/English/Dec-21/001

FAQs related to Super Top-Up Plans

What is the difference between a Super Top Up health insurance and a regular health insurance plan?

The main difference between a Super Top Up health insurance and your regular health insurance plan is that, your health insurance plan will cover for your complete, or 70% of your hospitalization expenses (depending on your health insurance policy). However, a Super Top Up health insurance only covers your expenses if it is above a certain limit.

For example: If your Super Top Up health insurance policy only covers for you after ₹5 lakhs...this means if your bill is ₹8 lakhs, it will only cover for the ₹3 lakhs after you’ve spent ₹5 lakhs from your pocket or from your standard health insurance policy.

What is the need of buying a Super Top Up?

When your existing medical cover is not sufficient to cover all your medical expenses, Super Top Up helps enhance the sum insured and provider wider coverage at an affordable premium.

Is Ayush treatment covered under Super Top Up plans?

Yes, most of the Super Top Up plans provide coverage for AYUSH treatment

Why is a Super Top Up health insurance plan cheaper?

This is because the entire costs are not borne by the Super Top Up health insurer. Additionally, costs are only born once one has passed the deductible limit.

What are the factors that will affect my Super Top Up health insurance premium?

The factors that will affect your Super Top Up health insurance premium include, your age, geographical location, and the deductible and sum insured you’ve chosen as part of your Super Top Up health insurance plan.

What is deductible and how does it operate?

Deductible is the amount you pay towards your health care expenses before your insurance plan starts to pay. The amount of deductible depends on the plan and can be exhausted in a single claim or in multiple claims in a policy year.

Will Pre-existing diseases be covered in Super Top Up?

Pre-existing diseases will be covered in Super Top Up only after the imposed waiting period by the particular insurer