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Why Should you Choose Top up and Super Top up Health Insurance?



Given the high rate of medical inflation in India, a comprehensive health insurance policy is paramount for people from all strata of society. A recent report by the Central Bureau of Health Intelligence reveals that 25% rural and 20% urban households succumb to a substantial debt or liquidate their assets to meet the medical expenses required for their respective family members.

The cost of health insurance- How much is enough?

It points to a critical element- having an Individual Health Insurance cover is not always enough; you have to ensure that you have the adequate sum insured. However, that’s easier said than done. One has to consider the high premium rate for such a high coverage limit, and it’s not always feasible to shell out such amounts regularly.

On the other hand, Bajaj Finserv brings you Group Health Insurance Policy that provides financial cover from Rs. 3 Lakh to Rs. 5 Lakh. Still, it may often not be adequate to meet the medical costs connected with severe ailments. Individuals have two options in such scenarios- arrange money in any way possible (debts, liquidation of assets) or have a high amount insured which equates to a steep monthly premium.

There is a 3rd option as well, one which is not known to many people- top-up and super top-up health insurance plans. Here’s a brief overview of both.

Top-up health insurance

A top up health insurance plan goes above and beyond the traditional cover offered by health insurance policies. It has two primary components- the sum covered by insurance and a corresponding deductible limit. In simple terms, it allows you to draw an additional amount up to a specific limit even after your insurance cover is exhausted.

For instance, let’s say that you have a Top Up Health Insurance from Bajaj Finserv of Rs. 10 Lakh with Rs. 5 Lakh as the deductible limit. It essentially means that your health insurance will cover any amount up to Rs. 5 Lakh as part of the natural insurance policy. In case any additional cost is incurred, and your medical bill exceeds the Rs. 5 Lakh limit, it will be settled by the top-up insurance policy. The catch is that you have to pay the premium only for the amount insured.

Super top-up health insurance

Apart from top up health insurance plans, super top-up health insurance policies are also rapidly gaining traction in the Indian market. The primary difference between these two types of schemes is how they consider claims. A super top-up health insurance scheme matches the aggregate claims incurred throughout the year against the deductible limit.

Let’s elaborate it with an example.

Suppose you have a super top-up health insurance policy coverage of Rs. 10 Lakh with a deductible limit of Rs.  5 Lakh. You incur a medical bill of Rs. 3 Lakh in the month of January of the cover year. Since it is within the deductible limit, there won’t be any benefit of a top-up scheme. You incur another bill of Rs. 3 Lakh in April. Like before, a top-up policy won’t be beneficial in this case either because the amount is lower than your maximum coverage limit.

A super top-up health insurance policy comes in handy in such situations. It calculates the total amount incurred throughout the year, which in this case is Rs. 6 Lakhs and above your coverage limit. The super top-up policy will pay for the extra Rs. 1 Lakh.

Medical costs are not going down anytime soon. The verdict on the best health insurance plan between these two is still on hold. In the meanwhile, you must choose one based on your requirements and financial situation.