How Super Top-Ups Work
“Traditionally, top-up plans are for a single, catastrophic, high-cost event, whereas super top-ups are for receiving additional sum insured for multiple events that may not be catastrophic,” Dr. Bhabatosh Mishra, Director, Underwriting, says Product Claims, Niva Bupa Health Insurance.
Both these schemes work on the premise that a deductible limit has to be crossed in order to activate them. So, if you have Rs. 20 lakhs super top-up plan and deductible limit of Rs 5 lakhs, then you have to pay Rs 5 lakhs from your pocket or through Aadhaar cover before super top. -up can be used. In a top-up plan, you need to exceed the deductible limit on one hospitalization, whereas for a super top-up, multiple hospitalization bills in a policy year to calculate the deductible limit can be added. So if you pay two hospital bills of Rs 4 lakh and Rs 7 lakh in one policy year, a top-up plan will not pay the first claim, only the second. In super top-up, both the claims will be covered as the combined bill of Rs 11 lakh in a year exceeds the limit of Rs 5 lakh.
If you buy a super top-up… Rising Medical inflation And hospitalization in the past two years means that more than one episode requiring hospitalization could end you financially. Super top-ups offer a good strategy to increase the health cover as these are low cost plans that are available up to a sum insured of up to Rs 1 crore. “Their premiums are low not only because of higher deductibles, but also because the underwriting may vary and the plans may lack features like OPD cover, wellness benefit, cumulative bonus, etc.,” says Dr. Mishra. These should be purchased with a low base plan, so that the latter can take care of the deductible amount. So you can buy a base plan of Rs 3-5 lakh and a super top-up plan of Rs 25-30 lakh instead of the higher base plan of Rs 30-35 lakh, which will cost more (see table).
However, make sure that you do not buy a very small base plan just to cut costs as most of the benefits and discounts are linked to the basic plan and not the super top-up plan. It is also important to buy both Aadhaar and Super Top-up plans from the same insurer to ensure cashless payment, “Hospitals will consider Aadhaar scheme only for cashless reimbursement. If the super top-up is from a single company, it will be treated as a single claim,” says Bhaskar Nerurkar, head, health administration team, Bajaj Allianz General Insurance.
Choose a base and super top-up plan from a company that has similar features for both, as you may end up with a super top-up that does not cover all the services, leaving you to pay out of pocket. is forced to. Family floater plan can also be a good option especially if a member is suffering from chronic illness, but do not include your parents as it will increase the premium. The cost depends on age, city, size of cover and amount of deductible. The higher the deductible, the lower the premium. If you choose a 2- or 3-year plan instead of a one-year plan, you will not only get the exemption, but the total claims for 2/3 years will be considered for the deductible limit.
Super Top-Up: On the Flip Side
This may be the best option to increase your health cover, but keep the following limitations in mind.
Reconsider whether there is a restore option in the base plan
If you have a large base plan, in which the sum insured is fully restored in one policy year, reconsider the size of the super top-up cover you should buy, or whether you should buy it or not. Restoration benefits can easily provide an optimal cover size and also come at a low cost. However, check that the restorative benefit applies to recurrences of similar ailments. If the base plan is smaller, buy a larger top-up plan.
No cashless with different insurers
If you have an Aadhaar plan from one insurer and a super top-up from another, the hospital will consider only the Aadhaar plan for cashless reimbursement. If this amount runs out, you will have to pay for the balance out of your own pocket and reimburse it later. If both the base and super top-up plans are from the same insurer, then the entire bill can be paid in a cashless manner.
Buy both independently, regardless of employer cover
If you have only one base plan from your employer, do not independently buy a super top-up plan from another or similar insurer. This is because if you change jobs and your base cover lapses, you will have to pay a deductible amount out of your own pocket to be able to use the top-up plan. So even if you have Aadhaar and top-up from your employer, buy another set independently.
Don’t buy the base plan too small
Most of the insurers link the benefits like cumulative bonus, renewal discount etc. to the base plan and not the top-up plan. So make sure you don’t have a very small base cover or the benefits earned will be negligible.
less features
Try to choose a super top-up plan that has the same features as the base plan as the latter may not be as comprehensive: waiting period for pre-existing diseases may be longer, may have room rent limits, Or OPD cover may not be offered. ,