Everything changes with time and so do your health insurance needs and priorities. You might have bought the best health policy with a substantial sum assured, but after a couple of years, you may find it insufficient. This could be due to changes in your health condition or simply due to the rising cost of medical care. It is not possible though to keep changing your policies or buying new ones with higher coverage due to the higher costs and complications involved. To help you face this tricky situation, a lot of insurance companies have come up with the top up and super top up plans in addition to your existing health insurance plan that proves economically beneficial for you.
Both top ups and super top-ups come into action after the “threshold” limit of insurance is crossed. The threshold is the maximum limit on your existing policy and only after utilizing that amount completely you can use top ups or super top-ups.
How does top-up work?
Let’s take an illustrative model to understand it:
Mr. A has an existing health plan with a sum assured of Rs. 5 lakhs and he get a top up cover of Rs. 10 lakhs. In the event of single hospitalization in a year, Mr. A incurs a bill of Rs. 6 lakhs. Now Rs. 5 lakhs will be paid as part of the threshold limit and the remaining Rs. 1 lakh will be paid from the top up cover out of the total cover of Rs. 10 lakhs.
Imagine another scenario where Mr. A gets hospitalized again in the same year and incurs a bill of Rs. 4 lakhs. Since he has already utilized his entire threshold limit of his health insurance plan in the previous claim, he will have to incur this cost from his own pocket as top ups work only once in a year and that too over and above the threshold limit!
How does super top-up work?
Carrying forward the above example of Mr. A, with a super top up plan he will be able to pay off the second bill of Rs. 4 lakhs despite his threshold limit being utilized in the first claim. Also, if there is a third claim of Rs. 5 lakhs in the same year, the super top cover can be used to pay it too up to the limit of the health plan. In this case, the limit is fixed at Rs. 10 lakhs. Therefore, a super top cover will cover the entire claim in a given year up to the pre-fixed limit thereby providing adequate financial coverage to the insured.
Given the individual benefits of both the covers, top up plans attract lower premiums compared to super top-ups. Health insurance policies can be bought with either of the plans depending upon what kind of cover you need and what is your budget.
You have to analyse your medical needs carefully to understand which plan will work for the best. If you’re a healthy young person, then having a super top up might prove to be costly in the long run. In such a case a simple top up cover shall suffice. However, if you have a history of illnesses and require regular medical attention, super top up can go a long way in aiding your financial needs, keeping your overall costs down without compromising on your health cover.
Health insurance policies strive to provide you the right health cover. It all depends on you how you want to avail them! Make an informed decision!