Maximize your health insurance benefits with top-up plans

Written on Thursday, September 10, 2015
By Narender Anand, Sr. VP & Product Head - GI, Bajaj Capital Ltd.

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As health expenses inflate by 18 % every year, you may find that your base health insurance is no longer sufficient for your needs. A serious illness or accident can require long term care and complicated treatment can quickly become expensive and exhaust your health cover. If you think that the sum assured of your existing health insurance plan (personal or employer's group mediclaim) does not suffice for expenses due to illness or accidents, you may consider buying a top up or super top up health insurance plan.

What they offer and how it works

Top up health insurance plans are uniquely designed health cover policies that offer you (insured) an additional coverage, which is beyond the “threshold limit” (or) the maximum limit of the existing health insurance policies. Top up plans work on 'per hospitalization' basis. A Top up plan will pay you, if your claim amount for a single hospitalization is above the threshold limit.

For example: Suppose you have an existing health insurance policy of Rs 5 lakhs and you further opt for a top-up amount of Rs 10 lakh with a threshold limit of Rs 3 lakh. Suppose you incur hospitalization expenses of Rs. 8 lakhs. In such a scenario, Rs. 5 lakhs would be paid from your existing policy and the top-up would take care of the balance Rs. 3 lakhs. Expenses would be taken care of up to Rs10 lakh.

These plans are loaded with additional benefits to make it an attractive choice and cost efficient too.

Difference between top up and super top up

The key difference between a super top up plan and a top up plan lies in its working. In case of a top up plan, the compensation for medical expenses is covered for a single illness. The overheads for a single injury or disease needs be above the threshold limit to be eligible for a claim. In a super top-up plan, the expenses covered are for all illnesses put together that occur during an entire year. That means, the total medical expenditure in a year must be above the threshold level for the claim to be eligible. Super top up plans are more beneficial as they would cover entire range of ailments in a particular year. This product is suitable for the elderly and senior citizens who may have frequent medical expenses.

Although these products are comparatively new in market but have already gained popularity among health insurance buyers. They prove to be an ideal option for those who wish to go in for a higher cover at a lower cost. If you already have an insurance policy, or you have opted for a corporate health plan and you feel it is not adequate according to your needs, go ahead and top it up. It is cost efficient as the premium rates would be at least 30 to 40 percent cheaper than taking an individual health plan for a higher coverage. However, do keep in mind the threshold limit, as these policies do not bear fruit till this level gets activated.


#Insurance is a subject matter of solicitation, please read the offer document carefully before buying a plan. 

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